Q Fever: Queries Remaining after Decades of Research

D. Raoult; J.-L. Mege; T. Marrie

doi:10.1128/9781555816988.ch3

3 : Q Fever: Queries Remaining after Decades of Research

Authors: D. Raoult¹, J.-L. Mege¹, T. Marrie²

VIEW AFFILIATIONS HIDE AFFILIATIONS

Affiliations: 1: Unité des Rickettsies, Faculté de Médecine, Université de la Méditerranée, CNRS UPRES A 6020, 27, Boulevard Jean Moulin, 13385 Marseille Cedex 05, France; 2: Department of Medicine, Walter C. Mackenzie Health Sciences Center, 8440 112th St., Edmonton, Alberta, Canada

Content Type: Monograph

Publication Year: 2001

Category: Clinical Microbiology

Book DOI: 10.1128/9781555816988

Chapter DOI: 10.1128/9781555816988.ch3

MyBook is a cheap paperback edition of the original book and will be sold at uniform, low price.

Preview this chapter:

Q Fever: Queries Remaining after Decades of Research, Page 1 of 2

< Previous page | Next page > /docserver/preview/fulltext/10.1128/9781555816988/9781555812164_Chap03-1.gif /docserver/preview/fulltext/10.1128/9781555816988/9781555812164_Chap03-2.gif

Abstract:

Query (Q) fever is a zoonosis caused by Coxiella burnetii. The current understanding of the natural history of Q fever is that a nonimmune patient enters into contact with C. burnetii. The immune control of Q fever is T cell dependent, but it does not lead to C. burnetii eradication, and immunosuppression can induce relapse of infection in apparently cured patients or laboratory animals. Incubation of monocytes from patients with Q fever endocarditis demonstrated an increase in the secretion of interleukin 10 (IL-10), which was also increased in patients who had relapsed after treatment of Q fever endocarditis. A higher rate of complaints of various pains (headaches, myalgias, and arthralgias) in Q fever hepatitis patients were observed, including thrombocytopenia as well as elevated sedimentation rate. Q fever hepatitis patients frequently exhibit autoantibodies, including anti-smooth muscle antibodies, antinuclear antibodies, and antiphospholipid antibodies. The combination of hydroxychloroquine and doxycycline is currently the most effective therapy. The diagnosis of Q fever is easy when it is considered as part of the differential diagnosis, and the main diagnostic test for Q fever is microimmunofluorescence serology.

Citation: Raoult D, Mege J, Marrie T. 2001. Q Fever: Queries Remaining after Decades of Research, p 29-56. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 5. ASM Press, Washington, DC. doi: 10.1128/9781555816988.ch3

Highlighted Text: Show | Hide

Full text loading...

Figures

Q Fever: Queries Remaining after Decades of Research

[com.pub2web.rdf.cci.facet.ContentItem[id=http://asm.metastore.ingenta.com/content/author/10.1128/9781555816988.chap3-1,webId=/content/author/10.1128/9781555816988.chap3-1,properties={foaf_givenname=D., foaf_name=D. Raoult, foaf_surname=Raoult, pub_isAffiliatedWith=[com.pub2web.rdf.cci.facet.ContentItem[id=http://asm.metastore.ingenta.com/content/affiliation/10.1128/9781555816988.chap3-aff1]]}], com.pub2web.rdf.cci.facet.ContentItem[id=http://asm.metastore.ingenta.com/content/author/10.1128/9781555816988.chap3-2,webId=/content/author/10.1128/9781555816988.chap3-2,properties={foaf_givenname=J.-L., foaf_name=J.-L. Mege, foaf_surname=Mege, pub_isAffiliatedWith=[com.pub2web.rdf.cci.facet.ContentItem[id=http://asm.metastore.ingenta.com/content/affiliation/10.1128/9781555816988.chap3-aff1]]}], com.pub2web.rdf.cci.facet.ContentItem[id=http://asm.metastore.ingenta.com/content/author/10.1128/9781555816988.chap3-3,webId=/content/author/10.1128/9781555816988.chap3-3,properties={foaf_givenname=T., foaf_name=T. Marrie, foaf_surname=Marrie, pub_isAffiliatedWith=[com.pub2web.rdf.cci.facet.ContentItem[id=http://asm.metastore.ingenta.com/content/affiliation/10.1128/9781555816988.chap3-aff2]]}]]

/content/10.1128/9781555816988.chap3.fig3-1

Figure 1

Number of cases of Q fever in France as diagnosed at the National Reference Center (1985 to 1999). (A) Number of submitted sera (bars) and number of positive sera (IgG titer of ≥1/200 by immunofluorescence) (diamonds). (B) Number of recorded observations of acute (squares) and chronic (triangles) Q fever.

