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急性 Q 热在急性发热疾病个体中与接触农场动物有关:临床表现和诊断方法。

Acute Q fever in individuals with acute febrile illness & exposure to farm animals: Clinical manifestations & diagnostic approaches.

机构信息

Department of Veterinary Public Health & Epidemiology, Nagpur Veterinary College, Maharashtra Animal and Fishery Sciences University, Nagpur, India.

ICAR-National Meat Research Institute, Hyderabad, Karnataka, India.

出版信息

Indian J Med Res. 2024 Jun;159(6):681-688. doi: 10.25259/IJMR_1549_23.

Abstract

Background & objectives Q fever is an important zoonotic disease affecting humans as well as animals. The objective of this study was to assess the burden of Q fever in individuals with acute febrile illness, particularly those in close contact with animals. Various diagnostic methods were also evaluated in addition to clinical examination analysis and associated risk factors. Methods Individuals presenting with acute febrile illness who had animal exposure were enrolled (n=92) in this study. Serum samples were tested using IgG and IgM phase 2 enzyme linked immunosorbent assay (ELISA) and immunofluorescence assay (IFA). The PCR targeting the com1 and IS1111 genes was performed on blood samples. PCR amplicons were sequenced and phylogenetically analysed. Demographic data, symptoms, and risk factors were collected through a structured questionnaire. Results Among individuals with acute febrile illness, 34.7 per cent (32 out of 92) were found to be infected with Coxiella burnetii. PCR exhibited the highest sensitivity among the diagnostic methods employed. The most common clinical manifestations included headache, chills, arthralgia, and fatigue. Individuals engaged in daily livestock-rearing activities were found to be at an increased risk of infection. Interpretation & conclusions Q fever is underdiagnosed due to its varied clinical presentations, diagnostic complexities, and lack of awareness. This study underscores the importance of regular screening for Q fever in individuals with acute febrile illness, particularly those with animal exposure. Early diagnosis and increased awareness among healthcare professionals are essential for the timely management and prevention of chronic complications associated with Q fever.

摘要

背景与目的

Q 热是一种重要的人畜共患病,影响人类和动物。本研究的目的是评估急性发热性疾病患者(尤其是与动物密切接触者)中 Q 热的负担。除了临床检查分析和相关危险因素外,还评估了各种诊断方法。

方法

本研究纳入了有动物接触史的急性发热性疾病患者(n=92)。使用 IgG 和 IgM 相位 2 酶联免疫吸附试验(ELISA)和免疫荧光分析(IFA)检测血清样本。对血液样本进行靶向 com1 和 IS1111 基因的 PCR 检测。对 PCR 扩增子进行测序和系统发育分析。通过结构化问卷收集人口统计学数据、症状和危险因素。

结果

在急性发热性疾病患者中,34.7%(32/92)被发现感染了伯氏考克斯氏体。在使用的诊断方法中,PCR 显示出最高的灵敏度。最常见的临床表现包括头痛、寒战、关节痛和疲劳。从事日常家畜养殖活动的个体感染风险增加。

结论

由于其临床表现多样、诊断复杂以及缺乏认识,Q 热的诊断不足。本研究强调了对急性发热性疾病患者(特别是有动物接触史的患者)进行常规 Q 热筛查的重要性。早期诊断和提高医疗保健专业人员的认识对于及时管理和预防 Q 热相关的慢性并发症至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61db/11463860/a14d2649dcda/IJMR-159-6-681-g1.jpg

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