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Q fever in maritime Canada
Abstract:
Only nine cases of Q fever were recorded in Canada in the 20 years prior to 1978. In the 18 months from August 1979 to January 1981 the disease was diagnosed serologically in six patients from the Maritime provinces. All were epidemiologically unrelated and none had been exposed to animals. Five had pneumonia and one had chronic Q fever with probable prosthetic valve endocarditis. Three of the five pneumonia patients presented with signs and symptoms of an acute lower respiratory tract infection and were indistinguishable clinically from other patients with atypical pneumonias. The other two with pneumonia presented with nonresolving pulmonary infiltrates and complained of decreased energy. Four of the five pneumonia patients responded well to treatment with erythromycin; the fifth required two courses of tetracycline. The patient with chronic Q fever had a large amount of cryoglobulins in his serum and evidence of immune complex disease. These cases indicate that Q fever should be considered as a possible cause of atypical pneumonia in Canada.
Insights
Q fever, a rare disease in Canada, was diagnosed in six unrelated patients between 1979-1981. This suggests Q fever may cause atypical pneumonia in Canada.
Area of Science:
- Infectious Diseases
- Public Health
- Clinical Medicine
Background:
- Q fever incidence in Canada was historically low, with only nine cases reported in the two decades preceding 1978.
- The study period (August 1979 to January 1981) saw a notable increase in Q fever diagnoses in the Maritime provinces.
Observation:
- Six epidemiologically unrelated patients were diagnosed with Q fever via serology.
- None of the patients reported animal exposure, challenging typical transmission assumptions.
- Clinical presentations varied, including five cases of pneumonia and one of chronic Q fever with suspected endocarditis.
Findings:
- Pneumonia cases presented either as acute lower respiratory tract infections or nonresolving pulmonary infiltrates.
- Treatment responses varied, with most pneumonia cases responding to erythromycin and one requiring tetracycline.
- The chronic Q fever case exhibited cryoglobulinemia and immune complex disease, indicating a severe manifestation.
Implications:
- These findings suggest Q fever should be considered in the differential diagnosis of atypical pneumonias in Canada.
- The lack of animal exposure in these cases warrants further investigation into potential transmission routes.
- Increased awareness and diagnostic consideration of Q fever are crucial for timely patient management.