Patrick Dolcé, Annie de Beaumont-Dupont, Philippe Jutras, Florence Mailhot-Léonard, Maria Alexandra Rosca, Joanne Aubé-Maurice
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Patients with confirmed acute, probable acute, and chronic Q fever were classified using standard case definitions and mapped according to the postal code, to assess the correlation between cases and sheep distribution.</p><p><strong>Results: </strong>Out of 295 cases, 258 were included (241 confirmed acute, seven probable acute, 10 chronic). Median age was 49 years, 76% were male. For acute cases, the prominent symptoms were fever (99%), headache (83%), chills (80%), sweating (72%), myalgia (69%), and fatigue (67%). Clinical presentation was mostly febrile syndrome with mild hepatitis (84%). A seasonal peak was observed from May to July (56% of acute cases). Most cases (56%) occurred within the two counties where sheep production was highest. Exposure to sheep was prominent 93%, including 64% direct contact (15% shepherds, 49% sheepfold visitors), 14% indirect contact, and 15% sheepfold neighbors.</p><p><strong>Conclusions: </strong>To our knowledge, this is one of the largest retrospective studies of Q fever cases reported in Canada. Q fever in Quebec LSLRR is associated mainly with sheep exposure. Fever and hepatitis were the most common manifestations. 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引用次数: 0
摘要
背景:魁北克省圣劳伦斯河下游地区(LSLRR)的Q热发病率比全省高10倍。本研究旨在回顾该地区的临床病例和Q热风险暴露情况。方法:数据来源于微生物实验室、Rimouski地区医院1991 - 2018年的医疗记录和公共卫生报告。使用Epi Info 7.2.2.6进行分析。使用标准病例定义对确诊的急性、可能急性和慢性Q热患者进行分类,并根据邮政编码绘制地图,以评估病例与绵羊分布之间的相关性。结果:共纳入295例病例258例(确诊急性241例,疑似急性7例,慢性10例)。中位年龄49岁,76%为男性。急性病例的主要症状为发热(99%)、头痛(83%)、发冷(80%)、出汗(72%)、肌痛(69%)和疲劳(67%)。临床表现多为发热综合征伴轻度肝炎(84%)。5月至7月为季节性高峰(56%的急性病例)。大多数病例(56%)发生在羊产量最高的两个县。与羊的接触占93%,其中直接接触占64%(牧羊人占15%,羊圈游客占49%),间接接触占14%,羊圈邻居占15%。结论:据我们所知,这是加拿大报道的Q热病例中最大的回顾性研究之一。魁北克LSLRR的Q热主要与绵羊接触有关。发热和肝炎是最常见的表现。该地区应考虑采取预防措施,保护羊圈工作人员、访客及其邻居。
The lower Saint Lawrence River region of Quebec, a hot spot for sheepfold-associated Q fever in Canada: Review of 258 cases.
Background: The lower Saint Lawrence river region (LSLRR), in Quebec, has a 10-fold higher incidence of Q fever compared to the provincial rate. This study aimed to review clinical cases and the Q fever risk exposure in this region.
Methods: Data were retrieved from microbiology laboratory, medical records from Rimouski Regional Hospital and Public Health reports between 1991 and 2018. They were analyzed with Epi Info 7.2.2.6. Patients with confirmed acute, probable acute, and chronic Q fever were classified using standard case definitions and mapped according to the postal code, to assess the correlation between cases and sheep distribution.
Results: Out of 295 cases, 258 were included (241 confirmed acute, seven probable acute, 10 chronic). Median age was 49 years, 76% were male. For acute cases, the prominent symptoms were fever (99%), headache (83%), chills (80%), sweating (72%), myalgia (69%), and fatigue (67%). Clinical presentation was mostly febrile syndrome with mild hepatitis (84%). A seasonal peak was observed from May to July (56% of acute cases). Most cases (56%) occurred within the two counties where sheep production was highest. Exposure to sheep was prominent 93%, including 64% direct contact (15% shepherds, 49% sheepfold visitors), 14% indirect contact, and 15% sheepfold neighbors.
Conclusions: To our knowledge, this is one of the largest retrospective studies of Q fever cases reported in Canada. Q fever in Quebec LSLRR is associated mainly with sheep exposure. Fever and hepatitis were the most common manifestations. Preventive measures should be considered in this region to protect sheepfold workers, visitors, and their neighbors.
期刊介绍:
The aim of this interdisciplinary and international journal is to provide a forum for the exchange of original ideas, techniques, designs and experiences in the rapidly growing field of location based services on networked mobile devices. It is intended to interest those who design, implement and deliver location based services in a wide range of contexts. Published research will span the field from location based computing and next-generation interfaces through telecom location architectures to business models and the social implications of this technology. The diversity of content echoes the extended nature of the chain of players required to make location based services a reality.