10.1128/9781555816988/fig3-1a_thmb.gif

10.1128/9781555816988/fig3-1a.gif

Figure 1

References

/content/book/10.1128/9781555816988.chap3

1. Aboudharam, G.,, B. La Scola,, D. Raoult,, and M. Drancourt. 2000. Detection of Coxiella burnetii DNA in dental pulp during experimental bacteremia. Microb. Pathog. 28: 249– 254.

2. Ackland, J. R.,, D. A. Worswick,, and B. P. Marmion. 1994. Vaccine prophylaxis of Q fever—a follow-up study of the efficacy of Q-Vax (CSL) 1985-1990. Med. J. Aust. 160: 704– 708.

3. Anstey, N. M.,, H. Tissot-Dupont,, C. G. Hahn,, E. D. Mwaikambo,, M. I. McDonald,, D. Raoult,, and D. J. Sexton. 1997. Seroepidemiology of Rickettsia typhi, spotted fever group rickettsiae, and Coxiella burnetii infection in pregnant women from urban Tanzania. Am. J. Trop. Med. 57: 187– 189.

4. Ariel, B. M.,, T. N. Khavkin,, and N. I. Amosenkova. 1973. Interaction between Coxiella burnetii and the cells in experimental Q-rickettsiosis. Histologic and electron microscope studies. Pathol. Microbiol. (Basel) 39: 412– 423.

5. Armengaud, A.,, N. Kessalis,, J. Desenclos,, E. Maillot,, P. Brousse,, P. Brouqui,, H. Tissot Dupont,, D. Raoult,, P. Provensal,, and Y. Obadia. 1997. Une épidémie urbaine de fiévre Q, Briançon, France, mars-juin 1996. Eurosurveillance 2: 1– 3.

6. Ayres, J. G.,, N. Flint,, E. G. Smith,, W. S. Tunnicliffe,, T. J. Fletcher,, K. Hammond,, D. Ward,, and B. P. Marmion. 1998. Post-infection fatigue syndrome following Q fever. Q. J. Med. 91: 105– 123.

7. Baca, O. G.,, and D. Paretsky. 1983. Q fever and Coxiella burnetii: a model for host-parasite interactions. Microbiol. Rev. 47: 127– 149.

8. Boyle, B.,, and R. Hone. 1999. Q fever endocarditis revisited. Ir. J. Med. Sci. 168: 53– 54.

9. Brouqui, P.,, and D. Raoult. 2001. Endocarditis due to rare and fastidious bacteria. Clin. Microbiol. Rev. 14: 177– 207.

10. Brouqui, P.,, J. S. Dumler,, and D. Raoult. 1994. Immunohistologic demonstration of Coxiella burnetii in the valves of patients with Q fever endocarditis. Am. J. Med. 97: 451– 458.

11. Buhariwalla, F.,, B. Cann,, and T. J. Marrie. 1996. A dog-related outbreak of Q fever. Clin. Infect. Dis. 23: 753– 755.

12. Burnet, F. M.,, and M. Freeman. 1937. Experimental studies on the virus of "Q" fever. Med. J. Aust. 2: 299– 305.

13. Capo, C.,, N. Amirayan,, E. Ghigo,, D. Raoult,, and J. L. Mege. 1999. Circulating cytokine balance and activation markers of leucocytes in Q fever. Clin. Exp. Immunol. 115: 120– 123.

14. Capo, C.,, F. P. Lindberg,, S. Meconi,, Y. Zaffran,, G. Tardei,, E. J. Brown,, D. Raoult,, and J. L. Mege. 1999. Subversion of monocyte functions by Coxiella burnetii: impairment of the cross-talk between α vβ 3 integrin and CR3. J. Immunol. 163: 6078– 6085.

15. Capo, C.,, Y. Zaffran,, F. Zugun,, P. Houpikian,, D. Raoult,, and J.L. Mege. 1996. Production of interleukin-10 and transforming growth factor beta by peripheral blood mononuclear cells in Q fever endocarditis. Infect. Immun. 64: 4143– 4147.

16. Clark, W. H.,, E. H. Lennette,, O. C. Railback,, and M. S. Romer. 1951. Q fever in California— clinical features in one hundred eighty cases. Arch. Intern. Med. 88: 155– 161.

17. Cottalorda, J.,, J. L. Jouve,, G. Bollini,, P. Touzet,, A. Poujol,, F. Kelberine,, and D. Raoult. 1995. Osteoarticular infection due to Coxiella burnetii in children. J. Pediatr. Orthoped. B 4: 219– 221.

