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Q fever in Plymouth, 1972–88: A review with particular reference to neurological manifestations

Published online by Cambridge University Press:  15 May 2009

S. Reilly ,
J. L. Northwood  and
E. O. Caul
S. Reilly
Affiliation:
Department of Microbiology and Public Health Laboratory, Derriford Hospital, Plymouth PL6 SDH
J. L. Northwood
Affiliation:
Department of Microbiology and Public Health Laboratory, Derriford Hospital, Plymouth PL6 SDH
E. O. Caul
Affiliation:
Regional Department of Virology and Public Health Laboratory, Myrtle Road, Kingsdown, Bristol, BS2 8EL
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Summary

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Between 1972 and 1988 we have serologically confirmed 103 Coxiella burnetii infections: 46 were acute, 5 were chronic, 52 represented past infections. Details of 61 cases are presented.

Of acute cases 80 % had respiratory involvement; at least 63 % had pneumonias. The incidence (22%) of neurological complications was of particular interest; 40% of these patients had prolonged sequelae. One acutely ill patient died of fulminating hepatitis. Patients with pre-existing pathology or immunosuppression were especially susceptible to C. burnetii.

In the absence of acute sera, the complement fixation test alone provided inadequate differentiation between recent and past Q fever: phase II titres persisted at ⋝ 80 for more than 1 year after the acute infection in 15 cases; maximum duration of persistence was 14 years. Three patients acquired high phase I titres.

Only 5% of cases had chronic Q fever, but in view of the diverse sequelae observed in this series, we suggest that long-term serological and clinical follow-up of all cases of Q fever is fully justified.

Type
Research Article
Information
Epidemiology & Infection , Volume 105 , Issue 2 , October 1990 , pp. 391 - 408
Copyright
Copyright © Cambridge University Press 1990

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