The Epidemiology and Characteristics of Q fever and Co‐infections with Scrub Typhus, Murine Typhus or Leptospirosis in Taiwan: A Nationwide Database Study
Summary Q fever (QF) is a worldwide zoonosis associated with outbreaks. Only a few nationwide studies regarding the surveillance and epidemiology of human QF have been reported. Although QF is endemic in Taiwan, a nationwide database investigation of the epidemiology and characteristics of QF and it...
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| Veröffentlicht in: | Zoonoses and public health 2017-11, Vol.64 (7), p.517-526 |
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| creator | Lai, C.‐H. Sun, W. Lee, C.‐H. Lin, J.‐N. Liao, M.‐H. Liu, S.‐S. Chang, T.‐Y. Tsai, K.‐F. Chang, Y.‐C. Lin, H.‐H. Chen, Y.‐H. |
| description | Summary
Q fever (QF) is a worldwide zoonosis associated with outbreaks. Only a few nationwide studies regarding the surveillance and epidemiology of human QF have been reported. Although QF is endemic in Taiwan, a nationwide database investigation of the epidemiology and characteristics of QF and its associations with scrub typhus (ST), murine typhus (MT) and leptospirosis (LS) has never been reported. We analysed nationwide databases of suspected QF, ST, MT and LS cases from October 2007 to December 2014 obtained from the Centers for Disease Control, Taiwan. A total of 468 (4.2%) QF cases were identified among 11 109 suspected QF cases. QF cases were mainly distributed in the southern and Kaohsiung–Pingtung regions but rarely in the eastern region. Compared to non‐QF cases, QF cases had significantly higher percentages of males (88.7 versus 66.2%) and high‐risk occupations (farming, animal husbandry or veterinary medicine) (16.2 versus 10.5%). But the percentages of specific animal contact, including cattle (0.6 versus 0.8%) and goats (0.9 versus 1.0%), were low in both. The majority of suspected QF cases (89.4%) were simultaneously suspected with ST, MT or LS, and the combinations of suspected diseases differed between regions. The number of suspected QF cases from the eastern region decreased since 2009, which was not observed in other regions. A total of 1420 (12.8%) cases had confirmed diseases, including QF (453, 4.1%), QF+ST (7, 0.06%), QF+MT (4, 0.04%), QF+LS (4, 0.04%), MT (186, 1.7%), ST (545, 4.9%), ST+LS (11, 0.1%) and LS (210, 1.9%). Compared to cases of unknown disease, QF cases had larger percentages of high‐risk occupations (16.2 versus 9.6%) but similar histories of animal contact (29.8 versus 25.1%). QF is an endemic disease in southern Taiwan. It is difficult to differentiate QF from ST, MT or LS only by high‐risk occupations and history of animal contact, and co‐infection of QF with these diseases should be considered. |
| doi_str_mv | 10.1111/zph.12333 |
| format | Article |
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Q fever (QF) is a worldwide zoonosis associated with outbreaks. Only a few nationwide studies regarding the surveillance and epidemiology of human QF have been reported. Although QF is endemic in Taiwan, a nationwide database investigation of the epidemiology and characteristics of QF and its associations with scrub typhus (ST), murine typhus (MT) and leptospirosis (LS) has never been reported. We analysed nationwide databases of suspected QF, ST, MT and LS cases from October 2007 to December 2014 obtained from the Centers for Disease Control, Taiwan. A total of 468 (4.2%) QF cases were identified among 11 109 suspected QF cases. QF cases were mainly distributed in the southern and Kaohsiung–Pingtung regions but rarely in the eastern region. Compared to non‐QF cases, QF