Targeted screening as a tool for the early detection of chronic Q fever patients after a large outbreak

M. C. A. Wegdam-Blans*, R. A. Stokmans, J. H. T. Tjhie, J. M. Korbeeck, M. P. Koopmans, S. M. A. A. Evers, P. H. van der Voort, J. A. W. Teijink

*Corresponding author for this work

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In the aftermath of the Dutch Q fever outbreak, an increasing number of patients are being diagnosed with chronic Q fever. Most of these patients are unaware of being infected with Coxiella burnetii, the causative agent of Q fever. To find patients in an earlier, asymptomatic stage, a targeted screening strategy (TSS) for patients with risk factors for chronic Q fever was started in the southeast region of Noord-Brabant. In total, 763 patients were tested using an IgG phase II indirect fluorescent antibody test (IFAT), of which 52 (7 %) patients tested positive. Ten of these 52 patients displayed a chronic Q fever serological profile. All of these 10 patients had a heart valve(s) or (endo-)vascular prosthesis. All except one were asymptomatic. Suggestive signs for chronic infections on positron emission tomography-computed tomography (PET-CT) were demonstrated in 5 (50 %) of these patients. Forty-two out of the 52 patients with a positive screening test showed a past Q fever serological profile. After a year of follow-up (every 3 months), none of these patients showed elevation of antibody titres and no new chronic Q fever patients were found in this group. A targeted screening programme is a useful instrument for detecting patients at risk of developing chronic Q fever.
Original languageEnglish
Pages (from-to)353-359
JournalEuropean Journal of Clinical Microbiology & Infectious Diseases
Issue number3
Publication statusPublished - Mar 2013

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