Persistent high IgG phase I antibody levels against Coxiella burnetii among veterinarians compared to patients previously diagnosed with acute Q fever after three years of follow-up.

Cornelia C H Wielders,Peter M Schneeberger,Daan W Notermans,René Van Den Brom,Barbara Schimmer,Wim Van Der Hoek,Anneroos W Boerman,Daniel E Voth

doi:10.1371/journal.pone.0116937

Cornelia C H Wielders, Peter M Schneeberger + Show 6 more

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https://doi.org/10.1371/journal.pone.0116937

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Abstract

BackgroundLittle is known about the development of chronic Q fever in occupational risk groups. The aim of this study was to perform long-term follow-up of Coxiella burnetii seropositive veterinarians and investigate the course of IgG phase I and phase II antibodies against C. burnetii antigens and to compare this course with that in patients previously diagnosed with acute Q fever.MethodsVeterinarians with IgG phase I ≥1:256 (immunofluorescence assay) that participated in a previous seroprevalence study were asked to provide a second blood sample three years later. IgG antibody profiles were compared to a group of acute Q fever patients who had IgG phase I ≥1:256 twelve months after diagnosis.ResultsIgG phase I was detected in all veterinarians (n = 76) and in 85% of Q fever patients (n = 98) after three years (p<0.001). IgG phase I ≥1:1,024, indicating possible chronic Q fever, was found in 36% of veterinarians and 12% of patients (OR 3.95, 95% CI: 1.84–8.49).ConclusionsIgG phase I persists among veterinarians presumably because of continuous exposure to C. burnetii during their work. Serological and clinical follow-up of occupationally exposed risk groups should be considered.

Highlights

Q fever is a zoonotic disease caused by the intracellular, Gram-negative bacterium Coxiella burnetii
IgG phase I 1:1,024, indicating possible chronic Q fever, was found in 36% of veterinarians and 12% of patients
IgG phase I persists among veterinarians presumably because of continuous exposure to C. burnetii during their work

Summary

Introduction

Q fever is a zoonotic disease caused by the intracellular, Gram-negative bacterium Coxiella burnetii. Sheep, and goats are considered the primary source of infection [1]. Acute Q fever usually presents as a flu-like illness, pneumonia or hepatitis. In 60% of the cases the primary infection remains asymptomatic [3]. From 2007 until 2010, the Netherlands experienced the largest community Q fever epidemic documented in the world, which resulted in >4,000 notified patients [4]. The aim of this study was to perform long-term follow-up of Coxiella burnetii seropositive veterinarians and investigate the course of IgG phase I and phase II antibodies against C. burnetii antigens and to compare this course with that in patients previously diagnosed with acute Q fever

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Conclusion