18. Crespo, M.,, B. Sopena,, J. Bordon,, J. de la Fuente,, M. Rubianes,, and C. Martinez-Vazquez. 1999. Steroids treatment of granulomatous hepatitis complicating Coxiella burnetii acute infection. Infection 27: 132– 133.

19. Dellacasagrande, J.,, E. Ghigo,, C. Capo,, D. Raoult,, and J.-L. Mege. 2000. Coxiella burnetii survives in monocytes from patients with Q fever endocarditis: involvement of tumor necrosis factor. Infect. Immun. 68: 160– 164.

20. Dellacasagrande, J.,, E. Ghigo,, S. Machergui-El Hammami,, R. Toman,, D. Raoult,, C. Capo,, and J.-L. Mege. 2000. α vβ 3 integrin and bacterial lipopolysaccharide are involved in Coxiella burnetii-stimulated production of tumor necrosis factor by human monocytes. Infect. Immun. 68: 5673– 5678.

21. Dellacasagrande, J.,, P. A. Moulin,, C. Guilianelli,, C. Capo,, D. Raoult,, G. E. Grau,, and J.-L. Mege. 2000. Reduced transendothelial migration of monocytes infected by Coxiella burnetii. Infect. Immun. 68: 3784– 3786.

22. Derrick, E. H. 1937. "Q" fever, a new fever entity: clinical features, diagnosis and laboratory investigation. Med. J. Aust. 2: 281– 299.

23. Derrick, E. H. 1973. The course of infection with Coxiella burnetii. Med. J. Aust. 21: 1051– 1057.

24. Dupuis, G.,, J. Petite,, O. Peter,, and M. Vouilloz. 1987. An important outbreak of human Q fever in a Swiss Alpine valley. Int. J. Epidemiol. 16: 282– 287.

25. Duroux-Vouilloz, C.,, G. Praz,, P. Francioli,, and O. Peter. 1998. Fiévre Q avec endocardite: présentation clinique et suivi sérologique de 21 patients. Schweiz. Med. Wochenschr. 128: 521– 527.

26. Ellis, M. E.,, C. C. Smith,, and M. A. Moffat. 1983. Chronic or fatal Q-fever infection: a review of 16 patients seen in north-east Scotland (1967-80). Q. J. Med. 52: 54– 66.

27. Fenollar, F.,, P. E. Fournier,, P. Carrieri,, G. Habib,, T. Messana,, and D. Raoult. Risk factors and prevention of Q fever endocarditis. Clin. Infect. Dis., in press.

28. Fergusson, R. J.,, T. R. Shaw,, A. H. Kitchin,, M. B. Matthews,, J. M. Inglis,, and J. F. Peutherer. 1985. Subclinical chronic Q fever. Q. J. Med. 57: 669– 676.

29. Ferrante, M. A.,, and M. J. Dolan. 1993. Q fever meningoencephalitis in a soldier returning from the Persian Gulf War. Clin. Infect. Dis. 16: 489– 496.

30. Field, P. R.,, J. L. Mitchell,, A. Santiago,, D. J. Dickeson,, S. W. Chan,, D. W. T. Ho,, A. M. Murphy,, A. J. Cuzzubbo,, and P. L. Devine. 2000. Comparison of a commercial enzyme-linked immunosorbent assay with immunofluorescence and complement fixation tests for detection of Coxiella burnetii (Q fever) immunoglobulin M. J. Clin. Microbiol. 38: 1645– 1647.

31. Fiset, P.,, and T. E. Woodward,. 1982. Q fever, p. 435– 448. In A. S. Evans, and H. A. Feldman (ed.), Bacterial Infections of Humans. Plenum Medical Book Company, New York, N.Y.

32. Fishbein, D. B.,, and D. Raoult. 1992. A cluster of Coxiella burnetii infections associated with exposure to vaccinated goats and their unpasteurized dairy products. Am. J. Trop. Med. Hyg. 47: 35– 40.

33. Fournier, P. E.,, J. P. Casalta,, G. Habib,, T. Messana,, and D. Raoult. 1996. Modification of the diagnostic criteria proposed by the Duke Endocarditis Service to permit improved diagnosis of Q fever endocarditis. Am. J. Med. 100: 629– 633.

34. Fournier, P. E.,, J. P. Casalta,, P. Piquet,, P. Tournigand,, A. Branchereau,, and D. Raoult. 1998. Coxiella burnetii infection of aneurysms or vascular grafts: report of seven cases and review. Clin. Infect. Dis. 26: 116– 121.

35. Fournier, P. E.,, J. Etienne,, J. R. Harle,, G. Habib,, and D. Raoult. 2001. Myocarditis, a rare but severe manifestation of Q fever: report of 8 cases and review of the literature. Clin. Infect. Dis. 32: 1440– 1447.

