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Since this first description, knowledge about this pathogen and its associated infections has increased dramatically. We review here all the progress made over the last 20 years on this topic.\n                      <jats:named-content content-type=\"genus-species\">C. burnetii<\/jats:named-content>\n                      is classically a strict intracellular, Gram-negative bacterium. However, a major step in the characterization of this pathogen was achieved by the establishment of its axenic culture.\n                      <jats:named-content content-type=\"genus-species\">C. burnetii<\/jats:named-content>\n                      infects a wide range of animals, from arthropods to humans. The genetic determinants of virulence are now better known, thanks to the achievement of determining the genome sequences of several strains of this species and comparative genomic analyses. Q fever can be found worldwide, but the epidemiological features of this disease vary according to the geographic area considered, including situations where it is endemic or hyperendemic, and the occurrence of large epidemic outbreaks. In recent years, a major breakthrough in the understanding of the natural history of human infection with\n                      <jats:named-content content-type=\"genus-species\">C. burnetii<\/jats:named-content>\n                      was the breaking of the old dichotomy between \u201cacute\u201d and \u201cchronic\u201d Q fever. The clinical presentation of\n                      <jats:named-content content-type=\"genus-species\">C. burnetii<\/jats:named-content>\n                      infection depends on both the virulence of the infecting\n                      <jats:named-content content-type=\"genus-species\">C. burnetii<\/jats:named-content>\n                      strain and specific risks factors in the infected patient. Moreover, no persistent infection can exist without a focus of infection. This paradigm change should allow better diagnosis and management of primary infection and long-term complications in patients with\n                      <jats:named-content content-type=\"genus-species\">C. burnetii<\/jats:named-content>\n                      infection.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/cmr.00045-16","type":"journal-article","created":{"date-parts":[[2016,11,17]],"date-time":"2016-11-17T20:10:27Z","timestamp":1479413427000},"page":"115-190","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":909,"title":["From Q Fever to Coxiella burnetii Infection: a Paradigm Change"],"prefix":"10.1128","volume":"30","author":[{"given":"Carole","family":"Eldin","sequence":"first","affiliation":[{"name":"URMITE, UMR CNRS 7278, IRD 198, INSERM U1095, Facult\u00e9 de M\u00e9decine, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cl\u00e9a","family":"M\u00e9lenotte","sequence":"additional","affiliation":[{"name":"URMITE, UMR CNRS 7278, IRD 198, INSERM U1095, Facult\u00e9 de M\u00e9decine, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oleg","family":"Mediannikov","sequence":"additional","affiliation":[{"name":"URMITE, UMR CNRS 7278, IRD 198, INSERM U1095, Facult\u00e9 de M\u00e9decine, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Ghigo","sequence":"additional","affiliation":[{"name":"URMITE, UMR CNRS 7278, IRD 198, INSERM U1095, Facult\u00e9 de M\u00e9decine, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthieu","family":"Million","sequence":"additional","affiliation":[{"name":"URMITE, UMR CNRS 7278, IRD 198, INSERM U1095, Facult\u00e9 de M\u00e9decine, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Edouard","sequence":"additional","affiliation":[{"name":"URMITE, UMR CNRS 7278, IRD 198, INSERM U1095, Facult\u00e9 de M\u00e9decine, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Louis","family":"Mege","sequence":"additional","affiliation":[{"name":"URMITE, UMR CNRS 7278, IRD 198, INSERM U1095, Facult\u00e9 de M\u00e9decine, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max","family":"Maurin","sequence":"additional","affiliation":[{"name":"Institut de Biologie et de Pathologie, CHU de Grenoble, Grenoble, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Didier","family":"Raoult","sequence":"additional","affiliation":[{"name":"URMITE, UMR CNRS 7278, IRD 198, INSERM U1095, Facult\u00e9 de M\u00e9decine, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmaid.2012.11.001"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2014.05.029"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.14-0282"},{"key":"e_1_3_2_5_2","first-page":"382","article-title":"Q fever in the Netherlands from 2007 to 2010","volume":"68","author":"Delsing CE","year":"2010","unstructured":"Delsing CE KullbergBJ Bleeker-RoversCP. 2010. 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