Abstract
IntroductionFrom 2007 through 2010, the Netherlands experienced a large Q-fever epidemic, with 4,107 notifications. The most serious complication of Q-fever is chronic Q-fever.MethodIn 2014, we contacted all 2,161 adult inhabitants of the first village in the Netherlands affected by the Q-fever epidemic and offered to test for antibodies against Coxiella burnetii using immunofluorescence assay (IFA) to screen for chronic infections and assess whether large-scale population screening elsewhere is warranted.ResultsOf the 1,517 participants, 33.8% were IFA-positive. Six IFA-positive participants had an IgG phase I titer ≥1:512. Two of these six participants were previously diagnosed with chronic Q-fever. Chronic infection was diagnosed in one of the other four participants after clinical examination.ConclusionsSeven years after the initial outbreak, seroprevalence remains high, but the yield of screening the general population for chronic Q-fever is low. A policy of screening known high-risk groups for chronic Q-fever in outbreak areas directly following an outbreak might be more efficient than population screening. A cost-effectiveness analysis should also be performed before initiating a population screening program for chronic Q-fever.
Highlights
From 2007 through 2010, the Netherlands experienced a large Q-fever epidemic, with 4,107 notifications
Six immunofluorescence assay (IFA)-positive participants had an IgG phase I titer !1:512. Two of these six participants were previously diagnosed with chronic Q-fever
A cost-effectiveness analysis should be performed before initiating a population screening program for chronic Q-fever
Summary
From 2007 through 2010, the Netherlands experienced a large Q-fever epidemic, with 4,107 notifications. The most serious complication of Q-fever is chronic Q-fever. Data Availability Statement: Due to ethical restrictions, our data are unsuitable for public deposition. Specific permission to share data is granted by the Medical Ethical Review Committee (METC Utrecht). Requests to access data may be sent to the corresponding author. Reduction prices serological IFA testing Laboratory of Medical Microbiology Jeroen Bosch Hospital and of personnel by the Municipal Health Service, Hart voor Brabant. In 2014, we contacted all 2,161 adult inhabitants of the first village in the Netherlands affected by the Q-fever epidemic and offered to test for antibodies against Coxiella burnetii using immunofluorescence assay (IFA) to screen for chronic infections and assess whether large-scale population screening elsewhere is warranted
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