36. Fournier, P. E.,, T. J. Marrie,, and D. Raoult. 1998. Diagnosis of Q fever. J. Clin. Microbiol. 36: 1823– 1834.

37. Garcia-Alfranca, F.,, C. Clemente-Rodriguez,, C. Pigrau-Serrallach,, V. Fonollosa-Pla,, and M. Vilardell-Tarres. 1994. Q fever associated with persistent fever: an immunologic disorder? Clin. Infect. Dis. 18: 122– 123.

38. Garner, M. G.,, H. M. Longbottom,, R. M. Cannon,, and A. J. Plant. 1997. A review of Q fever in Australia 1991-1994. Aust. N. Z. J. Public Health 21: 722– 730.

39. Ghigo, E.,, C. Capo,, N. Amirayan,, D. Raoult,, and J. L. Mege. 2000. The 75-kD tumour necrosis factor (TNF) receptor is specifically up-regulated in monocytes during Q fever endocarditis. Clin. Exp. Immunol. 121: 295– 301.

40. Ghigo, E.,, C. Capo,, D. Raoult,, and J.-L. Mege. 2001. Interleukin-10 stimulates Coxiella burnetii replication in human monocytes through tumor necrosis factor down-modulation: role in microbicidal defect of Q fever. Infect. Immun. 69: 2345– 2352.

41. Guo, H. R.,, R. Gilmore,, D. M. Waag,, L. Shireley,, and E. Freund. 1998. Prevalence of Coxiella burnetii infections among North Dakota sheep producers. J. Occup. Environ. Med. 40: 999– 1006.

42. Hall, C. J.,, S. J. Richmond,, E. O. Caul,, N. H. Pearce,, and I. A. Silver. 1982. Laboratory outbreak of Q fever acquired from sheep. Lancet i: 1004– 1006.

43. Harris, R. J.,, P. A. Storm,, A. Lloyd,, M. Arens,, and B. P. Marmion. 2000. Long-term persistence of Coxiella burnetii in the host after primary Q fever. Epidemiol. Infect. 124: 543– 549.

44. Heinzen, R. A.,, M. E. Frazier,, and L. P. Mallavia. 1992. Coxiella burnetii superoxide dismutase gene: cloning, sequencing, and expression in Escherichia coli. Infect. Immun. 60: 3814– 3823.

45. Howe, D.,, and L. P. Mallavia. 1999. Coxiella burnetii infection increases transferrin receptors on J774A.1 cells. Infect. Immun. 67: 3236– 3241.

46. Howe, D.,, and L. P. Mallavia. 2000. Coxiella burnetii exhibits morphological change and delays phagolysosomal fusion after internalization by J774A.1 cells. Infect. Immun. 68: 3815– 3821.

47. Htwe, K. K.,, T. Yoshida,, S. Hayashi,, T. Miyake,, K. I. Amano,, C. Morita,, T. Yamaguchi,, H. Fukushi,, and H. Katsuya. 1993. Prevalence of antibodies to Coxiella burnetii in Japan. J. Clin. Microbiol. 31: 722– 723.

48. Kayser, K.,, M. Wiebel,, V. Schulz,, and H. J. Gabius. 1995. Necrotizing bronchitis, angiitis, and amyloidosis associated with chronic Q fever. Respiration 62: 114– 116.

49. Kazar, J., 1996. Q fever, p. 353– 362. In J. Kazar, and R. Toman (ed.), Rickettsiae and Rickettsial Diseases. Slovak Academy of Sciences, Bratislava, Slovakia.

50. Kelly, P. J.,, L. A. Matthewman,, P. R. Mason,, and D. Raoult. 1993. Q fever in Zimbabawe. S. Afr. Med. J. 83: 21– 25.

51. Khan, M. A.,, C. Herzog,, J. St. Peter,, G. Hartley,, R. Madlon-Kay,, C. Dick,, R. Asinger,, and J. Vessey. 1998. The prevalence of cardiac valvular insufficiency assessed by transthoracic echocardiography in obese patients treated with appetite-suppressant drugs. N. Engl. J. Med. 339: 713– 718.

52. Ko, W. C.,, J. W. Liu,, and Y. C. Chuang. 1997. Acute Q fever as a cause of acute febrile illness of unknown origin in Taiwan: report of seven cases. J. Formosa Med. Assoc. 96: 295– 297.

53. Kosatsky, T. 1984. Household outbreak of Q-fever pneumonia related to a parturient cat. Lancet ii: 1447– 1449.

54. Kovacova, E.,, J. Kazar,, and A. Simkova. 1998. Clinical and serological analysis of a Q fever outbreak in Western Slovakia with four-year follow-up. Eur. J. Clin. Microbiol. Infect. Dis. 17: 867– 869.

