Q fever in the Netherlands: a sero-epidemiological survey among human population groups from 1968 to 1983.

A sero-epidemiological survey, using an indirect immunofluorescence test for IgG against Coxiella burnetii (phase II), was carried out in the Netherlands. Serum samples taken in 1968, 1975, 1979 and 1983 were tested. Occupational groups with a supposedly high risk of infection (veterinarians, residents of dairy farms and taxidermists) showed a significantly higher percentage of seropositives than defined controls. The percentage of seropositive amateur wool spinners was significantly higher than that of the controls from the same region. Since 1968 there has been no increase in the percentage of infected persons, indicating that, contrary to earlier assumptions, Q fever has been endemic in The Netherlands for a long time already. The increase in numbers of notified cases of overt Q fever is considered to be the result of the recent introduction of a sensitive indirect immunofluorescence test for IgM antibodies against C. burnetii. Antibody percentages in all age classes between 1 and 64 years were much alike, suggesting that most infections occur in early childhood. This is in accordance with the finding that 35% of our patients are younger than 3 years. The possibility of infection related to childbirth and lactation is discussed.

[Coxiella burnetii as a possible cause of endocarditis in a 7-year old boy]. / Coxiella burnetii als mogelijke verwekker van endocarditis bij een 7-jarige jongen.

The case-history of a 7-year-old boy with endocarditis, myocarditis and pericarditis, possibly caused by Coxiella burnetii (Q-fever), is presented. As far as we know only one case of Q-fever endocarditis in a child is previously described in literature. That child had, contrary to our patient, a pre-existing valve abnormality. Q-fever was diagnosed after demonstration of a significant rise in titer of the antibodies against Coxiella burnetii in both the IgM and the IgG fractions. IgA antibodies, indicative for an endocarditis, were also demonstrated.

Q fever as a possible cause of bilateral optic neuritis.

A 59-year-old farmer developed a bilateral optic neuritis in the course of an infection with Coxiella burnetii (Q fever), resulting in a lasting unilateral blindness. A complete medical (including neurological) evaluation gave no evidence of other possible causes. A possible source of infection was cattle.

Q fever in infancy: a review of 18 cases.

Infection with Coxiella burnetti (Q fever) was diagnosed in 18 children younger than 3 years of age in The Netherlands during a 16-month period. The diagnosis was confirmed serologically by means of a complement-fixation test and immunofluorescence for IgM determination. A summary of the clinical, hematologic, serologic and epidemiologic features is given. Four children had relapsing episodes of fever during several months. The problem of childhood infection with C. burnetii, particularly in relation to the possibility of intrauterine infection or infection during birth and in the neonatal period, is discussed. In at least one child of this series, an infection by means of breast feeding was considered likely. Q fever is possibly underdiagnosed in children; it should be considered in children with fever of unknown origin.

[Serological study of the presence of antibodies against Coxiella burnetti and Brucella abortus in veterinarians in the Netherlands]. / Serologisch onderzoek bij dierenartsen in nederland op het vóórkomen van antistoffen tegen Coxiella burnetii en Brucella abortus.

Two hundred and twenty-two large animal practitioners in the Netherlands were studied serologically for the presence of antibodies to Coxiella burnetii (Q-fever) and Brucella abortus. Eighty-four percent showed antibodies to Coxiella burnetii, which were equally distributed over all age-groups. For blood donors the proportion in men was 31 per cent and 14 per cent in women, also equally distributed over all age-groups. In the case of Brucella abortus, the number of veterinarians showing antibodies in creased with age from 6 to 69 per cent. The conclusion that Q-fever is enzootic in the Netherlands would appear to be justified. This is contrary to the view that was previously accepted.

Therapeutic keratoplasty for active herpetic corneal disease: viral culture and prognosis.

Data are presented on a 5-year follow-up of 23 patients with active herpetic corneal disease, who underwent lamellar or penetrating corneal grafts. Excised corneal buttons were virologically examined and positive herpes simplex virus was found in 7 cases. The prognosis of these 7 cases was particularly grave. For comparison 23 cases are reported of patients with inactive herpetic corneal disease. Causes of failure in both groups are discussed.

Characterization of rotaviral RNA isolated from children with gastroenteritis in two hospitals in Rotterdam.

Rotavirus RNA was extracted from stools collected from children with gastroenteritis in two hospitals in Rotterdam. Electrophoresis of the RNAs showed that at least 19 different electropherotypes were isolated from stools collected in the period from 1977 to 1982. It was possible to identify the index case in some hospital-acquired cases of rotaviral gastroenteritis.

Immune electron microscopy and a cultural test in the diagnosis of adenovirus ocular infection.

Immune electron microscopy (IEM) and virus isolation in cell culture were compared in the diagnosis of adenovirus ocular infection during an outbreak of the disease in 1979. Eleven of 14 patients with a keratoconjunctivitis clinically indicative of adenovirus infection had IEM evidence of adenovirus infection or had the virus isolated from ocular swabs. The IEM was positive in 8 patients. Virus as isolated from 10 patients. IEM was positive in one culture negative patient. Since IEM provides a rapid and sensitive method for the detection of adenovirus in human tears, it may be a valuable diagnostic tool for the clinician.

Adenovirus 37: identification and characterization of a medically important new adenovirus type of subgroup D.

A new human adenovirus has been isolated from 62 eyes with (kerato)conjunctivitis and from nine genitourinary sites. The virus is closely related in haemagglutination inhibition tests to adenovirus type 19 (Ad 19) and Ad 10. Antiserum adsorption experiments demonstrated the presence of three haemagglutinin antigens in the virus: One unique, another common to Ad 19, and a third common to Ad 10 and 19. In neutralization tests, the virus is distantly related to Ad 13, 30, 19, and 10. Despite this relationship, it is proposed to call the virus adenovirus 37, in agreement with current species definitions. It belongs to subgroup D of human adenoviruses. Antisera to the new virus show virtually no neutralization of other human adenovirus types. Only bay use of this antiserum it is in practice possible to avoid wrong or indefinite typing, which has often occurred in the past.

A new intermediate adenovirus type causing conjunctivitis.

A new adenovirus of intermediate type involved in conjunctivitis has been isolated. The virus is related to adenovirus types 13 and 30 by neutralization and to types 10 and 19 by hemagglutination inhibition. Since 1976 the agent has been causing sporadic cases of conjunctivitis in different parts of The Netherlands. Twenty-three cases have been established by virus isolation from the affected eyes. The symptoms of the disease range from epidemic keratoconjunctivitis to pharyngoconjunctival fever. Also, adenovirus type 13-30/10-19 has been isolated from the cervix uteri of four women in a series of 1,477 women with cervicitis.