{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T19:49:57Z","timestamp":1780084197573,"version":"3.54.0"},"reference-count":33,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2016,12,14]],"date-time":"2016-12-14T00:00:00Z","timestamp":1481673600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["MOST 104\u20102314\u2010B\u2010650\u2010004"],"award-info":[{"award-number":["MOST 104\u20102314\u2010B\u2010650\u2010004"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004738","name":"E-Da Hospital","doi-asserted-by":"publisher","award":["EDAHP103001"],"award-info":[{"award-number":["EDAHP103001"]}],"id":[{"id":"10.13039\/501100004738","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004694","name":"Kaohsiung Medical University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004694","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Zoonoses and Public Health"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>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\u00a0109 suspected QF cases. QF cases were mainly distributed in the southern and Kaohsiung\u2013Pingtung regions but rarely in the eastern region. Compared to non\u2010QF cases, QF cases had significantly higher percentages of males (88.7 versus 66.2%) and high\u2010risk 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\u2010risk 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\u2010risk occupations and history of animal contact, and co\u2010infection of QF with these diseases should be considered.<\/jats:p>","DOI":"10.1111\/zph.12333","type":"journal-article","created":{"date-parts":[[2016,12,15]],"date-time":"2016-12-15T13:51:24Z","timestamp":1481809884000},"page":"517-526","source":"Crossref","is-referenced-by-count":15,"title":["The Epidemiology and Characteristics of Q fever and Co\u2010infections with Scrub Typhus, Murine Typhus or Leptospirosis in Taiwan: A Nationwide Database Study"],"prefix":"10.1111","volume":"64","author":[{"given":"C.\u2010H.","family":"Lai","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases Department of Internal Medicine and Division of Infection Control Laboratory E\u2010Da Hospital and I\u2010Shou University Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.","family":"Sun","sequence":"additional","affiliation":[{"name":"Infection Control Department Pao\u2010Chien Hospital Pingtung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.\u2010H.","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Internal Medicine Kaohsiung Chang Gung Memorial Hospital Kaohsiung Taiwan"},{"name":"College of Medicine Chang Gung University Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.\u2010N.","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Internal Medicine and Department of Critical Care Medicine E\u2010Da Hospital Kaohsiung Taiwan"},{"name":"School of Medicine College of Medicine I\u2010Shou University Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.\u2010H.","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Veterinary Medicine College of Veterinary Medicine National Pingtung University of Science and Technology Pingtung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.\u2010S.","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Veterinary Medicine College of Veterinary Medicine National Pingtung University of Science and Technology Pingtung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.\u2010Y.","family":"Chang","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Pingtung Christian Hospital Pingtung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.\u2010F.","family":"Tsai","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Internal Medicine Kaohsiung Chang Gung Memorial Hospital Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.\u2010C.","family":"Chang","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Internal Medicine Kaohsiung Chang Gung Memorial Hospital Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.\u2010H.","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Internal Medicine and Division of Infection Control Laboratory E\u2010Da Hospital and I\u2010Shou University Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.\u2010H.","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Internal Medicine Kaohsiung Medical University Hospital Kaohsiung Taiwan"},{"name":"School of Medicine Graduate Institute of Medicine Sepsis Research Center Center for Dengue Fever Control and Research Kaohsiung Medical University Kaohsiung Taiwan"},{"name":"Department of Biological Science and Technology College of Biological Science and Technology National Chiao Tung University HsinChu Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,12,14]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"Statistics of Communicable Diseases and Surveillance Report, Republic of China 2007","author":"Centers for Disease Control","year":"2008"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.2012.11-0465"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.14-0503"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1574-695X.2011.00876.x"},{"key":"e_1_2_9_6_1","doi-asserted-by":"crossref","first-page":"108","DOI":"10.4269\/ajtmh.2006.74.108","article-title":"Causes of fever in adults on the Thai\u2010Myanmar border","volume":"74","author":"Ellis R. D.","year":"2006","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268814002593"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid1703.100882"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/zph.12218"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/160.2.354"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.phrp.2012.12.006"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1086\/520680"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/00365540701558722"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid1510.090007"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0929-6646(09)60080-2"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2008.07.020"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0077640"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0102808"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0095810"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2112.141997"},{"key":"e_1_2_9_21_1","doi-asserted-by":"crossref","first-page":"525","DOI":"10.4269\/ajtmh.2007.77.525","article-title":"Coinfection with leptospirosis and scrub typhus in Taiwanese patients","volume":"77","author":"Lee C. H.","year":"2007","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.12.4.518"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.2006.75.1.0750036"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2015.04.024"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ956"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir411"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2011.03562.x"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(05)70052-9"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid1704.101562"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268810002268"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1086\/426440"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2003.131111"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.2003.68.89"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmii.2011.09.015"}],"container-title":["Zoonoses and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fzph.12333","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fzph.12333","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/zph.12333","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T13:56:07Z","timestamp":1695477367000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/zph.12333"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,12,14]]},"references-count":33,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2017,11]]}},"alternative-id":["10.1111\/zph.12333"],"URL":"https:\/\/doi.org\/10.1111\/zph.12333","archive":["Portico"],"relation":{},"ISSN":["1863-1959","1863-2378"],"issn-type":[{"value":"1863-1959","type":"print"},{"value":"1863-2378","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,12,14]]}}}