High seroprevalence of Coxiella burnetii infection in Eastern Cantabria (Spain).

BACKGROUND: Coxiella burnetii is the causative agent of Q fever, a worldwide zoonosis which shows a wide diversity of clinical manifestations. The objective of this seroepidemiological study was to estimate the prevalence of antibodies to C. burnetii in a representative population of the Eastern area of the Cantabrian Community (Northern Spain). METHODS: A cross-sectional study was conducted in 595 subjects from Eastern Cantabria. Four different zones (one urban and three rural zones) were defined according to the geographical characteristics of the area and the economic activities of the population. The population sample for this study was collected between December 1994 and March 1995, and was stratified by age, sex and municipality of residence. IgG and IgM antibodies against C. burnetii were assayed by an indirect immunofluorescence technique. RESULTS: The prevalence of anti-phase II Coxiella IgG (titre > or = 1:16) was 48.6% (95% confidence interval: 44.6-52.6%), with 81.3% havinga titre of > or = 1:64. The prevalence of IgG increased with age, ranging from 12.0% in people < 15 years to 70.3% in those > 65 years (P < 0.001). The antibody detection rate was higher in males (53.6%) than in females (43.3%) (P < 0.01). The prevalence of anti-phase II Coxiella IgG was less among subjects living in the urban zone (32.8%) than in those living in the other three rural zones: the two situated on the coast (54.0% and 54.9% respectively) and the inner mountainous zone (82.3%) (P < 0.001). CONCLUSIONS: The prevalence of C. burnetii infection observed in this study is one of the highest reported in Europe. The eastern area of Cantabria is a hyperendemic area for Q fever.

Clinical presentation of acute Q fever in lanzarote (Canary Islands): a 2-year prospective study.

The clinical manifestations of acute Q fever may differ markedly from country to country. In this regard, fever and hepatitis seem to be the dominant clinical features of acute Coxiella burnetii infection in Lanzarote, Canary Islands. A possible interaction between environmental factors and some strains of C. burnetii could explain the different clinical presentations of acute Q fever.

[Seroprevalence of Q fever among the adult population of Lanzarote (Canary Islands)]. / Seroprevalencia de la fiebre Q en la población adulta de Lanzarote (Islas Canarias).

Q fever is an endemic zoonosis in the Canary Islands. In 1986, we detected, in a pilot study, residual antibodies of the infection in 3% of the population from Lanzarote. In 1989, we performed a new study in order to assess seroprevalence of Q fever among the adult native population from the island. We studied 390 human serums obtained from an statistically representative sample. Age ranged from 30 to 64 years. Out of 390 serums, 196 (50.25%) were obtained from men and 194 (49.74%) from women. The serological technique used was the fixation of complement using Coxiella burnetii antigens in phase II. Titres equal or higher than 1/8 were considered positive. No statistically significant differences were observed with regard to seroprevalence rates considering sex, age, nor living in or outside the island's capital city. However, when dividing the island's territory in three areas (north, centre and south), and assessing independently their respective seroprevalences, we observed relatively higher seroprevalences in the furthest areas (13.3% in the north and 13.5% in the south) than in the central area (4.7%), although only the higher seroprevalence in the south reached statistical significance when compared with the mean prevalence. Probably, these observations indicate that, although Q fever is extended all over the island, it is a more frequent infection in rural areas of Lanzarote, at the north and the south, than in the central area, where the main urban areas are located.

[Acute suppurative arthritis: an unusual manifestation of murine typhus (endemic)]. / Artritis aguda supurada: una manifestación excepcional del tifus murino (endémico).

A 37-year-old patient had fever, diffuse maculopapular rash and acute suppurative arthritis of both knees, which was totally cured with doxycycline without sequelae. Skin biopsy showed characteristic findings of rickettsiosis. In the serological investigation the Weil-Felix reaction was positive and antibodies against Rickettsia typhi but not against Rickettsia conorii were detected by indirect immunofluorescence. No similar case has found in the reviewed literature.