cases had significantly higher percentages of males (88.7 versus 66.2%) and high‐risk occupations (farming, animal husbandry or veterinary medicine) (16.2 versus 10.5%). But the percentages of specific animal contact, including cattle (0.6 versus 0.8%) and goats (0.9 versus 1.0%), were low in both. The majority of suspected QF cases (89.4%) were simultaneously suspected with ST, MT or LS, and the combinations of suspected diseases differed between regions. The number of suspected QF cases from the eastern region decreased since 2009, which was not observed in other regions. A total of 1420 (12.8%) cases had confirmed diseases, including QF (453, 4.1%), QF+ST (7, 0.06%), QF+MT (4, 0.04%), QF+LS (4, 0.04%), MT (186, 1.7%), ST (545, 4.9%), ST+LS (11, 0.1%) and LS (210, 1.9%). Compared to cases of unknown disease, QF cases had larger percentages of high‐risk occupations (16.2 versus 9.6%) but similar histories of animal contact (29.8 versus 25.1%). QF is an endemic disease in southern Taiwan. It is difficult to differentiate QF from ST, MT or LS only by high‐risk occupations and history of animal contact, and co‐infection of QF with these diseases should be considered.</description><identifier>ISSN: 1863-1959</identifier><identifier>EISSN: 1863-2378</identifier><identifier>DOI: 10.1111/zph.12333</identifier><identifier>PMID: 27966835</identifier><language>eng</language><publisher>Germany: Blackwell Publishing Ltd</publisher><subject>Adult ; Aged ; Animal husbandry ; Animals ; Coinfection - epidemiology ; Coinfection - microbiology ; co‐infection ; Databases, Factual ; Disease ; Disease control ; Diseases ; Epidemiology ; Farming ; Female ; Fever ; Goats ; History ; Humans ; Infections ; Leptospirosis ; Leptospirosis - complications ; Leptospirosis - epidemiology ; Male ; Males ; Middle Aged ; Murine typhus ; Occupations ; Outbreaks ; Q fever ; Q Fever - complications ; Regions ; Risk ; Scrub typhus ; Scrub Typhus - complications ; Scrub Typhus - epidemiology ; Taiwan ; Taiwan - epidemiology ; Typhus ; Typhus, Endemic Flea-Borne - complications ; Typhus, Endemic Flea-Borne - epidemiology ; Veterinary medicine ; Zoonoses</subject><ispartof>Zoonoses and public health, 2017-11, Vol.64 (7), p.517-526</ispartof><rights>2016 Blackwell Verlag GmbH</rights><rights>2016 Blackwell Verlag GmbH.</rights><rights>Copyright © 2017 Blackwell Verlag GmbH</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3533-1b8467e53f08c3a4be7cdf58d4974c657fb1305dda5205c3c3affe07c1f9e5973</citedby><cites>FETCH-LOGICAL-c3533-1b8467e53f08c3a4be7cdf58d4974c657fb1305dda5205c3c3affe07c1f9e5973</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fzph.12333$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fzph.12333$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,777,781,1412,27905,27906,45555,45556</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27966835$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lai, C.‐H.</creatorcontrib><creatorcontrib>Sun, W.</creatorcontrib><creatorcontrib>Lee, C.‐H.</creatorcontrib><creatorcontrib>Lin, J.‐N.</creatorcontrib><creatorcontrib>Liao, M.‐H.</creatorcontrib><creatorcontrib>Liu, S.‐S.</creatorcontrib><creatorcontrib>Chang, T.‐Y.</creatorcontrib><creatorcontrib>Tsai, K.‐F.</creatorcontrib><creatorcontrib>Chang, Y.‐C.</creatorcontrib><creatorcontrib>Lin, H.‐H.</creatorcontrib><creatorcontrib>Chen, Y.‐H.</creatorcontrib><title>The Epidemiology and Characteristics of Q fever and Co‐infections with Scrub Typhus, Murine Typhus or Leptospirosis in Taiwan: A Nationwide Database Study</title><title>Zoonoses and public health</title><addtitle>Zoonoses Public Health</addtitle><description>Summary
