{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T06:48:04Z","timestamp":1781678884906,"version":"3.54.5"},"reference-count":45,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2013,3,29]],"date-time":"2013-03-29T00:00:00Z","timestamp":1364515200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2013,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Chronic <jats:styled-content style=\"fixed-case\">Q<\/jats:styled-content>\u2010fever, a condition with high morbidity and mortality, may develop after an acute infection with <jats:italic><jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>oxiella burnetii<\/jats:italic> (acute <jats:styled-content style=\"fixed-case\">Q<\/jats:styled-content>\u2010fever). Several strategies have been suggested for early detection of chronic <jats:styled-content style=\"fixed-case\">Q<\/jats:styled-content>\u2010fever, focusing on follow\u2010up of known acute Q\u2010fever patients and detection of asymptomatic or unknown chronic infections. As there is no international standard or consensus, the aims of this study were to summarise the available literature and assess the evidence for different follow\u2010up and screening strategies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>We conducted a systematic review by searching PubMed and Embase. Twenty articles were included, of which fourteen only provided information on follow\u2010up of known acute Q\u2010fever cases, four presented data on identification of previously unknown <jats:italic><jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>.\u00a0burnetii<\/jats:italic> infections, and two had information on both topics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The conversion rate of acute to chronic Q\u2010fever ranged from 0 to 5\u00b70%. Most studies advised serological follow\u2010up of acute Q\u2010fever patients, but without consistent advice on optimum timing and duration. The recommendation to use echocardiography for all acute Q\u2010fever patients to detect valvular damage remains controversial. Screening of high\u2010risk patients in an outbreak setting is advised by studies investigating such strategy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There is sufficient evidence to support serological follow\u2010up of all known acute Q\u2010fever patients at least once during the first year following the acute infection, and more frequently in patients with known risk factors for chronic disease, such as heart valve\u2010 or vascular prosthesis. Screening of risk groups should be considered in outbreaks of Q\u2010fever.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eci.12073","type":"journal-article","created":{"date-parts":[[2013,3,5]],"date-time":"2013-03-05T00:12:06Z","timestamp":1362442326000},"page":"616-639","source":"Crossref","is-referenced-by-count":19,"title":["Strategies for early detection of chronic <scp>Q<\/scp>\u2010fever: a systematic review"],"prefix":"10.1111","volume":"43","author":[{"given":"Cornelia C. 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