By Steven Reinberg
Latest Infectious Disease News
“Q fever is underdiagnosed in the United States,” said lead researcher Dr. Christine Akamine, assistant professor of medicine at Loma Linda University in California. “We suspect this is because most patients have only mild symptoms and do not present for medical evaluation.”
People can get Q fever either by direct contact with livestock that carry the bacteria, called Coxiella burnetii, or by inhaling the spores carried by dust and wind.
For the study, Akamine and colleagues collected data on patients hospitalized for Q fever between 2000 and 2016. Patients lived in a dusty, dry, windy area of Southern California ideal for spread of the disease.
Although 20 cases in one hospital over more than a decade may seem small, researchers said the number of chronic cases and two deaths are far higher than the national average.
Though other studies have concluded that it’s rare for Q fever to become chronic, 15% of patients in this study developed chronic disease. And the death rate is five times higher than reported before, according to the U.S. Centers for Disease Control and Prevention.
Even so, Akamine suspects Q fever is even more widespread than the findings suggest, because her study included only hospitalized patients. Most people who get infected don’t get sick enough to seek treatment.
Moreover, several forms of Q fever may exist — some more deadly than others and not all destined to become chronic. No international agreement defines these forms of the disease, Akamine noted.
“We thought that chronic Q fever was less than 5%, but this study found a much higher percent,” he said. “We need much faster diagnosis and early treatment.”
Doctors who treat people in areas where Q fever is more common should be on the lookout for unexplained flu-like symptoms, Siegel said. Patients with such symptoms should be tested for the disease and perhaps given antibiotics even before test results are in, he said.
The report was published online May 20 in the American Journal of Tropical Medicine and Hygiene.
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SOURCES: Christine Akamine, M.D., assistant professor, medicine, Loma Linda University, Loma Linda, Calif.; Marc Siegel, M.D., professor, medicine, New York University School of Medicine, New York City; American Journal of Tropical Medicine and Hygiene, May 20, 2019, online