perature beyond the range of 2? or 3? between the morning and evening indication. The very fact that quinine in such cases is powerless to make any impression on their course, removes their etiology from the sphere of malarious influence. For such cases Sir Joseph Fayrer has preferred the name of typho-malarial, inasmuch aa they combine the characteristics of both, and are yet distinctive in th...

BACKGROUND Between 2007 and 2011, the Netherlands experienced the largest documented Q-fever outbreak to date with a total of 4108 notified acute Q-fever patients. Previous studies have indicated that Q-fever patients may suffer from long-lasting health effects, such as fatigue and reduced quality of life. Our study aims to determine the long-term health impact of Q-fever. It will also compare ...

Two outbreaks of Q fever were reported in the Netherlands in 2007 and 2008. The ongoing 2008 outbreak in the south-eastern part of the Netherlands is the largest community outbreak ever described, with 808 cases reported until August 2008. The changing epidemiology of Q fever is most likely related to intensive goat farming, and has important implications for the clinical care of patients in en...

BACKGROUND Q fever is caused by Coxiella burnetii, a bacterium that persists in M2-polarized macrophages. We wondered whether the concept of M1/M2 polarization is applicable to Q fever patients. METHODS Monocytes from healthy controls were cultured with IFN-γ and IL-4, agonists of M1 and M2 macrophages, respectively, and their gene expression was assessed using whole-genome microarrays. Selec...

BACKGROUND The influence of immune response gene variations on the development of chronic complications of Q fever is presently unclear. AIM To compare the frequencies of allelic polymorphisms in immune response genes in different Q fever patient groups. DESIGN Genetic association study. METHODS We measured the frequencies of immune response gene variants in: (i) an expanded group of 31 p...

the disease. A patient who has been suffering from remittent fever of the prevailing type, is found at one of the visits to have become quite unconscious ; he lies on his back or side, and does not by word 01* gesture show any sign of consciousness. lie cannot be roused, even though loudly addressed or roughly shaken ; the breathing is easy; the pupils perhaps somewhat sluggish, but not strikin...

A detailed analysis of the humoral response to Coxiella burnetii may provide insight into the pathogenesis of Q fever, a zoonosis caused by C. burnetii. The subclasses of C. burnetii-specific antibodies were determined by immunofluorescence in 20 patients with acute Q fever and 20 patients with chronic Q fever. Although immunoglobulin G1 (IgG1) and IgG3 antibodies were found in acute and chroni...

OBJECTIVE Whether areas affected by Q fever during a large outbreak (2008-2010) had higher rates of adverse pregnancy outcomes than areas not affected by Q fever. DESIGN Nationwide registry-based ecological study. SETTING Pregnant women in areas affected and not affected by Q fever in the Netherlands, 2003-2004 and 2008-2010. PARTICIPANTS Index group (N=58,737): pregnant women in 307 area...

This week’s issue of Eurosurveillance presents two articles on Q fever. A surveillance report about a Q fever outbreak in Cheltenham, United Kingdom (UK), describes the traditional pattern of Q fever epidemiology involving clusters of cases reported around farms with infected animals (sheep, goats) [1]. The second article provides an update on a long-lasting and ongoing Q fever outbreak with a ...