Epidemiological investigation and physician awareness regarding the diagnosis and management of Q fever in South Korea, 2011 to 2017.

BACKGROUND: In South Korea, the number of Q fever cases has rapidly increased since 2015. Therefore, this study aimed to characterize the epidemiological and clinical features of Q fever in South Korea between 2011 and 2017. METHODS/PRINCIPAL FINDINGS: We analyzed the epidemiological investigations and reviewed the medical records from all hospitals that had reported at least one case of Q fever from 2011 to 2017. We also conducted an online survey to investigate physicians' awareness regarding how to appropriately diagnose and manage Q fever. The nationwide incidence rate of Q fever was annually 0.07 cases per 100,000 persons. However, there has been a sharp increase in its incidence, reaching up to 0.19 cases per 100,000 persons in 2017. Q fever sporadically occurred across the country, with the highest incidences in Chungbuk (0.53 cases per 100,000 persons per year) and Chungnam (0.27 cases per 100,000 persons per year) areas. Patients with acute Q fever primarily presented with mild illnesses such as hepatitis (64.5%) and isolated febrile illness (24.0%), whereas those with chronic Q fever were likely to undergo surgery (41.2%) and had a high mortality rate (23.5%). Follow-up for 6 months after acute Q fever was performed by 24.0% of the physician respondents, and only 22.3% of them reported that clinical and serological evaluations were required after acute Q fever diagnosis. CONCLUSIONS: Q fever is becoming an endemic disease in the midwestern area of South Korea. Given the clinical severity and mortality of chronic Q fever, physicians should be made aware of appropriate diagnosis and management strategies for Q fever.

Assessing health status and quality of life of Q-fever patients: the Nijmegen Clinical Screening Instrument versus the Short Form 36.

BACKGROUND: The aim of the study was to assess the use of the Nijmegen Clinical Screening Instrument (NCSI) and Short Form 36 (SF-36) in providing a detailed assessment of health status of Q-fever patients and to evaluate which subdomains within the NCSI and SF-36 measure unique aspects of health status. FINDINGS: Patients received a study questionnaire, which contained the NCSI and SF-36. Pearson correlation coefficients between subdomains of the instruments were calculated. The response rate was 94% (309 out of 330 eligible patients). Intercorrelations between subdomains of the NCSI were generally lower than of the SF-36. Four subdomains of the NCSI showed conceptual similarity (Pearson's r ≥ .70) with one or more subdomains of the SF-36 and vice versa. Subdomains that showed no conceptual similarity were NCSI Subjective Pulmonary Symptoms, Subjective Impairment, Dyspnoea Emotions and Satisfaction Relations, and SF-36 Social functioning, Bodily Pain, Role Physical and Role Emotional. CONCLUSIONS: Our results show that either the NCSI or SF-36 can be used to measure health status in Q-fever patients. When the aim is to obtain a detailed overview of the patients' health, a combination of the two instruments, consisting of the complete NCSI and the four unique subdomains of the SF-36, is preferred.