55. Langley, J. M.,, T. J. Marrie,, A. Covert,, D. M. Waag,, and C. Williams. 1988. Poker players’ pneumonia. An urban outbreak of Q fever following exposure to a parturient cat. N. Engl. J. Med. 319: 354– 355.

56. La Scola, B.,, H. Lepidi,, and D. Raoult. 1997. Pathologic changes during acute Q fever: influence of the route of infection and inoculum size in infected guinea pigs. Infect. Immun. 65: 2443– 2447.

57. Lautenschläger, S.,, H. Willems,, C. Jäger,, and G. Baljer. 2000. Sequencing and characterization of the cryptic plasmid QqRS from Coxiella burnetii. Plasmid 44: 85– 88.

58. Lederberg, J., 2000. Biological warfare and bioterrorism, p. 3235– 3238. In G. L. Mandell,, J. E. Bennet,, and R. Dolin (ed.), Principles and Practice of Infectious Diseases. Churchill Livingstone, Philadelphia, Pa.

59. Levy, P. Y.,, and D. Raoult. 1999. Coxiella burnetii pericarditis: a report of 15 cases and review. Clin. Infect. Dis. 29: 393– 397.

60. Levy, P. Y.,, D. Raoult,, and J. J. Razongles. 1989. Q-fever and autoimmunity. Eur. J. Epidemiol. 5: 447– 453.

61. Lohuis, P. J. F. M.,, P. C. Ligtenberg,, R. J. A. Dieperslost,, and M. de Graaf. 1994. Q fever in a patient with a ventriculo-peritoneal drain. Case report and short review of the literature. Netherlands J. Med. 44: 60– 64.

62. Lovey, P. Y.,, A. Morabia,, D. Bleed,, O. Péter,, G. Dupuis,, and J. Petite. 1999. Long term vascular complications of Coxiella burnetii infection in Switzerland: cohort study. BMJ 319: 284– 286.

63. Macellaro, A.,, A. Akesson,, and L. Norlander. 1993. A survey of Q-fever in Sweden. Eur. J. Epidemiol. 9: 213– 216.

64. Manfredi Selvaggi, T.,, G. Rezza,, M. Scagnelli,, R. Rigoli,, M. Rassu,, F. de Lalla,, G. P. Pellizzer,, A. Tramarin,, C. Bettini,, L. Zampieri,, M. Belloni,, E. Dalla Pozza,, S. Marangon,, N. Marchioretto,, G. Togni,, M. Giacobbo,, A. Todescato,, and N. Binkin. 1996. Investigation of a Q-fever outbreak in Northern Italy. Eur. J. Epidemiol. 12: 403– 408.

65. Marrie, T. J.,, W. F. Schlech III,, J. C. Williams,, and L. Yates. 1986. Q fever pneumonia associated with exposure to wild rabbits. Lancet i: 427– 429.

66. Maurin, M.,, A. M. Benoliel,, P. Bongrand,, and D. Raoult. 1992. Phagolysosomal alkalinization and the bactericidal effect of antibiotics: the Coxiella burnetii paradigm. J. Infect. Dis. 166: 1097– 1102.

67. Maurin, M.,, and D. Raoult. 1999. Q fever. Clin. Microbiol. Rev. 12: 518– 553.

68. McCaul, T. F.,, and J. C. Williams. 1981. Developmental cycle of Coxiella burnetii structure and morphogenesis of vegetative and sporogenic differentiations. J. Bacteriol. 147: 1063– 1076.

69. McDade, J. E., 1990. Historical aspects of Q fever, p. 5– 21. In T. J. Marrie (ed.), Q Fever, vol. I. The Disease. CRC Press, Boca Raton, Fla.

70. Meconi, S.,, V. Jacomo,, P. Boquet,, D. Raoult,, J. L. Mege,, and C. Capo. 1998. Coxiella burnetii induces reorganization of the actin cytoskeleton in human monocytes. Infect. Immun. 66: 5527– 5533.

71. Meiklejohn, G.,, L. G. Reimer,, P. S. Graves,, and C. Helmick. 1981. Cryptic epidemic of Q fever in a medical school. J. Infect. Dis. 144: 107– 113.

72. Mejia, A.,, B. Toursarkissian,, R. T. Hagino,, J. G. Myers,, and M. T. Sykes. 2000. Primary aortoduodenal fistula and Q fever: an underrecognized association? Ann. Vasc. Surg. 14: 271– 273.

