Volume 94, Issue 5
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Q fever is an important cause of undifferentiated fever that is rarely recognized or reported in Brazil. The objective of this study was to look for the presence of during a dengue fever outbreak in the municipality of Itaboraí, Rio de Janeiro, Brazil, where this bacterium had previously infected humans and domesticated animals. Blood samples from clinically suspected dengue fever patients were tested by polymerase chain reaction (PCR) for ; the DNA was detected in nine (3.3%) of 272 patients. One was coinfected with dengue virus, which was also detected in another 166 (61.3%) patients. The nucleotide sequence of PCR amplification and DNA sequencing of the IS transposase elements in the genome of exhibited 99% identity with the sequence in GenBank. The detection of in patients suspected of dengue fever indicates that awareness and knowledge of Q fever should be strengthened and that this bacterium is present in Brazil. Finally, because a negative molecular result does not completely rule out the diagnosis of Q fever and the serological assay based on seroconversion was not available, the actual number of this zoonosis is likely to be much higher than that reported in this study.


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  1. Angelakis E, Raoult D, , 2010. Review Q fever. Vet Microbiol 140: 297309.[Crossref] [Google Scholar]
  2. Fenollar F, Fournier PE, Raoult D, , 2004. Molecular detection of Coxiella burnetii in the sera of patients with Q fever endocarditis or vascular infection. J Clin Microbiol 42: 49194924.[Crossref] [Google Scholar]
  3. Maurin M, Raoult D, , 1999. Q fever. Clin Microbiol Ver 12: 518553. [Google Scholar]
  4. Georgiev M, Afonso A, Neubauer H, Needham H, Thiéry R, Rodolakis A, Roest HJ, Stärk KD, Stegeman JA, Vellema P, van der Hoek W, More SJ, , 2013. Q fever in humans and farm animals in four European countries, 1982 to 2010. Euro Surveill 18: 20407. Available at: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20407. [Google Scholar]
  5. Anderson AD, Kruszon-Moran D, Loftis AD, McQuillan G, Nicholson WL, Priestley RA, Candee AJ, Patterson NE, Massung RF, , 2009. Seroprevalence of Q fever in the United States, 2003–2004. Am J Trop Med Hyg 81: 691694.[Crossref] [Google Scholar]
  6. Delsing CE, Kullberg BJ, Bleeker-Rovers CP, , 2010. Q fever in the Netherlands from 2007 to 2010. Neth J Med 68: 382387. [Google Scholar]
  7. Anderson AD, Smoak B, Shuping E, Ockenhouse C, Petruccelli B, , 2005. Q fever and the U.S. military [letter]. Emerg Infect Dis. 11: 13201322. doi:10.3201/eid1108.050314.[Crossref] [Google Scholar]
  8. Aronson NE, Sanders JW, Moran KA, , 2006. In harm's way: infections in deployed American military forces. Clin Infect Dis 43: 10451051.[Crossref] [Google Scholar]
  9. Centers for Disease Control and Prevention, 2001. Bioterrorism Agents/Diseases (Page last updated February 12, 2007). Available at: http://emergency.cdc.gov/agent/agentlist.asp. [Google Scholar]
  10. Brandão H, Valle L, Christóvão D, , 1953. Investigações sobre a febre Q em São Paulo. Estudo sorológico em operários de um frigorífico. Arq Fac Hig Saude Publica Univ Sao Paulo 7: 127133.[Crossref] [Google Scholar]
