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Time-course of antibody responses against Coxiella burnetii following acute Q fever

  • P. F. M. TEUNIS (a1) (a2), B. SCHIMMER (a1), D. W. NOTERMANS (a3), A. C. A. P. LEENDERS (a4), P. C. WEVER (a4), M. E. E. KRETZSCHMAR (a1) (a5) and P. M. SCHNEEBERGER (a4)...

Summary

Large outbreaks of Q fever in The Netherlands have provided a unique opportunity for studying longitudinal serum antibody responses in patients. Results are presented of a cohort of 344 patients with acute symptoms of Q fever with three or more serum samples per patient. In all these serum samples IgM and IgG against phase 1 and 2 Coxiella burnetii were measured by an immunofluorescence assay. A mathematical model of the dynamic interaction of serum antibodies and pathogens was used in a mixed model framework to quantitatively analyse responses to C. burnetii infection. Responses show strong heterogeneity, with individual serum antibody responses widely different in magnitude and shape. Features of the response, peak titre and decay rate, are used to characterize the diversity of the observed responses. Binary mixture analysis of IgG peak levels (phases 1 and 2) reveals a class of patients with high IgG peak titres that decay slowly and may represent potential chronic cases. When combining the results of mixture analysis into an odds score, it is concluded that not only high IgG phase 1 may be predictive for chronic Q fever, but also that high IgG phase 2 may aid in detecting such putative chronic cases.

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Corresponding author

*Author for correspondence: Professor P. F. M. Teunis, Centre for Infectious Disease Control, Epidemiology and Surveillance Unit, RIVM, PO Box 1, 3720BA Bilthoven, The Netherlands. (Email: peter.teunis@rivm.nl)

References

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1.Schimmer, B, et al. Large ongoing Q fever outbreak in the south of The Netherlands. Eurosurveillance 2008; 13(31).
2.Schimmer, B, et al. Sustained intensive transmission of Q fever in the south of The Netherlands. Eurosurveillance 2009; 14(9).
3.van der Hoek, W, et al. Q fever in The Netherlands: an update on the epidemiology and control measures. Eurosurveillance 2010; 15(12).
4.Dijkstra, F, et al. The 2007–2010 Q fever epidemic in The Netherlands: characteristics of notified acute Q fever patients and the association with dairy goat farming. FEMS Immunology and Medical Microbiology 2012; 64: 312.
5.Dupont, HT, Thirion, X, Raoult, D. Q fever serology: cutoff determination for microimmunofluorescence. Clinical Diagnostics and Laboratory Immunology 1994; 1: 189196.
6.Marrie, TJ, de Carolis, E. Seroepidemiology of Coxiella burnetii infection and its frequency as a cause of community-acquired pneumonia in Canada. Canadian Journal of Infectious Diseases 2002; 13: 164166.
7.Fournier, PE, Marrie, TJ, Raoult, D. Diagnosis of Q fever. Journal of Clinical Microbiology 1998; 36: 18231834.
8.Schneeberger, PM, et al. Real-time PCR with serum samples is indispensable for early diagnosis of acute Q fever. Clinical and Vaccine Immunology 2010; 17: 286290.
9.Raoult, D, Marrie, TJ, Mege, JL. Natural history and pathophysiology of Q fever. Lancet Infectious Diseases 2005; 5: 219226.
10.Morroy, G, et al. The health status of Q fever patients after long-term follow up. BMC Infectious Diseases 2011; 11: 97.
11.van der Hoek, W, et al. Follow-up of 686 patients with acute Q fever and detection of chronic infection. Clinical Infectious Diseases 2011; 52: 14311436.
12.Landais, C, et al. From acute Q fever to endocarditis: serological follow-up strategy. Clinical Infectious Diseases 2007; 44: 13371340.
13.Dupont, HT, et al. Epidemiologic features and clinical presentation of acute Q fever in hospitalized patients: 323 French cases. American Journal of Medicine 1992; 93: 427434.
14.Teunis, PFM, et al. Kinetics of IgG antibody response to pertussis toxin after infection with B. pertussis. Epidemiology and Infection 2002; 129: 479489.
15.Edelstein-Keshet, L. Mathematical Models in Biology (Birkhauser Mathematics series). New York: McGraw-Hill Inc., 1988.
16.Simonsen, J, et al. Estimation of incidences of infectious diseases based on antibody measurements. Statistics in Medicine 2009; 28: 18821885.
17.Teunis, PFM, et al. Biomarker dynamics: estimating infection rates from serological data. Statistics in Medicine (in press).
18.Teunis, PFM, Ogden, ID, Strachan, NJC. Hierarchical dose response of E. coli O157:H7 from human outbreaks incorporating heterogeneity in exposure. Epidemiology and Infection 2008;136: 761770.
19.Gilks, WR, Richardson, S, Spiegelhalter, DJ (eds). Markov Chain Monte Carlo in Practice. London: Chapman & Hall, 1996.
20.Teunis, PF, et al. Usefulness of sero-surveillance for Trichinella infections in animal populations. Veterinary Parasitology 2009; 159: 345349.
21.Sunder, S, et al. Chronic Q fever: relevance of serology. Clinical Infectious Diseases 2011; 53: 749750.
22.Limonard, GJM, et al. One-year follow-up of patients of the ongoing Q fever outbreak: clinical, serological and echocardiographic findings. Infection 2010; 38: 471477.
23.Hung, MN, et al. Serologic assessment of the risk of developing chronic Q fever in cohorts of acutely infected individuals. Journal of Infection 2011; 62: 3944.

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