Persistent high IgG phase I antibody levels against Coxiella burnetii among veterinarians compared to patients previously diagnosed with acute Q fever after three years of follow-up

Cornelia C H Wielders; Anneroos W Boerman; Barbara Schimmer; René van den Brom; Daan W Notermans; Wim van der Hoek; Peter M Schneeberger

doi:10.1371/journal.pone.0116937

Persistent high IgG phase I antibody levels against Coxiella burnetii among veterinarians compared to patients previously diagnosed with acute Q fever after three years of follow-up

PLoS One. 2015 Jan 20;10(1):e0116937. doi: 10.1371/journal.pone.0116937. eCollection 2015.

Authors

Cornelia C H Wielders¹, Anneroos W Boerman¹, Barbara Schimmer², René van den Brom³, Daan W Notermans², Wim van der Hoek², Peter M Schneeberger¹

Affiliations

¹ Department of Medical Microbiology and Infection Control, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands; Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
² Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
³ Department of Small Ruminant Health, GD Animal Health, Deventer, The Netherlands.

Abstract

Background: Little is known about the development of chronic Q fever in occupational risk groups. The aim of this study was to perform long-term follow-up of Coxiella burnetii seropositive veterinarians and investigate the course of IgG phase I and phase II antibodies against C. burnetii antigens and to compare this course with that in patients previously diagnosed with acute Q fever.

Methods: Veterinarians with IgG phase I ≥ 1:256 (immunofluorescence assay) that participated in a previous seroprevalence study were asked to provide a second blood sample three years later. IgG antibody profiles were compared to a group of acute Q fever patients who had IgG phase I ≥ 1:256 twelve months after diagnosis.

Results: IgG phase I was detected in all veterinarians (n = 76) and in 85% of Q fever patients (n = 98) after three years (p<0.001). IgG phase I ≥ 1:1,024, indicating possible chronic Q fever, was found in 36% of veterinarians and 12% of patients (OR 3.95, 95% CI: 1.84-8.49).

Conclusions: IgG phase I persists among veterinarians presumably because of continuous exposure to C. burnetii during their work. Serological and clinical follow-up of occupationally exposed risk groups should be considered.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Autoantibodies / immunology*
Coxiella burnetii / immunology*
Cross-Sectional Studies
Female
Humans
Immunoglobulin G / immunology*
Male
Q Fever / immunology*
Veterinarians

Substances

Autoantibodies
Immunoglobulin G

Grants and funding

The follow-up study of acute Q fever patients four years after diagnosis was financially supported by The Netherlands Organisation for Health Research and Development (ZonMw; grant number 205520006). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.