  11. Lemos ER, Rozental T, Mares-Guia MA, Almeida DN, Moreira N, Silva RG, Barreira JD, Lamas CC, Favacho AR, Damasco PV, , 2011. Q fever as a cause of fever of unknown origin and thrombocytosis: first molecular evidence of Coxiella burnetii in Brazil. Vector Borne Zoonotic Dis 11: 8587.[Crossref] [Google Scholar]
  12. Mares-Guia MAMM, Rozental T, Guterres A, Gomes R, Almeida DNP, Moreira NS, Barreira JD, Favacho ARM, Santana AL, Lemos ERS, , 2014. Molecular identification of the agent of Q fever—Coxiella burnetii—in domestic animals in State of Rio de Janeiro, Brazil. Rev Soc Bras Med Trop 47: 231234.[Crossref] [Google Scholar]
  13. Lamas CC, Ramos RG, Lopes GQ, Santos MS, Golebiovski WF, Weksler C, Ferraiuoli GID, Fournier P, Lepidi H, Raoult D, , 2013. Bartonella and Coxiella infective endocarditis in Brazil: molecular evidence from excised valves from a cardiac surgery referral center in Rio de Janeiro, Brazil, 1998 to 2009. Int J Infect Dis 17: e65e66.[Crossref] [Google Scholar]
  14. Rozental T, Mascarenhas LF, Rozenbaum R, Gomes R, Mattos GS, Magno CC, Almeida DN, Rossi MI, Favacho AR, de Lemos ER, , 2012. Coxiella burnetii, the agent of Q fever in Brazil: its hidden role in seronegative arthritis and the importance of molecular diagnosis based on the repetitive element IS1111 associated with the transposase gene. Mem Inst Oswaldo Cruz 107: 695697.[Crossref] [Google Scholar]
  15. Lamas CR, , 2009. Seroprevalence of Coxiella burnetii antibodies in human immunodeficiency virus-positive patients in Jacarepaguá, Rio de Janeiro, Brazil. Clin Microbiol Infect 15: 140141.[Crossref] [Google Scholar]
  16. Siciliano RR, , 2008. Endocarditis due to Coxiella burnetii (Q fever). A rare or underdiagnosed disease? Case report. Rev Soc Bras Med Trop 41: 409412.[Crossref] [Google Scholar]
  17. Arricau-Bouvery N, Rodolakis A, , 2005. Is Q fever an emerging or re-emerging zoonosis? Vet Res 36: 327349.[Crossref] [Google Scholar]
  18. Heringer M, Nogueira RM, de Filippis AM, Lima MR, Faria NR, Nunes PC, Nogueira FB, Dos Santos FB, , 2015. Impact of the emergence and re-emergence of different dengue viruses' serotypes in Rio de Janeiro, Brazil, 2010 to 2012. Trans R Soc Trop Med Hyg 109: 268274.[Crossref] [Google Scholar]
  19. Willems H, Thiele D, Frolich-Ritter R, Krauss H, , 1994. Detection of Coxiella burnetii in cow's milk using the polymerase chain reaction (PCR). J Vet Med 41: 580587.[Crossref] [Google Scholar]
  20. Hoover TA, Vodkin MH, Williams JC, , 1992. A Coxiella burnetii repeated DNA element resembling a bacterial insertion sequence. J Bacteriol 174: 55405548.[Crossref] [Google Scholar]
  21. Denison AM, Thompson HA, Massung RF, , 2007. IS1111 insertion sequences of Coxiella burnetii: characterization and use for repetitive element PCR-based differentiation of Coxiella burnetii isolates. BMC Microbiol 7: 91.[Crossref] [Google Scholar]
  22. Altschul SF, Gish W, Miller W, Myers EW, Lipman DJ, , 1990. Basic local alignment search tool. J Mol Biol 215: 403410.[Crossref] [Google Scholar]
  23. Ayres M, Ayres M, Jr Ayres DL, Santos AS, , 2007. BioEstat—Aplicações Estatísticas nas Áreas das Ciências Biológicas e Médicas. Belém/PA, Brasil: Ong Mamirauá. [Google Scholar]
  24. Secretaria de Vigilância em Saúde – Ministério da Saúde–Brasil, 2014. Boletim Epidemiológico. Vol. 45, No. 17. p. 16. Available at: http://portalsaude.saude.gov.br/images/pdf/2014/agosto/04/BE-2014-45–17—Dengue-SE29.pdf. [Google Scholar]