73. Meskini, M.,, L. Beati,, A. Benslimane,, and D. Raoult. 1995. Seroepidemiology of rickettsial infections in Morocco. Eur. J. Epidemiol. 11: 655– 660.

74. Niang, M.,, P. Parola,, H. Tissot-Dupont,, L. Baidi,, P. Brouqui,, and D. Raoult. 1998. Prevalence of antibodies to Rickettsia conorii, Rickettsia africae, Rickettsia typhi and Coxiella burnetii in Mauritania. Eur. J. Epidemiol. 14: 817– 818.

75. Okabayashi, T.,, F. Hasebe,, K. L. Samui,, A. S. Mweene,, S. G. Pandey,, T. Yanase,, Y. Muramatsu,, H. Ueno,, and C. Morita. 1999. Short report: prevalence of antibodies against spotted fever, murine typhus, and Q fever rickettsiae in humans living in Zambia. Am. J. Trop. Med. Hyg. 61: 70– 72.

76. Omezzine-Letaief, A.,, S. Yacoub,, H. Tissot-Dupont,, C. Le Cam,, L. Ghachem,, J. Letaief,, and D. Raoult. 1995. Seroepidemiological survey of rickettsial infections among blood donors in central Tunisia. Trans. R. Soc. Trop. Med. Hyg. 89: 266– 268.

77. Ordi-Ros, J.,, A. Selva-O’Callaghan,, F. Monegal-Ferran,, Y. Monasterio-Aspiri,, C. Juste- Sanchez,, and M. Vilardell-Tarres. 1994. Prevalence, significance, and specificity of antibodies to phospholipids in Q fever. Clin. Infect. Dis. 18: 213– 218.

78. Ormsbee, R.,, and B. Marmion,. 1990. Prevention of Coxiella burnetii infection: vaccines and guidelines for those at risk, p. 226. In T. Marrie (ed.), Q Fever, vol. I. The Disease. CRC Press, Boca Raton, Fla.

79. Pebody, R. G.,, P. G. Wall,, M. J. Ryan,, and C. Fairley. 1996. Epidemiological features of Coxiella burnetii infection in England and Wales. Commun. Dis. Rep. 6: R128– R132

80. Penttila, I. A.,, R. J. Harris,, P. Storm,, D. Haynes,, D. A. Worswick,, and B. P. Marmion. 1998. Cytokine dysregulation in the post-Q-fever fatigue syndrome. Q. J. Med. 91: 549– 560.

81. Pinsky, R. L.,, D. B. Fischbein,, C. R. Greene,, and K. F. Gensheimer. 1991. An outbreak of cat-associated Q fever in the United States. J. Infect. Dis. 164: 202– 204.

82. Raoult, D. 1993. Treatment of Q fever. Antimicrob. Agents Chemother. 37: 1733– 1736.

83. Raoult, D. 1996. Q fever: still a query after all these years. J. Med. Microbiol. 44: 77– 78.

84. Raoult, D.,, P. Brouqui,, B. Marchou,, and J. A. Gastaut. 1992. Acute and chronic Q fever in patients with cancer. Clin. Infect. Dis. 14: 127– 130.

85. Raoult, D.,, M. Drancourt,, and G. Vestris. 1990. Bactericidal effect of doxycycline associated with lysosomotropic agents on Coxiella burnetii in P388D1 cells. Antimicrob. Agents Chemother. 34: 1512– 1514.

86. Raoult, D.,, J. Etienne,, P. Massip,, S. Iaocono,, M. A. Prince,, P. Beaurain,, S. Benichou,, J. C. Auvergnat,, P. Mathieu,, and P. Bachet. 1987. Q fever endocarditis in the south of France. J. Infect. Dis. 155: 570– 573.

87. Raoult, D.,, P. Houpikian,, H. Tissot Dupont,, J. M. Riss,, J. Arditi-Djiane,, and P. Brouqui. 1999. Treatment of Q fever endocarditis: comparison of two regimens containing doxycycline and ofloxacin or hydroxychloroquine. Arch. Intern. Med. 159: 167– 173.

88. Raoult, D.,, P. Levy,, H. Tissot-Dupont,, C. ChichePortiche,, C. Tamalet,, J. A. Gastaut,, and J. Salducci. 1993. Q fever and HIV infection. AIDS 7: 81– 86.

89. Raoult, D.,, and D. Stein. 1994. Q fever during pregnancy—a risk for women, fetuses, and obstetricians. N. Engl. J. Med. 330: 371.

90. Raoult, D.,, H. Tissot-Dupont,, C. Foucault,, J. Gouvernet,, P. E. Fournier,, E. Bernit,, A. Stein,, M. Nesri,, J. R. Harle,, and P. J. Weiller. 2000. Q fever 1985-1998—clinical and epidemiologic features of 1,383 infections. Medicine 79: 109– 123.

