Volume 70, Issue 5
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


The aim of this study was to investigate the incidence, epidemiology, and clinical manifestations of Q fever among hospitalized children in Greece. During a two-year period, 1,200 children with various clinical manifestations were prospectively tested for infection by indirect immunofluorescence. Acute Q fever was diagnosed in eight (0.67%) patients. No chronic case of infection was detected. Multivariate analysis showed that children 11–14 years old and children reporting consumption of cheese from rural areas were at increased risk for this illness. Clinical manifestations of acute Q fever were pneumonia (two patients), meningitis (two), prolonged fever (two), hepatitis (one), and hemolytic-uremic syndrome (one). Q fever accounted for 2.9% of the cases with prolonged fever, 1.2% of the cases of meningitis, and 0.5% of the cases of pneumonia. Fever and headache were the most common symptoms at presentation. Our study indicates that Q fever is a rare cause of hospitalization during childhood.


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  1. Maurin M, Raoult D, 1999. Q fever. Clin Microbio. Rev 12 : 518–553.
  2. Richardus JH, Dumas AM, Huisman J, Schaap GJ, 1985. Q fever in infancy: a review of 18 cases. Pediatr Infect Dis J 4 : 369–373.
  3. Ruiz-contreras J, Gonzalez MR, Ramos AJ, Giancaspro CE, Scarpellini VA, 1993. Q fever in children. Am J Dis Child 147 : 300–302.
  4. Fournier PE, Casalta JP, Habib G, Messana T, Raoult D, 1996. Modification of the diagnostic criteria proposed by the Duke Endocarditis Service to permit improved diagnosis of Q fever endocarditis. Am J Med 100 : 629–633.
  5. Fenollar F, Fournier PE, Carrieri MP, Habib G, Messana T, Raoult D, 2001. Risks factors and prevention of Q fever endocarditis. Clin Infect Dis 33 : 312–316.
  6. Raoult D, Tissot-Dupont H, Foucault C, Gouvernet J, Fournier PE, Bernit E, Stein A, Nesri M, Harle JR, Weiller PJ, 2000. Q fever 1985–1998 - Clinical and epidemiologic features of 1,383 infections. Medicine (Baltimore) 79 : 109–123.
  7. Tissot-Dupont H, Thirion X, Raoult D, 1994. Q fever serology: cutoff determination for microimmunofluorescence. Clin Diagn Lab Immunol 1 : 189–196.
  8. Maltezou HC, Kallergi C, Kavazarakis E, Stabouli S, Kafetzis DA, 2001. Hemolytic-uremic syndrome associated with Coxiella burnetii infection. Pediatr Infect Dis J 20 : 811–813.
  9. Tselentis Y, Gikas A, Kofteridis D, Kyriakakis E, Lydataki N, Bouros D, Tsaparas N, 1995. Q fever in the greek Island of Crete: epidemiologic, clinical, and therapeutic data from 98 cases. Clin Infect Dis 20 : 1311–1316.
  10. Maltezou HC, Raoult D, 2002. Q fever in children. Lancet Infect Dis 2 : 686–691.
  11. Richardus JH, Donkers A, Dumas AM, Schaap GJ, Akkermans JP, Huisman J, Valkenburg HA, 1987. Q fever in the Netherlands: a sero-epidemiological survey among human population groups from 1968 to 1983. Epidemiol Infect 98 : 211–219.
  12. Dupuis G, Vouilloz M, Peter O, Mottiez MC, 1985. Rev Med Suisse Romande 105 : 949–954.
  13. Ruiz-Beltran R, Herrero-Herrero JI, Martin-Sanchez AM, Martin-Gonzalez JA, 1990. Prevalence of antibodies to Rickettsia conorii, Coxiella burnetii and Rickettsia typhi in Salamanca Province (Spain). Serosurvey in the human population. Eur J Epidemiol 6 : 293–299.
  14. Antoniou M, Tselentis Y, Babalis T, Gikas A, Stratigakis N, Vlachonikolis I, Kafatos A, Fioretos M, 1995. The seroprevalence of ten zoonoses in two villages of Crete, Greece. Eur. J. Epidemiol. 11 : 415–423.
  15. Dupuis G, Peter O, Pedroni D, Petite J, 1985. Aspects cliniques observés lors d’une épidémie de 415 cases cas de fièvre Q. Schweiz Med Wochenschr 115 : 814–818.
  16. Jorm LR, Lightfoot NF, Morgan KL, 1990. An epidemiological study of an outbreak of Q fever in a secondary school. Epidemio. Infect 104 : 467–477.
  17. Tissot-Dupont H, Raoult D, Brouqui P, Janbon F, Peyramond D, Weiller PJ, Chicheportiche C, Nezri M, Poirier R, 1992. Epidemiologic features and clinical presentation of acute Q fever in hospitalized patients: 323 French cases. Am J Med 93 : 427–434.
  18. Domingo P, Munoz C, Franquet T, Gurgui M, Sancho F, Vazquez G, 1999. Acute Q fever in adult patients: report on 63 sporadic cases in an urban area. Clin Infect Dis 29 : 874–879.
  19. Hellenbrand W, Breuer T, Petersen L, 2001. Changing epidemiology of Q fever in Germany, 1947–1999. Emerg Infect Dis 7 : 789–796.
  20. Fishbein DB, Raoult D, 1992. A cluster of Coxiella burnetii infections associated with exposure to vaccinated goats and their unpasteurized dairy products. Am J Trop Med Hyg 47 : 35–40.
  21. Hatchette TF, Hudson RC, Schlech WF, Campbell NA, Hatchette JE, Ratman S, Raoult D, Donovan C, Marrie TJ, 2001. Goat-associated Q fever: a new disease in Newfoundland. Emerg Infect Dis 7 : 413–419.
  22. Dupuis G, Petite J, Peter O, Vouilloz M, 1987. An important outbreak of human Q fever in a Swiss Alpine valley. Int J Epidemiol 16 : 282–287.
  23. Leone M, Honstettre A, Lepidi H, Capo C, Bayard F, Raoult D, Mege JL, 2004. Gender effect on Coxiella burnetii infection: protective role of 17beta-estradiol. J Infect Dis (in press).
  24. Drancourt M, Raoult D, Xeridat B, Milandre L, Nezri M, Dano P, 1991. Q fever meningoencephalitis in five patients. Eur J Epidemiol 7 : 134–138.
  25. Gomez-Aranda F, Pachon Diaz J, Romero Acebal M, Romero Acebal M, Lopez Cortes L, Navarro Rodriguez A, Maestre Moreno J, 1984. Computed tomographic brain scan findings in Q fever encephalitis. Neuroradiology 26 : 329–332.
  26. Berkovitch M, Aladjem M, Beer S, Cohar K, 1985. A fatal case of Q fever hepatitis in a child. Helv Paediatr Acta 40 : 87–91.
  27. Chevalier P, Vandenesch F, Brouqui P, Kirkorian G, Tabib A, Etienne J, Raoult D, 1997. Fulminant myocardial failure in a previously healthy young man. Circulation 95 : 1654–1657.
  28. Meis JF, Weemaes CR, Horrevorts AM, Aerdts SJ, Westenend PJ, Galama JM, 1992. Rapidly fatal Q-fever pneumonia in a patient chronic granulomatous disease. Infection 20 : 287–289.

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  • Received : 18 Jan 2003
  • Accepted : 17 Nov 2003

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