No abstract available.
Hepatitis* ; Myocarditis* ; Pancytopenia* ; Q Fever*

No abstract available.
Antibodies* ; Coxiella burnetii* ; Coxiella* ; Korea* ; Prevalence* ; Q Fever*

OBJECTIVES: Cattle slaughterhouse workers are known as the high risk group for the zoonoses. We surveyed the awareness of zoonoses among cattle slaughterhouse workers to suggest direction of education and public relations. METHODS: We evaluated the epidemiological characteristics of zoonoses and the process of cattle slaughtering. We designed different questionnaires for the workers involved in slaughtering, the handlers of residual products, the inspectors and their assistants, and the grading testers and their assistants respectively. We visited 73 cattle slaughterhouses and 62 residual products handle houses across the country and conducted a questionnaire survey of the general characteristics and the awareness of zoonoses. The data collected was evaluated using the SPSS 17.0 statistical package. RESULTS: The awareness rate of brucellosis, Q fever and Enterohemorrhagic Escherichia coli (EHEC) were 83.9%, 18.5%, 62.7% among cattle slaughterhouse workers. The awareness rate of zoonoses among the workers involved in slaughtering and the handlers of residual products was lower than other workers. The awareness rate of zoonoses tended to increase as the school career. In the correct awareness rate of the transmission of zoonoses, 'transmission by tick bite', 'person to person' and 'air transmission' were lower than other transmission items. The most common reason why cattle slaughterhouse workers think that it is difficult to prevent zoonoses was the ignorance of how to prevent. CONCLUSIONS: An educational program is needed for the cattle slaughterhouse workers on zoonoses especially Q fever. And publicity activities about prevention of infection are needed for high risk groups.
Abattoirs ; Animals ; Brucellosis ; Cattle ; Enterohemorrhagic Escherichia coli ; Humans ; Korea ; Q Fever ; Ticks ; Zoonoses ; Surveys and Questionnaires

OBJECTIVES: We surveyed awareness levels of brucellosis, Q fever and enterohemorrhagic Escherichia coli (EHEC) among dairy farmers in Gyeonggi Province to suggest directions for public education and public relations. METHODS: We designed questionnaires to evaluate awareness of 3 major zooneses. We conducted a questionnaire survey to assess knowledge of the general characteristics of them, information sources for the awareness of zooneses, and the mode of transmission. Subjects were 716 workers from 482 dairy farms in Gyeonggi province. RESULTS: The awareness levels for brucellosis, Q fever, and EHEC were 90.2%, 2.5% and 56.6%, respectively. Awareness of brucellosis and EHEC were tended to increase with higher number of school years. Television was the most common route of information for these zoonoses. Most common responses for questions concerning the method of transmission for each zoonoses, 'Contact with parturient fluid or placenta of animal' was 63.2% for brucellosis, 'Ingestion of raw meat or residual product' was 66.7% and 64.2% for Q fever and EHEC, respectively. The most common reason why dairy farmers think that it is difficult to prevent zoonoses was the inconvenience of wearing protection. CONCLUSIONS: Education programs for zoonoses, especially Q fever, are needed for dairy farmers. In addition, publicity information activities about prevention of zoonoses are needed for high risk groups, such as the dairy farmers surveyed.
Brucellosis ; Dairying ; Enterohemorrhagic Escherichia coli ; Humans ; Meat ; Placenta ; Q Fever ; Television ; Zoonoses ; Surveys and Questionnaires

Q fever is an important zoonosis caused by the rickrttsial organism, Coxiella burnetii. It is a very contagious organism which humans can contact by inhaling aerosolized organisms. Most commonly it leads to an acute flu-like illness. The diagnosis is usually confirmed serologically using a complement fixation or microimmunofluorescence test. Previous reports suggest that case-to-case in men is rare. We report person-to-person transmission, within a familly and doctors who participated in the care of the C. burnetii-infected the patient Q fever is possibly underdiagnosed in children, it should be considered in children with fever of unknown origin.
Child ; Complement System Proteins ; Coxiella burnetii ; Diagnosis ; Fever of Unknown Origin ; Humans ; Inhalation ; Multiple Endocrine Neoplasia Type 1 ; Q Fever*

BACKGROUND: Q fever caused by Coxiella burnetii presents with diverse clinical and pathological features including subclinical or cholestatic hepatitis. However, the pathological features of liver biopsies from patients with Q fever have not been well described. METHODS: Clinical features and pathological findings of liver biopsies were reviewed in seven cases of Q fever that were confirmed by serological, microbiological, or molecular tests. RESULTS: All cases presented with fever. Liver enzymes were mildly elevated except one case with marked hyperbilirubinemia. Characteristic fibrin ring granulomas were present in three cases, epithelioid granulomas with eosinophilic infiltration in two cases, extensive extravasated fibrins without ring configuration mimicking necrotizing granuloma in one case, and acute cholangitis without granuloma in one case. All cases were treated with antibiotics for 20 days. Six cases were completely cured, but one suffered from multiorgan failure. CONCLUSIONS: C. burnetii infection is uncommon, but should always be considered in patients with acute hepatitis and fever. Because variable-sized circumferential or radiating fibrin deposition was a consistent feature of the present cases, Q fever can be strongly suggested by pathological features and confirmed by serological and/or molecular tests.
Anti-Bacterial Agents ; Biopsy ; Cholangitis ; Coxiella burnetii ; Eosinophils ; Fever ; Fibrin ; Granuloma ; Hepatitis ; Humans ; Hyperbilirubinemia ; Liver ; Q Fever

