Emerg Infect Dis. 2022 Jul;28(7):1403-1409. doi: 10.3201/eid2807.212273.
Early detection of and treatment for chronic Q fever might prevent potentially life-threatening complications. We performed a chronic Q fever screening program in general practitioner practices in the Netherlands 10 years after a large Q fever outbreak. Thirteen general practitioner practices located in outbreak areas selected 3,419 patients who had specific underlying medical conditions, of whom 1,642 (48%) participated. Immunofluorescence assay of serum showed that 289 (18%) of 1,642 participants had a previous Coxiella burnetii infection (IgG II titer >1:64), and 9 patients were suspected of having chronic Q fever (IgG I y titer >1:512). After medical evaluation, 4 of those patients received a chronic Q fever diagnosis. The cost of screening was higher than estimated earlier, but the program was still cost-effective in certain high risk groups. Years after a large Q fever outbreak, targeted screening still detected patients with chronic Q fever and is estimated to be cost-effective.
早期发现和治疗慢性 Q 热可能预防潜在的危及生命的并发症。在一次大规模 Q 热爆发 10 年后，我们在荷兰的全科医生诊所开展了慢性 Q 热筛查计划。13 家位于疫情地区的全科医生诊所选择了 3419 名具有特定潜在医疗条件的患者，其中 1642 名（48%）参与了该计划。血清免疫荧光检测显示，1642 名参与者中有 289 名（18%）以前感染过贝氏柯克斯体（IgG II 滴度>1:64），9 名患者疑似患有慢性 Q 热（IgG I y 滴度>1:512）。经过医学评估，其中 4 名患者被诊断为慢性 Q 热。筛查的成本高于早期估计，但该计划在某些高危人群中仍然具有成本效益。在一次大规模 Q 热爆发多年后，有针对性的筛查仍能发现慢性 Q 热患者，且估计具有成本效益。
