Jorm L R, Lightfoot N F, Morgan K L
Department of Veterinary Medicine, University of Bristol, Langford, Avon.
Epidemiol Infect. 1990 Jun;104(3):467-77. doi: 10.1017/s0950268800047476.
Five cases of clinical Q fever were identified amongst students and staff of a Somerset secondary school between 23 October 1987 and 21 December 1987. Five goats which were kept at the school were found to have antibodies to Coxiella burnetii phase II. A cross-sectional study was conducted at the school in July 1988. A single CF test was used to identify evidence of prior infection, and a self-administered questionnaire was used to collect data on exposure variables and illness during 1987. Four hundred and ninety-nine eligible subjects took part in the study, and serological information was obtained from 461 of these. Eighty-seven subjects (18.9%) had CF titres of 20 or greater. It was estimated that only 1 in every 30 individuals with evidence of past C. burnetii infection had been recognized as a clinical case of Q fever. Antibody positive subjects were more likely to have been off school sick and to report having suffered chest pain than negative subjects. Contact with school animals, specifically cleaning the school poultry, collecting their eggs and visiting a school goat on the day of kidding, was associated with the presence of antibodies to C. burnetii. However, a large proportion of the antibody positives (24.2%) had no known contact with the school animals. Spread of organisms, either wind-borne or in straw or manure, may have been responsible for the high prevalence of unexplained infection.
1987年10月23日至12月21日期间，在萨默塞特郡一所中学的学生和教职员工中发现了5例临床Q热病例。该校饲养的5只山羊被发现对伯纳特立克次体II期有抗体。1988年7月在该校进行了一项横断面研究。采用单次补体结合试验（CF试验）来确定既往感染的证据，并使用一份自填式问卷收集1987年期间暴露变量和疾病的数据。499名符合条件的受试者参与了该研究，其中461人获得了血清学信息。87名受试者（18.9%）的CF滴度为20或更高。据估计，每30名有既往伯纳特立克次体感染证据的人中只有1人被确诊为Q热临床病例。抗体阳性的受试者比阴性受试者更有可能因病缺课并报告曾患胸痛。与学校动物接触，特别是清理学校家禽、收集它们的蛋以及在产羔当天去看学校的山羊，与伯纳特立克次体抗体的存在有关。然而，很大一部分抗体阳性者（24.2%）与学校动物没有已知的接触。病原体通过空气传播、附着在稻草或粪便上传播，可能是导致不明原因感染高发的原因。
