Volume 14, Number 10—October 2008
Research
Prophylaxis after Exposure to Coxiella burnetii
Table 1
Input values used in the primary and secondary analyses of PEP efficacy*
Variable | Primary analysis (sensitivity analysis) | Sensitivity analyses |
References | |
---|---|---|---|---|
Less virulent | More virulent | |||
Exposure | (0.10, 0.25, 0.50, 1.00) | NA | NA | NA |
Efficacy of doxycycline PEP (8–12 d postexposure) | 0.82 (0.82–0.965) | 0.965 | 0.40 | (22,23) |
Efficacy of trimethoprim-sulfamethoxazole PEP (8–12 d postexposure) | 0.82 (0.40–0.965) | 0.965 | 0.40 | (21,24,25) |
Asymptomatic infection w/o PEP (all groups) | 0.50 | 0.65 | 0.40 | (1,3,5,7,8,26) |
Full recovery after acute (gp) | 0.74 | Residual (0.934) | Residual (0.576) | (7–9) |
Full recovery after acute illness (hr) | 0.28 | Residual (0.739) | Residual (0.076) | (7–9) |
Full recovery after acute illness (pw) | 0.08 | Residual (0.57) | Residual (0.02) | (7–9) |
Probability of hospitalization and recovery given acute illness (gp) | 0.04 | 0.01 | 0.05 | (5,7,27) |
Probability of hospitalization and recovery given acute illness (hr) | 0.01 | 0.01 | 0.05 | (5,7) |
Probability of hospitalization and recovery given acute illness (pw) | 0.01 | 0.01 | 0.02 | (5,7) |
Q fever fatigue syndrome (gp) | 0.20 | 0.05 | 0.30 | (1,10,16,28–30) |
Q fever fatigue syndrome (hr) | 0.30 | 0.05 | 0.20 | (1,10,16,28–30) |
Q fever fatigue syndrome (pw) | 0.03 | Residual (0.03) | Residual (0.04) | (1,10,16,17,28–30) |
Death from acute illness (gp) | 0.01 | 0.001 | 0.024 | (7,9–11) |
Death from acute illness (hr and pw) | 0.02 | 0.001 | 0.024 | (7,9–11) |
Chronic disease (gp) | 0.01 | 0.005 | 0.05 | (8,11,12,26,31) |
Chronic disease (hr) | 0.39 | 0.20 | 0.65 | (13,14,31) |
Chronic disease (pw) | 0.86 | 0.39 | 0.90 | (17) |
Endocarditis (all groups) | 0.65 | 0.60 | 0.90 | (1,7,8) |
Death from endocarditis (all groups) | 0.10 | 0.05 | 0.60 | (1,3,7,8,11,15,32) |
Death from other chronic diseases (all groups) | 0.30 | 0.05 | 0.60 | (9) |
Abortion or neonatal death | 0.38 | 0.25 | 0.56 | (8,14 ,17,21) |
Premature birth/low birth weight baby | 0.33 | 0.25 | 0.28 | (8,14,17,21) |
Healthy, unaffected baby | 0.29 | 0.50 | 0.16 | (8,14,17,21) |
*PEP, postexposure prophylaxis; NA, not applicable; gp, general population; hr, high-risk; pw, pregnant women. See online Appendix Table 1 for a detailed explanation of how the primary input values were selected.
References
- Health Protection Agency Center for Infections. Interim guidelines for action in the event of a deliberate release: Q fever. 2005. Version 1.4, revised 2007 Jun 18 [cited 2008 Aug 1]. Available from www.hpa.org.uk/webw/HPAweb&HPAwebStandard/HPAweb_C/1195733766607?p=1192454969657
- McQuiston JH, Childs JE. Q fever in humans and animals in the United States. Vector Borne Zoonotic Dis. 2002;2:179–91. DOIPubMedGoogle Scholar
- Kagawa FT, Wehner JH, Mohindra V. Q fever as a biological weapon. Semin Respir Infect. 2003;18:183–95.PubMedGoogle Scholar
- United States Army Medical Research Institute for Infectious Diseases. Medical management of biological casualities handbook. 5th ed. Frederick (MD): The Institute; 2004.