BACKGROUND: Q fever caused by Coxiella burnetii presents with diverse clinical and pathological features including subclinical or cholestatic hepatitis. However, the pathological features of liver biopsies from patients with Q fever have not been well described. METHODS: Clinical features and pathological findings of liver biopsies were reviewed in seven cases of Q fever that were confirmed by serological, microbiological, or molecular tests. RESULTS: All cases presented with fever. Liver enzymes were mildly elevated except one case with marked hyperbilirubinemia. Characteristic fibrin ring granulomas were present in three cases, epithelioid granulomas with eosinophilic infiltration in two cases, extensive extravasated fibrins without ring configuration mimicking necrotizing granuloma in one case, and acute cholangitis without granuloma in one case. All cases were treated with antibiotics for 20 days. Six cases were completely cured, but one suffered from multiorgan failure. CONCLUSIONS: C. burnetii infection is uncommon, but should always be considered in patients with acute hepatitis and fever. Because variable-sized circumferential or radiating fibrin deposition was a consistent feature of the present cases, Q fever can be strongly suggested by pathological features and confirmed by serological and/or molecular tests.
Anti-Bacterial Agents ; Biopsy ; Cholangitis ; Coxiella burnetii ; Eosinophils ; Fever ; Fibrin ; Granuloma ; Hepatitis ; Humans ; Hyperbilirubinemia ; Liver ; Q Fever

Q fever is a zoonotic infection caused by Coxiella burnetii. Acute Q fever usually develops as a self-limited flu-like illness, atypical pneumonia, or hepatitis. We experienced a case of Q fever in a 50-year-old male who had a prolonged fever. The bone marrow and lymph node biopsy revealed fibrin-ring granulomas, which is a distinct finding of Q fever. The diagnosis was proven by high titers of C. burnetii anti-phase II antibody (IgM 1:512 and IgG >,048) and positive nested PCR for the com-1 gene. Q fever is rare in Korea, but should be considered in the differential diagnosis of fever of unknown origin
Biopsy ; Bone Marrow ; Coxiella burnetii ; Diagnosis, Differential ; Fever ; Fever of Unknown Origin ; Granuloma ; Hepatitis ; Humans ; Immunoglobulin G ; Korea ; Lymph Nodes ; Male ; Middle Aged ; Pneumonia ; Polymerase Chain Reaction ; Q Fever

Although Q fever is an important zoonotic infection with a worldwide distribution, no human isolates of Coxiella burnetii have been identified in Korea. For the first time, we identified the nucleotide sequence of C. burnetii from a 32-year-old man with an acute febrile illness in Korea. Diagnosis of acute Q fever was confirmed by seroconversion using indirect immunofluorescence antibody assays. Phylogenetic analysis demonstrated high sequence similarity (99.6%–100%) with C. burnetii 16S rRNA sequences identified from the reservoir. These results are the first genetic analysis of C. burnetii in a human case of Q fever in Korea.
Adult ; Base Sequence ; Coxiella burnetii* ; Coxiella* ; Diagnosis ; Fluorescent Antibody Technique, Indirect ; Humans ; Korea* ; Q Fever ; Seroconversion ; Zoonoses

BACKGROUND/AIMS: Although only a few sporadic cases of Q fever have been reported in Korea, a total of 13 cases have been seen in our area. We performed this study to evaluate the clinical characteristics of these cases of acute Q fever. METHODS: Demographic features, clinical manifestations, laboratory and radiologic findings, and therapeutic outcomes of all cases were evaluated. Q fever was diagnosed using an indirect micro-immunofluorescence assay (MIFA) and polymerase chain reaction (PCR). RESULTS: A total of 13 patients with acute Q fever seen from January 2006 to August 2008 at three teaching hospitals in the Daegu Metropolitan City area were enrolled. The mean age was 49 years old (range, 24~76), and the male to female ratio was 11:2. Six (46.2%) cases had a history of animal contact. Fever (100%) was the most common manifestation, followed by myalgia (84.6%), headache (61.5%), anorexia (61.5%), and chills (61.5%). All cases were diagnosed with high titers of anti-phase II antibody (IgM> or = 1:50, IgG> or =1:200) and positive nested PCR for the 27-kDa OMP com-1 gene of Coxiella burnettii in the blood. In three cases, liver biopsies revealed the presence of compact fibrin-ring granulomas. No characteristics of pneumonia were diagnosed on chest X-rays. The predominant presentation was acute febrile illness with hepatitis, including three cases (27.3%) of severe cholestatic hepatitis. The most frequently used antimicrobial agent was doxycycline (84.6%), followed by azithromycin (7.7%). CONCLUSIONS: Acute Q fever may be added to the list of differential diagnosis of patients with acute febrile illness and hepatitis in the Daegu Metropolitan City area.
Animals ; Anorexia ; Azithromycin ; Biopsy ; Chills ; Coxiella ; Diagnosis, Differential ; Doxycycline ; Female ; Fever ; Granuloma ; Headache ; Hepatitis ; Hospitals, Teaching ; Humans ; Korea ; Liver ; Male ; Pneumonia ; Polymerase Chain Reaction ; Q Fever ; Thorax