Bolaños Margarita, Santana Otilia-Evora, Pérez-Arellano José Luis, Angel-Moreno Alfonso, Moreno Gustavo, Burgazzoli Juan Luis, Martín-Sánchez Antonio Manuel
Servicio de Microbiología. Hospital Universitario Insular de Gran Canaria. España.
Enferm Infecc Microbiol Clin. 2003 Jan;21(1):20-3. doi: 10.1016/s0213-005x(03)72869-9.
The aim of this study was to describe the clinical and epidemiologic features of Q fever in the southern area of the island of Gran Canaria (Spain).
We conducted a retrospective analysis of the clinical and epidemiological data of the cases of Q fever diagnosed by the Microbiology Laboratory of the Hospital Universitario Insular in Gran Canaria between 1998 and 2000. Antibodies against phase II Coxiella burnetii antigens were detected using an indirect immunofluorescence test. The diagnosis of acute Q fever was established by IgG titers > or = 1:320 and IgM titers > or = 1:80, or by seroconversion.
During the period of study 59 cases of acute Q fever were diagnosed, making an incidence of 5 cases/100,000 inhabitants/year. The seroprevalence (IgG > or = 1:80) in the patients for whom Q fever serology was requested during that period was 23.9%. Clinical and epidemiologic data were available for 40 patients. All were sporadic cases and 57% were hospitalized. The mean age of the patients was 40.6 6 13.3 years (range 20-74 years), 85% were males and 67.5% came from a rural background. The majority of cases (65%) clustered from April to July. The most frequent clinical presentation was an acute febrile process with elevated liver enzymes (87.5%). Pneumonia was infrequent (only three cases).
In our area Q fever is mainly manifested as an acute febrile illness with subclinical hepatic involvement. This fact and the small number of cases with pneumonia and chronic forms suggest the etiological involvement of C. burnetii strains different from those in other geographic areas.
本研究旨在描述大加那利岛(西班牙)南部地区Q热的临床和流行病学特征。
我们对1998年至2000年间大加那利岛大学医院微生物实验室诊断的Q热病例的临床和流行病学数据进行了回顾性分析。使用间接免疫荧光试验检测抗II期伯氏考克斯体抗原的抗体。急性Q热的诊断依据为IgG滴度≥1:320且IgM滴度≥1:80,或血清学转换。
在研究期间,共诊断出59例急性Q热病例,发病率为5例/100,000居民/年。在此期间进行Q热血清学检测的患者中,血清阳性率(IgG≥1:80)为23.9%。有40例患者的临床和流行病学数据可用。所有病例均为散发病例,57%的患者住院治疗。患者的平均年龄为40.6±13.3岁(范围20 - 74岁),85%为男性,67.5%来自农村地区。大多数病例(65%)集中在4月至7月。最常见的临床表现是伴有肝酶升高的急性发热过程(87.5%)。肺炎较少见(仅3例)。
在我们地区,Q热主要表现为伴有亚临床肝脏受累的急性发热性疾病。这一事实以及肺炎和慢性形式病例数量较少表明,与其他地理区域不同,伯氏考克斯体菌株在病因学上存在差异。