Q fever (QF) is a worldwide zoonosis associated with outbreaks. Only a few nationwide studies regarding the surveillance and epidemiology of human QF have been reported. Although QF is endemic in Taiwan, a nationwide database investigation of the epidemiology and characteristics of QF and its associations with scrub typhus (ST), murine typhus (MT) and leptospirosis (LS) has never been reported. We analysed nationwide databases of suspected QF, ST, MT and LS cases from October 2007 to December 2014 obtained from the Centers for Disease Control, Taiwan. A total of 468 (4.2%) QF cases were identified among 11 109 suspected QF cases. QF cases were mainly distributed in the southern and Kaohsiung–Pingtung regions but rarely in the eastern region. Compared to non‐QF cases, QF cases had significantly higher percentages of males (88.7 versus 66.2%) and high‐risk occupations (farming, animal husbandry or veterinary medicine) (16.2 versus 10.5%). But the percentages of specific animal contact, including cattle (0.6 versus 0.8%) and goats (0.9 versus 1.0%), were low in both. The majority of suspected QF cases (89.4%) were simultaneously suspected with ST, MT or LS, and the combinations of suspected diseases differed between regions. The number of suspected QF cases from the eastern region decreased since 2009, which was not observed in other regions. A total of 1420 (12.8%) cases had confirmed diseases, including QF (453, 4.1%), QF+ST (7, 0.06%), QF+MT (4, 0.04%), QF+LS (4, 0.04%), MT (186, 1.7%), ST (545, 4.9%), ST+LS (11, 0.1%) and LS (210, 1.9%). Compared to cases of unknown disease, QF cases had larger percentages of high‐risk occupations (16.2 versus 9.6%) but similar histories of animal contact (29.8 versus 25.1%). QF is an endemic disease in southern Taiwan. It is difficult to differentiate QF from ST, MT or LS only by high‐risk occupations and history of animal contact, and co‐infection of QF with these diseases should be considered.</description><subject>Adult</subject><subject>Aged</subject><subject>Animal husbandry</subject><subject>Animals</subject><subject>Coinfection - epidemiology</subject><subject>Coinfection - microbiology</subject><subject>co‐infection</subject><subject>Databases, Factual</subject><subject>Disease</subject><subject>Disease control</subject><subject>Diseases</subject><subject>Epidemiology</subject><subject>Farming</subject><subject>Female</subject><subject>Fever</subject><subject>Goats</subject><subject>History</subject><subject>Humans</subject><subject>Infections</subject><subject>Leptospirosis</subject><subject>Leptospirosis - complications</subject><subject>Leptospirosis - epidemiology</subject><subject>Male</subject><subject>Males</subject><subject>Middle Aged</subject><subject>Murine typhus</subject><subject>Occupations</subject><subject>Outbreaks</subject><subject>Q fever</subject><subject>Q Fever - complications</subject><subject>Regions</subject><subject>Risk</subject><subject>Scrub typhus</subject><subject>Scrub Typhus - complications</subject><subject>Scrub Typhus - epidemiology</subject><subject>Taiwan</subject><subject>Taiwan - epidemiology</subject><subject>Typhus</subject><subject>Typhus, Endemic Flea-Borne - complications</subject><subject>Typhus, Endemic Flea-Borne - epidemiology</subject><subject>Veterinary medicine</subject><subject>Zoonoses</subject><issn>1863-1959</issn><issn>1863-2378</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc1u1DAURi1ERcvAghdAV2IDEtPacRwn3VVDoUjDnzps2ESOc01cZeJgJ4zCikfgAfp0fZK6ZGCBhDe25aOj7_oj5Amjxyyukx99c8wSzvk9csTyjC8TLvP7-zMrRHFIHoZwRakQBZUPyGEiiyzLuTgi15sG4by3NW6ta93XCVRXw6pRXukBvQ2D1QGcgU9g8Dv6-dnd_PxlO4N6sK4LsLNDA5fajxVspr4Zw0t4N3rb4f4KzsMa-8GF3noXbADbwUbZnepO4QzeqzvNLmaAV2pQlQoIl8NYT4_IgVFtwMf7fUE-vz7frC6W6w9v3q7O1kvNBY8TVnmaSRTc0FxzlVYodW1EXqeFTHUmpKkYp6KulUio0DwyxiCVmpkCRSH5gjyfvb1330YMQ7m1QWPbqg7dGEqWiySTkmVpRJ_9g1650XcxXRk_mvIsoTHTgryYKR3HDR5N2Xu7VX4qGS3vKitjZeXvyiL7dG8cqy3Wf8k_HUXgZAZ2tsXp_6byy8eLWXkL2ROisA</recordid><startdate>201711</startdate><enddate>201711</enddate><creator>Lai, C.