- Dupuis G, Petite J, Peter O, Vouilloz M. An important outbreak of human Q fever in a Swiss Alpine valley. Int J Epidemiol. 1987;16:282–7. DOIPubMedGoogle Scholar
- Franz DR, Jahrling PB, Friedlander AM, McClain DJ, Hoover DL, Bryne WR, Clinical recognition and management of patients exposed to biological warfare agents. JAMA. 1997;278:399–411. DOIPubMedGoogle Scholar
- Raoult D, Tissot-Dupont H, Foucault C, Gouvernet J, Fournier PE, Bernit E, Q fever 1985–1998. Clinical and epidemiologic features of 1,383 infections. Medicine (Baltimore). 2000;79:109–23. DOIPubMedGoogle Scholar
- Bossi P, Tegnell A, Baka A, van Loock F, Werner A, Hendriks J, Bichat guidelines for the clinical management of Q fever and bioterrorism-related Q fever. Euro Surveill. 2004;9:E19–20.PubMedGoogle Scholar
- Kermode M, Yong K, Hurley S, Marmion B. An economic evaluation of increased uptake in Q fever vaccination among meat and agricultural industry workers following implementation of the National Q Fever Management Program. Aust N Z J Public Health. 2003;27:390–8. DOIPubMedGoogle Scholar
- Fournier PE, Marrie TJ, Raoult D. Diagnosis of Q fever. J Clin Microbiol. 1998;36:1823–34.PubMedGoogle Scholar
- Cutler SJ, Paiba GA, Howells J, Morgan KL. Q fever—a forgotten disease? Lancet Infect Dis. 2002;2:717–8. DOIPubMedGoogle Scholar
- Fenollar F, Fournier PE, Carrieri MP, Habib G, Messana T, Raoult D. Risks factors and prevention of Q fever endocarditis. Clin Infect Dis. 2001;33:312–6. DOIPubMedGoogle Scholar
- Maltezou HC, Raoult D. Q fever in children. Lancet Infect Dis. 2002;2:686–91. DOIPubMedGoogle Scholar
- Raoult D, Houpikian P, Tissot DH, Riss JM. rditi-Djiane J, Brouqui P. Treatment of Q fever endocarditis: comparison of 2 regimens containing doxycycline and ofloxacin or hydroxychloroquine. Arch Intern Med. 1999;159:167–73. DOIPubMedGoogle Scholar
- Marmion BP, Storm PA, Ayres JG, Semendric L, Mathews L, Winslow W, Long-term persistence of Coxiella burnetii after acute primary Q fever. QJM. 2005;98:7–20. DOIPubMedGoogle Scholar
- Raoult D, Fenollar F, Stein A. Q fever during pregnancy: diagnosis, treatment, and follow-up. Arch Intern Med. 2002;162:701–4. DOIPubMedGoogle Scholar
- Centers for Disease Control and Prevention. Bioterrorism agents/diseases [cited 2006 Sep 9]. Available from http://www.bt.cdc.gov/agent/agentlist-category.asp#b
- Benenson AS, Tigertt WD. Studies on Q fever in man. Trans Assoc Am Physicians. 1956;69:98–104.PubMedGoogle Scholar
- Byrne WR. Chapter 26: Q fever. In: Zajtchuk R, editor. Textbook of military medicine: medical aspects of chemical and biological warfare. Washington: US Department of the Army, Surgeon General and the Borden Institute; 1997. p. 523–37.