91. Sabatier, F.,, F. Dignat-George,, J. L. Mege,, C. Brunet,, D. Raoult,, and J. Sampol. 1997. CD4 + T-cell lymphopenia in Q fever endocarditis. Clin. Diagn. Lab. Immunol. 4: 89– 92.

92. Sahagun Sanchez, G.,, L. Cotter Lemus,, C. Zamora Gonzalez,, P. A. Reyes,, S. Ramirez,, and A. Buendia. 1998. Endocarditis por Coxiella burnetii. Informe del primer caso diagnosticado en Mexico. Arch. Inst. Cardiol. Mex. 68: 322– 327.

93. Sanchez-Recalde, A.,, I. Maté,, E. Lopez,, M. Yebra,, J. L. Merino,, J. Perea,, A. Tellez,, and J. A. Sobrino. 2000. Endocarditis por Coxiella burnetii: evolucion a largo plazo de 20 pacientes. Rev. Esp. Cardiol. 53: 940– 946.

94. Schulze, K.,, A. Schwalen,, R. M. Klein,, L. Thomas,, M. Leschke,, and B. E. Strauer. 1996. Eine Q-Fieber-Pneumonie-Epidemie in Düsseldorf. Pneumologie 50: 469– 473.

95. Sekeyova, Z.,, V. Roux,, and D. Raoult. 1999. Intraspecies diversity of Coxiella burnetii as revealed by com1 and mucZ sequence comparison. FEMS Microbiol. Lett. 180: 61– 67.

96. Serbezov, V.,, J. Kazar,, V. Novkirishki,, N. Gatcheva,, E. Kovacova,, and V. Voynova. 1999. Q fever in Bulgaria and Slovakia. Emerg. Infect. Dis. 5: 388– 394.

97. Sidwell, R. W.,, B. D. Thorpe,, and L. P. Gebhardt. 1964. Studies of latent Q fever infections. I. Effects of whole body X irradiation upon latently infected guinea pigs, white mice and deer mice. Am. J. Hyg. 79: 113– 124.

98. Sidwell, R. W.,, B. D. Thorpe,, and L. P. Gebhardt. 1964. Studies of latent Q fever infections. II. Effects of multiple cortisone injections. Am. J. Hyg. 79: 320– 327.

99. Siegman-Igra, Y.,, O. Kaufman,, A. Keysary,, S. Rzotkiewicz,, and I. Shalit. 1997. Q fever endocarditis in Israel and a worldwide review. Scand. J. Infect. Dis. 29: 41– 49.

100. Smith, D. L.,, J. G. Ayres,, I. Blair,, P. S. Burge,, M. J. Carpenter,, E. O. Caul,, B. Coupland,, U. Desselberger,, M. Evans,, M. Farrell,, J. I. Hawker,, E. G. Smith,, and M. J. Wood. 1993. A large Q fever outbreak in the West Midlands: clinical aspects. Resp. Med. 87: 509– 516.

101. Spyridaki, I.,, A. Gikas,, D. Kofteridis,, A. Psaroulaki,, and Y. Tselentis. 1998. Q fever in the Greek island of Crete: detection, isolation, and molecular identification of eight strains of Coxiella burnetii from clinical samples. J. Clin. Microbiol. 36: 2063– 2067.

102. Stein, A.,, H. Lepidi,, J. L. Mege,, T. J. Marrie,, and D. Raoult. 2000. Repeated pregnancies in BALB/ c mice infected with Coxiella burnetii cause disseminated infection resulting in stillbirth and endocarditis. J. Infect. Dis. 181: 188– 194.

103. Stein, A.,, and D. Raoult. 1998. Q fever during pregnancy: a public health problem in southern France. Clin. Infect. Dis. 27: 592– 596.

104. Stein, A.,, and D. Raoult. 1999. Pigeon pneumonia in Provence. A bird borne Q fever outbreak. Clin. Infect. Dis. 29: 617– 620.

105. Tay, S. T.,, T. M. Ho,, and M. Y. Rohani. 1998. Serological findings of Coxiella burnetii infection among patients with fevers in a health centre in Sarawak, Malaysia. Southeast Asian J. Trop. Med. Public Health 29: 94– 95.

106. Thiele, D.,, H. Willems,, G. Kopf,, and H. Krauss. 1993. Polymorphism in DNA restriction patterns of Coxiella burnetii isolates investigated by pulsed field gel electrophoresis and image analysis. Eur. J. Epidemiol. 9: 419– 425.