‐H.</creator><creator>Sun, W.</creator><creator>Lee, C.‐H.</creator><creator>Lin, J.‐N.</creator><creator>Liao, M.‐H.</creator><creator>Liu, S.‐S.</creator><creator>Chang, T.‐Y.</creator><creator>Tsai, K.‐F.</creator><creator>Chang, Y.‐C.</creator><creator>Lin, H.‐H.</creator><creator>Chen, Y.‐H.</creator><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7T2</scope><scope>7U7</scope><scope>7U9</scope><scope>C1K</scope><scope>F1W</scope><scope>H94</scope><scope>H95</scope><scope>K9.</scope><scope>L.G</scope><scope>M7N</scope><scope>7X8</scope></search><sort><creationdate>201711</creationdate><title>The Epidemiology and Characteristics of Q fever and Co‐infections with Scrub Typhus, Murine Typhus or Leptospirosis in Taiwan: A Nationwide Database Study</title><author>Lai, C.‐H. ; Sun, W. ; Lee, C.‐H. ; Lin, J.‐N. ; Liao, M.‐H. ; Liu, S.‐S. ; Chang, T.‐Y. ; Tsai, K.‐F. ; Chang, Y.‐C. ; Lin, H.‐H. ; Chen, Y.‐H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3533-1b8467e53f08c3a4be7cdf58d4974c657fb1305dda5205c3c3affe07c1f9e5973</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Animal husbandry</topic><topic>Animals</topic><topic>Coinfection - epidemiology</topic><topic>Coinfection - microbiology</topic><topic>co‐infection</topic><topic>Databases, Factual</topic><topic>Disease</topic><topic>Disease control</topic><topic>Diseases</topic><topic>Epidemiology</topic><topic>Farming</topic><topic>Female</topic><topic>Fever</topic><topic>Goats</topic><topic>History</topic><topic>Humans</topic><topic>Infections</topic><topic>Leptospirosis</topic><topic>Leptospirosis - complications</topic><topic>Leptospirosis - epidemiology</topic><topic>Male</topic><topic>Males</topic><topic>Middle Aged</topic><topic>Murine typhus</topic><topic>Occupations</topic><topic>Outbreaks</topic><topic>Q fever</topic><topic>Q Fever - complications</topic><topic>Regions</topic><topic>Risk</topic><topic>Scrub typhus</topic><topic>Scrub Typhus - complications</topic><topic>Scrub Typhus - epidemiology</topic><topic>Taiwan</topic><topic>Taiwan - epidemiology</topic><topic>Typhus</topic><topic>Typhus, Endemic Flea-Borne - complications</topic><topic>Typhus, Endemic Flea-Borne - epidemiology</topic><topic>Veterinary medicine</topic><topic>Zoonoses</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lai, C.‐H.</creatorcontrib><creatorcontrib>Sun, W.</creatorcontrib><creatorcontrib>Lee, C.‐H.</creatorcontrib><creatorcontrib>Lin, J.‐N.</creatorcontrib><creatorcontrib>Liao, M.‐H.</creatorcontrib><creatorcontrib>Liu, S.‐S.</creatorcontrib><creatorcontrib>Chang, T.‐Y.</creatorcontrib><creatorcontrib>Tsai, K.‐F.</creatorcontrib><creatorcontrib>Chang, Y.‐C.</creatorcontrib><creatorcontrib>Lin, H.‐H.</creatorcontrib><creatorcontrib>Chen, Y.‐H.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ASFA: Aquatic Sciences and Fisheries Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Aquatic Science & Fisheries Abstracts (ASFA) 1: Biological Sciences & Living Resources</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Aquatic Science & Fisheries Abstracts (ASFA) Professional</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>MEDLINE - Academic</collection><jtitle>Zoonoses and public health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lai, C.‐H.</au><au>Sun, W.