Q fever: a neglected zoonosis in Saudi Arabia

• Published in: Annals of Saudi medicine 2013-09, Vol.33 (5), p.464-468
• Main Authors: Almogren, Adel, Shakoor, Zahid, Hasanato, Rana, Adam, Mustafa Hussein
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Animals; Antigens; Blood & organ donations; Case-Control Studies; Child; Coxiella burnetii - isolation & purification; Endocarditis; Female; Fever - diagnosis; Fever - microbiology; Fluorescent Antibody Technique; Health risk assessment; Hepatitis; Humans; Illnesses; Immunoglobulin G - immunology; Immunoglobulins; Immunology; Infections; Laboratories; Male; Middle Aged; Original; Patients; Pneumonia; Prospective Studies; Q Fever - diagnosis; Q Fever - epidemiology; Saudi Arabia - epidemiology; Studies; Viral infections; Young Adult; Zoonoses; Zoonoses - diagnosis; Zoonoses - epidemiology; Zoonoses - microbiology
• ISSN: 0256-4947; 0975-4466
• DOI: 10.5144/0256-4947.2013.464

Infection due to Coxiella burnetii (C burnetii), the causative agent of Q fever is rarely sought for in clinical practice. This study was performed to detect C burnetii infection in patients with pyrexia of undetermined cause (PUC). This is a prospective study conducted at King Khalid University Hospital, Riyadh be.tween March 2011 and January 2013. A total of 3 mL venous blood was collected from 51 patients with PUC at King Khalid University Hospital, Riyadh. This group of patients included 30 males and 21 females (mean age 33.9 [21.3] years) with the history of febrile illness ranging between 4 and 8 weeks. A control group of 50 healthy individuals comprising 39 males and 11 females (mean age 27 [9] years) was also included in the study. Detection of phase II C burnetii-specific IgG antibodies was performed by immunofluorescence assay, and a titer of > 1:64 was considered positive. Phase II C burnetii-specific IgG antibodies were detected in 18 (35.2%) patients out of the total 51 tested. Two (4%) individuals out of 50 in the control group tested positive for anti-C burnetii IgG antibodies. The proportion of positive results among the patients was significantly higher than the controls (P < .0002, 95% CI, 15.09-46.25). The antibody titer range was between 1:128 and 1:1024 where 6 patients had titers of 1:256, 5 had 1:512, 4 had 1024, and 3 had 1:128. The evidence of C burnetii infection in a sizable number of patients emphasizes the need for inclusion of serologic investigations for Q fever in patients with PUC.