107. Tissot-Dupont, H.,, P. Brouqui,, B. Faugere,, and D. Raoult. 1995. Prevalence of antibodies to Coxiella burnetii, Rickettsia conorii, and Rickettsia typhi in seven African countries. Clin. Infect. Dis. 21: 1126– 1133.

108. Tissot-Dupont, H.,, X. Thirion,, and D. Raoult. 1994. Q fever serology: cutoff determination for microimmunofluorescence. Clin. Diagn. Lab. Immunol. 1: 189– 196.

109. Tissot-Dupont, H.,, S. Torres,, M. Nezri,, and D. Raoult. 1999. Hyperendemic focus of Q fever related to sheep and wind. Am. J. Epidemiol. 150: 67– 74.

110. Tylewska-Wierzbanowska, S.,, D. Kruszewska,, and T. Chmielewski. 1996. Epidemics of Q fever in Poland in 1992-1994. Rocz. Akad. Med. Bialymstoku 41: 123– 128.

111. Veras, P.,, C. De Chastellier,, M. Moreau,, V. Villiers,, M. Thibon,, D. Mattei,, and M. Rabinovitch. 2000. Fusion between large phagocytic vesicles: targeting of yeast and other particulates to phagolysosomes that shelter the bacterium Coxiella burnetii or the protozoan Leishmania amazonensis in Chinese hamster ovary cells. J. Cell Sci. 107: 3065– 3076.

112. Vodkin, M. H.,, and J. C. Williams. 1986. Overlapping deletion in two spontaneous phase variants of Coxiella burnetii. J. Gen. Microbiol. 132: 2587– 2594.

113. Webster, J. P.,, G. Lloyd,, and D. W. Macdonald. 1995. Q fever ( Coxiella burnetii) reservoir in wild brown rat ( Rattus norvegicus) populations in the UK. Parasitology 110: 31– 35.

114. Wildman, M.,, and J. G. Ayres. 2000. Long term vascular complications of Coxiella burnetii infection—cardiovascular risk factors cannot be ignored. Br. Med. J. 320: 58.

115. Willems, H.,, C. Jäger,, and G. Baljer. 1998. Physical and genetic map of the obligate intracellular bacterium Coxiella burnetii. J. Bacteriol. 180: 3816– 3822.

Tables

Q Fever: Queries Remaining after Decades of Research

/content/10.1128/9781555816988.chap3.tab3-1

Table 1

Conditions that predispose to chronic infection in human beings and in laboratory animals

10.1128/9781555816988/tab3-1_thmb.gif

10.1128/9781555816988/tab3-1.gif

Table 1

Conditions that predispose to chronic infection in human beings and in laboratory animals

/content/10.1128/9781555816988.chap3.tab3-2

Table 2

Immunological profile of patients with Q fever

10.1128/9781555816988/tab3-2_thmb.gif

10.1128/9781555816988/tab3-2.gif

Table 2

Immunological profile of patients with Q fever

/content/10.1128/9781555816988.chap3.tab3-3

Table 3

Clinical manifestations of Q fever

10.1128/9781555816988/tab3-3_thmb.gif

10.1128/9781555816988/tab3-3.gif

Table 3

Clinical manifestations of Q fever

/content/10.1128/9781555816988.chap3.tab3-4

Table 4

Clinical spectrum of Q fever

10.1128/9781555816988/tab3-4_thmb.gif

10.1128/9781555816988/tab3-4.gif

Table 4

Clinical spectrum of Q fever

/content/10.1128/9781555816988.chap3.tab3-5

Table 5

Recent series of cases of Q fever endocarditis (1997 to 2000)

10.1128/9781555816988/tab3-5_thmb.gif

10.1128/9781555816988/tab3-5.gif

Table 5

Recent series of cases of Q fever endocarditis (1997 to 2000)

/content/10.1128/9781555816988.chap3.tab3-6

Table 6

Clinical symptoms and signs and laboratory findings in Q fever endocarditis patients a

10.1128/9781555816988/tab3-6_thmb.gif

10.1128/9781555816988/tab3-6.gif

Table 6

Clinical symptoms and signs and laboratory findings in Q fever endocarditis patients a

/content/10.1128/9781555816988.chap3.tab3-7

Table 7

Diagnostic tests for Q fever

10.1128/9781555816988/tab3-7_thmb.gif

10.1128/9781555816988/tab3-7.gif

Table 7

Diagnostic tests for Q fever

/content/10.1128/9781555816988.chap3.tab3-8

Table 8

Recently reported outbreaks of Q fever

10.1128/9781555816988/tab3-8_thmb.gif

10.1128/9781555816988/tab3-8.gif

Table 8

Recently reported outbreaks of Q fever