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. 1990 Oct;105(2):391–408. doi: 10.1017/s095026880004797x

Q fever in Plymouth, 1972-88. A review with particular reference to neurological manifestations.

S Reilly 1, J L Northwood 1, E O Caul 1
PMCID: PMC2271878  PMID: 2209742

Abstract

Between 1972 and 1988 we have serologically confirmed 103 Coxiella burnetii infections: 46 were acute, 5 were chronic, 52 represented past infections. Details of 61 cases are presented. Of acute cases 80% had respiratory involvement; at least 63% had pneumonias. The incidence (22%) of neurological complications was of particular interest; 40% of these patients had prolonged sequelae. One acutely ill patient died of fulminating hepatitis. Patients with pre-existing pathology or immunosuppression were especially susceptible to C. burnetii. In the absence of acute sera, the complement fixation test alone provided inadequate differentiation between recent and past Q fever: phase II titres persisted at greater than or equal to 80 for more than 1 year after the acute infection in 15 cases; maximum duration of persistence was 14 years. Three patients acquired high phase I titres. Only 5% of cases had chronic Q fever, but in view of the diverse sequelae observed in this series, we suggest that long-term serological and clinical follow-up of all cases of Q fever is fully justified.

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Selected References

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