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Seroprevalence of Q fever in the United States, 2003-2004.

Published on Oct 1, 2009in American Journal of Tropical Medicine and Hygiene2.315
· DOI :10.4269/ajtmh.2009.09-0168
Alicia D. Anderson9
Estimated H-index: 9
,
Deanna Kruszon-Moran25
Estimated H-index: 25
+ 6 AuthorsRobert F. Massung42
Estimated H-index: 42
Abstract
We performed serum testing for IgG antibodies against Coxiella burnetii (phase I and phase II) and analyzed questionnaire data from 4,437 adults ≥ 20 years of age who participated in the National Health and Nutrition Examination Survey 2003-2004 survey cycle. National Q fever seroprevalence was determined by enzyme-linked immunosorbent assay and confirmed by using immunofluorescent antibody testing. Overall seroprevalence for Coxiella burnetii was 3.1% (95% confidence interval (CI) = 2.1-4.3%) among 4,437 adults ≥ 20 years of age. Coxiella burnetii age-adjusted antibody prev- alence was higher for men than for women (3.8%, 95% CI = 2.7-5.2% versus 2.5%, 95% CI = 1.5-3.7%, respectively, P < 0.05). Mexican Americans had a significantly higher antibody prevalence (7.4%, 95% CI = 6.6-8.3%) than either non- Hispanic whites (2.8%, 95% CI = 1.7-4.3%) or non-Hispanic blacks (1.3%, 95% CI = 0.6-2.5%) ( P < 0.001). Multivariate analysis showed that the risk for Q fever antibody positivity increased with age and was higher among persons who were foreign-born, male, and living in poverty. These findings indicate that the national seroprevalence of Q fever in the United States is higher than expected on the basis of case numbers reported to the Centers for Disease Control and Prevention from state health departments. Potential differences in risk for exposure by race/ethnicity warrant further study.
  • References (15)
  • Citations (62)
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References15
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Although Q fever is considered enzootic in the United States, surveillance for human Q fever has been historically limited. From 1978 through 1999, 436 cases (average 20 per year) of human Q fever were reported. After Q fever became nationally reportable in 1999, 255 human Q fever cases (average 51 per year) were reported with illness onset during 2000 through 2004. The median age of cases was 51 years, and most cases were male (77%). The average annual incidence of Q fever was 0.28 cases per mi...
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#1Amanda L. Dragan (University of Arkansas for Medical Sciences)H-Index: 1
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Abstract Coxiella burnetii is an intracellular bacterium that causes acute and chronic Q fever. This unique pathogen has been historically challenging to study due to obstacles in genetically manipulating the organism and the inability of small animal models to fully mimic human Q fever. Here, we review the current state of C. burnetii research, highlighting new approaches that allow the mechanistic study of infection in disease relevant settings.
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