- Carcopino X, Raoult D, Bretelle F, Boubli L, Stein A. Managing Q fever during pregnancy: the benefits of long-term cotrimoxazole therapy. Clin Infect Dis. 2007;45:548–55. DOIPubMedGoogle Scholar
- Haddix AC, Hillis SD, Kassler WJ. The cost effectiveness of azithromycin for Chlamydia trachomatis infections in women. Sex Transm Dis. 1995;22:274–80. DOIPubMedGoogle Scholar
- Nuovo J, Menikow J, Paliescheskey M, King J, Mowers R. Cost-effectiveness analysis of five different antibiotic regimens for the treatment of uncomplicated Chlamydia trachomatis cervicitis. J Am Board Fam Pract. 1995;8:7–16.PubMedGoogle Scholar
- Gomolin IH, Siami PF, Reuning-Scherer J, Haverstock DC, Heyd A. Efficacy and safety of ciprofloxacin oral suspension versus trimethoprim-sulfamethoxazole oral suspension for treatment of older women with acute urinary tract infection. J Am Geriatr Soc. 2001;49:1606–13. DOIPubMedGoogle Scholar
- DiRienzo AG, van Der HC, Finkelstein DM, Frame P, Bozzette SA, Tashima KT. Efficacy of trimethoprim-sulfamethoxazole for the prevention of bacterial infections in a randomized prophylaxis trial of patients with advanced HIV infection. AIDS Res Hum Retroviruses. 2002;18:89–94. DOIPubMedGoogle Scholar
- Franz DR, Jahrling PB, McClain DJ, Hoover DL, Byrne WR, Pavlin JA, Clinical recognition and management of patients exposed to biological warfare agents. Clin Lab Med. 2001;21:435–73.PubMedGoogle Scholar
- Ayres JG, Flint N, Smith EG, Post-infection fatigue syndrome following Q fever. QJM. 1998;91:105–23. DOIPubMedGoogle Scholar
- Marmion BP, Shannon M, Maddocks I, Storm P, Penttila I. Protracted debility and fatigue after acute Q fever. Lancet. 1996;347:977–8. DOIPubMedGoogle Scholar
- Smith DL, Ayres JG, Blair I, Burge PS, Carpenter MJ, Caul EO, A large Q fever outbreak in the West Midlands: clinical aspects. Respir Med. 1993;87:509–16. DOIPubMedGoogle Scholar
- Raoult D, Levy PY, Dupont HT, Chicheportiche C, Tamalet C, Gastaut JA, Q fever and HIV infection. AIDS. 1993;7:81–6. DOIPubMedGoogle Scholar
- Siegman-Igra Y, Kaufman O, Keysary A, Rzotkiewicz S, Shalit I. Q fever endocarditis in Israel and a worldwide review. Scand J Infect Dis. 1997;29:41–9.PubMedGoogle Scholar
- Fowler RA, Sanders GD, Bravata DM, Nouri B, Gastwirth JM, Peterson D, Cost-effectiveness of defending against bioterrorism: a comparison of vaccination and antibiotic prophylaxis against anthrax. Ann Intern Med. 2005;142:601–10.PubMedGoogle Scholar
- Sabbaj J, Hoagland VL, Shih WJ. Multiclinic comparative study of norfloxacin and trimethoprim-sulfamethoxazole for treatment of urinary tract infections. Antimicrob Agents Chemother. 1985;27:297–301.PubMedGoogle Scholar
- Talan DA, Stamm WE, Hooton TM, Moran DJ, Burke T, Travani A, Comparison of ciprofloxacin (7 days) and trimethoprim-sulfamethoxazole (14 days) for acute uncomplicated pyelonephritis in women: a randomized trial. JAMA. 2000;283:1583–90. DOIPubMedGoogle Scholar
- Kocak Z, Hatipoglu CA, Ertem G, Kinikli S, Tufan A, Irmak H, Trimethoprim-sulfamethoxazole induced rash and fatal hematologic disorders. J Infect. 2006;52:e49–52. DOIPubMedGoogle Scholar
- See S, Mumford JM. Trimethoprim/sulfamethoxazole-induced toxic epidermal necrolysis. Ann Pharmacother. 2001;35:694–7. DOIPubMedGoogle Scholar
- Fennelly KP, Davidow AL, Miller SL, Connell N, Ellner JJ. Airborne infection with Bacillus anthracis—from mills to mail. Emerg Infect Dis. 2004;10:996–1001.PubMedGoogle Scholar