Marrie T J, MacDonald A, Durant H, Yates L, McCormick L
Department of Medicine, Dalhousie University, Halifax, NS, Canada.
Chest. 1988 Jan;93(1):98-103. doi: 10.1378/chest.93.1.98.
Thirty-three cases (24 definite, nine probable) of Q fever were diagnosed in Victoria County, Cape Breton, Nova Scotia from May to August, 1985. Twenty-six of the cases occurred in residents of Baddeck (population 900, attack rate 2.8 percent), and 21 of the cases occurred during the month of June. There was geographic clustering of the cases: 14 of the 33 (42 percent) lived or worked in four buildings located side by side in the center of town. A case control study revealed that 25 of 29 cases were exposed to a cat that gave birth to stillborn kittens on June 8, 1985 and had bled per vaginum for three weeks prior to delivery. The cat lived in one of the buildings where geographic clustering occurred and frequently visited the other buildings. None of the 40 control subjects was so exposed (p less than 0.001). This cat had an antibody titer of 1:512 to Coxiella burnetii phase 1 antigen and a titer of 1:1024 to phase 2 antigen. Exposure to cattle, sheep and goats, the traditional reservoirs of Q fever, was uncommon among patients and control subjects and none of eight cattle tested had antibodies to C burnetii phase I antigen. We conclude that the infected parturient cat was probably responsible for this outbreak of Q fever affecting 2.8 percent of the population of the town of Baddeck.
1985年5月至8月期间,新斯科舍省布雷顿角岛维多利亚县确诊了33例Q热病例(24例确诊,9例可能病例)。其中26例发生在巴德克的居民中(人口900人,发病率2.8%),21例发生在6月份。病例存在地理聚集性:33例中的14例(42%)居住或工作在镇中心并排的四栋建筑中。一项病例对照研究显示,29例病例中有25例接触过一只猫,这只猫于1985年6月8日产下死胎小猫,并且在分娩前三周阴道出血。这只猫生活在发生地理聚集的其中一栋建筑里,还经常去其他建筑。40名对照对象中无人有此接触史(p<0.001)。这只猫对伯纳特柯克斯体1期抗原的抗体效价为1:512,对2期抗原的效价为1:1024。患者和对照对象中接触Q热传统宿主牛、羊和山羊的情况并不常见,检测的8头牛中无一有针对伯纳特柯克斯体1期抗原的抗体。我们得出结论,受感染的分娩母猫可能是此次影响巴德克镇2.8%人口的Q热疫情的源头。