Official websites use. Share sensitive information only on official, secure websites. Address correspondence to Didier Raoult, didier. From Q fever to Coxiella burnetii infection: a paradigm change. Clin Microbiol Rev β All Rights Reserved. Since this first description, knowledge about this pathogen and its associated infections has increased dramatically.
We review here all the progress made over the last 20 years on this topic. However, a major step in the characterization of this pathogen was achieved by the establishment of its axenic culture. The genetic determinants of virulence are now better known, thanks to the achievement of determining the genome sequences of several strains of this species and comparative genomic analyses. Q fever can be found worldwide, but the epidemiological features of this disease vary according to the geographic area considered, including situations where it is endemic or hyperendemic, and the occurrence of large epidemic outbreaks.
In recent years, a major breakthrough in the understanding of the natural history of human infection with C. The clinical presentation of C. Moreover, no persistent infection can exist without a focus of infection.
This paradigm change should allow better diagnosis and management of primary infection and long-term complications in patients with C. Qfever has long been considered a rare and regionally restricted disease. In recent years, spectacular advances have been made in the knowledge of this disease and its causative agent, Coxiella burnetii.
First, the worldwide role of Coxiella burnetii as a cause of endocarditis has been recognized in most countries performing systematic serology. Moreover, the classification of C. Third, the recent war in the Middle East 1 and research in the tropics 2 , 3 have shown that Q fever may be a very common cause of fever in the intertropical area. Finally, a very large outbreak in the Netherlands has shown that this disease could become a major public health problem 4.