</au><au>Lee, C.‐H.</au><au>Lin, J.‐N.</au><au>Liao, M.‐H.</au><au>Liu, S.‐S.</au><au>Chang, T.‐Y.</au><au>Tsai, K.‐F.</au><au>Chang, Y.‐C.</au><au>Lin, H.‐H.</au><au>Chen, Y.‐H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Epidemiology and Characteristics of Q fever and Co‐infections with Scrub Typhus, Murine Typhus or Leptospirosis in Taiwan: A Nationwide Database Study</atitle><jtitle>Zoonoses and public health</jtitle><addtitle>Zoonoses Public Health</addtitle><date>2017-11</date><risdate>2017</risdate><volume>64</volume><issue>7</issue><spage>517</spage><epage>526</epage><pages>517-526</pages><issn>1863-1959</issn><eissn>1863-2378</eissn><abstract>Summary
Q fever (QF) is a worldwide zoonosis associated with outbreaks. Only a few nationwide studies regarding the surveillance and epidemiology of human QF have been reported. Although QF is endemic in Taiwan, a nationwide database investigation of the epidemiology and characteristics of QF and its associations with scrub typhus (ST), murine typhus (MT) and leptospirosis (LS) has never been reported. We analysed nationwide databases of suspected QF, ST, MT and LS cases from October 2007 to December 2014 obtained from the Centers for Disease Control, Taiwan. A total of 468 (4.2%) QF cases were identified among 11 109 suspected QF cases. QF cases were mainly distributed in the southern and Kaohsiung–Pingtung regions but rarely in the eastern region. Compared to non‐QF cases, QF cases had significantly higher percentages of males (88.7 versus 66.2%) and high‐risk occupations (farming, animal husbandry or veterinary medicine) (16.2 versus 10.5%). But the percentages of specific animal contact, including cattle (0.6 versus 0.8%) and goats (0.9 versus 1.0%), were low in both. The majority of suspected QF cases (89.4%) were simultaneously suspected with ST, MT or LS, and the combinations of suspected diseases differed between regions. The number of suspected QF cases from the eastern region decreased since 2009, which was not observed in other regions. A total of 1420 (12.8%) cases had confirmed diseases, including QF (453, 4.1%), QF+ST (7, 0.06%), QF+MT (4, 0.04%), QF+LS (4, 0.04%), MT (186, 1.7%), ST (545, 4.9%), ST+LS (11, 0.1%) and LS (210, 1.9%). Compared to cases of unknown disease, QF cases had larger percentages of high‐risk occupations (16.2 versus 9.6%) but similar histories of animal contact (29.8 versus 25.1%). QF is an endemic disease in southern Taiwan. It is difficult to differentiate QF from ST, MT or LS only by high‐risk occupations and history of animal contact, and co‐infection of QF with these diseases should be considered.</abstract><cop>Germany</cop><pub>Blackwell Publishing Ltd</pub><pmid>27966835</pmid><doi>10.1111/zph.12333</doi><tpages>10</tpages></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adult Aged Animal husbandry Animals Coinfection - epidemiology Coinfection - microbiology co‐infection Databases, Factual Disease Disease control Diseases Epidemiology Farming Female Fever Goats History Humans Infections Leptospirosis Leptospirosis - complications Leptospirosis - epidemiology Male Males Middle Aged Murine typhus Occupations Outbreaks Q fever Q Fever - complications Regions Risk Scrub typhus Scrub Typhus - complications Scrub Typhus - epidemiology Taiwan Taiwan - epidemiology Typhus Typhus, Endemic Flea-Borne - complications Typhus, Endemic Flea-Borne - epidemiology Veterinary medicine Zoonoses |
| title | The Epidemiology and Characteristics of Q fever and Co‐infections with Scrub Typhus, Murine Typhus or Leptospirosis in Taiwan: A Nationwide Database Study |
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