  25. Daumas RP, Passos SRL, Oliveira RVC, Nogueira RMR, Georg I, Marzochi KBF, Patrícia Brasil P, , 2013. Clinical and laboratory features that discriminate dengue from other febrile illnesses: a diagnostic accuracy study in Rio de Janeiro, Brazil. BMC Infect Dis 13: 77.[Crossref] [Google Scholar]
  26. Martins VCA, Bastos MS, Ramasawmy R, Figueiredo RP, Gimaque JBL, Braga WSM, Nogueira ML, Nozawa S, Naveca FG, Figueiredo LTM, Mourão MPG, , 2014. Clinical and virological descriptive study in the 2011 outbreak of dengue in the Amazonas, Brazil. PLoS One 9: e100535.[Crossref] [Google Scholar]
  27. Anderson A, Bijlmer H, Fournier PE, Graves S, Hartzell J, Kersh GJ, Limonard G, Marrie TJ, Massung RF, McQuiston JH, Nicholson WL, Paddock CD, Sexton DJ, , 2013. Diagnosis and management of Q fever—United States, 2013: recommendations from CDC and the Q Fever Working Group. MMWR 62: 130. Available at: http://www.cdc.gov/mmwr/pdf/rr/rr6203.pdf. [Google Scholar]
  28. Hawker JI, Ayres JG, Blair I, Evans MR, Smith DL, Smith EG, Burge PS, Carpenter MJ, Caul EO, Coupland B, Desselberger U, Farrell ID, Saunders PJ, Wood MJ, , 1998. A large outbreak of Q fever in the West Midlands: windborne spread into a metropolitan area? Commun Dis Public Health 1: 180187. [Google Scholar]
  29. Gilsdorf A, Kroh C, Grimm S, Jensen E, Wagner-Wiening C, Alpers K, , 2008. Large Q fever outbreak due to sheep farming near residential areas, Germany, 2005. Epidemiol Infect 136: 10841087.[Crossref] [Google Scholar]
  30. Kersh GJ, Fitzpatrick KA, Self JS, Priestley RA, Kelly AJ, Lash RR, Marsden-Haug N, Nett RJ, Bjork A, Massung RF, Anderson AD, , 2013. Presence and persistence of Coxiella burnetii in the environments of goat farms associated with a Q fever outbreak. Appl Environ Microbiol 79: 16971703.[Crossref] [Google Scholar]
  31. Rovery C, Granel B, Casalta JP, Lepidi H, Habib G, Raoult D, , 2009. Coinfection with Coxiella burnetii in infectious endocarditis. Clin Microbiol Infect 15 (Suppl 2): 190191.[Crossref] [Google Scholar]
  32. Rolain JM, Gouriet F, Brouqui P, Larrey D, Janbon F, Vene S, Jarnestrom V, Raoult D, , 2005. Concomitant or consecutive infection with Coxiella burnetii and tickborne diseases. Clin Infect Dis 40: 8288.[Crossref] [Google Scholar]
  33. Centro de Informações e Respostas Estratégicas de Vigilância em Saúde–CIEVS, 2015. Informe Epidemiológico Cievs–Paraná Semana Epidemiológica 11/2015. Febre Q. Available at: http://www.saude.pr.gov.br/arquivos/File/informe_semanal_cievs_11.pdf. [Google Scholar]
  34. Kampschreur LM, Dekker S, Hagenaars JC, Lestrade PJ, Renders NH, de Jager-Leclercq MG, Hermans MH, Groot CA, Groenwold RH, Hoepelman AI, Wever PC, Oosterheert JJ, , 2012. Identification of risk factors for chronic Q fever, the Netherlands. Emerg Infect Dis 18: 563570.[Crossref] [Google Scholar]
  35. Prabhu M, Nicholson WL, Roche AJ, Kersh GJ, Fitzpatrick KA, Oliver LD, Massung RF, Morrissey AB, Bartlett JA, Onyango JJ, Maro VP, Kinabo GD, Saganda W, Crump JA, , 2011. Q fever, spotted fever group, and typhus group rickettsioses among hospitalized febrile patients in northern Tanzania. Clin Infect Dis 53: e8e15.[Crossref] [Google Scholar]

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  • Received : 08 Aug 2015
  • Accepted : 19 Sep 2015
  • Published online : 04 May 2016

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