{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T00:13:57Z","timestamp":1793060037636,"version":"4.5.0"},"reference-count":15,"publisher":"American Society for Microbiology","issue":"2","license":[{"start":{"date-parts":[[2010,2,1]],"date-time":"2010-02-01T00:00:00Z","timestamp":1264982400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Clin Vaccine Immunol"],"published-print":{"date-parts":[[2010,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    The world's largest Q fever outbreak is ongoing in The Netherlands with around 3,000 confirmed cases since the first half of 2007. Increased awareness has resulted in early referral of patients for diagnostics. An important drawback to serological diagnosis of acute Q fever is the lag phase in antibody response. Therefore, we evaluated the performance of a real-time PCR for detection of\n                    <jats:italic>Coxiella burnetii<\/jats:italic>\n                    DNA using serum samples from patients with acute Q fever. PCR, targeting IS\n                    <jats:italic>1111<\/jats:italic>\n                    , was retrospectively performed on acute-phase and follow-up convalescent-phase serum samples from 65 patients with acute Q fever as diagnosed by immunofluorescence assay. The results obtained by PCR were related to disease stage as defined by subsequent appearance of phase II IgM, phase II IgG, phase I IgM, and phase I IgG (IgM-II, IgG-II, IgM-I, and IgG-I, respectively) antibodies and time since onset of disease. In addition, we analyzed seronegative acute-phase serum samples from patients with inconclusive Q fever serology, because no convalescent-phase serum samples were available. PCR was scored positive in 49\/50 (98%) seronegative sera, 9\/10 (90%) sera with isolated IgM-II antibodies, 3\/13 (23%) sera with IgM-II\/IgG-II antibodies, 2\/41 (5%) sera with IgM-II\/IgG-II\/IgM-I antibodies, 0\/15 (0%) sera with IgM-II\/IgG-II\/IgM-I\/IgG-I antibodies, and 0\/1 (0%) serum sample with IgM-II\/IgG-II\/IgG-I antibodies. The latest time point after onset of disease in which\n                    <jats:italic>C. burnetii<\/jats:italic>\n                    DNA could be detected was at day 17. In patients with inconclusive Q fever serology, PCR was positive in 5\/50 (10%) cases. We conclude that real-time PCR with serum samples is indispensable for early diagnosis of acute Q fever.\n                    <jats:italic>C. burnetii<\/jats:italic>\n                    DNA becomes undetectable in serum as the serological response develops.\n                  <\/jats:p>","DOI":"10.1128\/cvi.00454-09","type":"journal-article","created":{"date-parts":[[2009,12,23]],"date-time":"2009-12-23T22:12:28Z","timestamp":1261606348000},"page":"286-290","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":218,"title":["Real-Time PCR with Serum Samples Is Indispensable for Early Diagnosis of Acute Q Fever"],"prefix":"10.1128","volume":"17","author":[{"given":"Peter M.","family":"Schneeberger","sequence":"first","affiliation":[{"name":"Department of Medical Microbiology and Infection Control"},{"name":"Department of Molecular Diagnostics, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands"},{"name":"Department of Medical Microbiology and Immunology, St. Antonius Hospital, Nieuwegein, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirjam H. A.","family":"Hermans","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Infection Control"},{"name":"Department of Molecular Diagnostics, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands"},{"name":"Department of Medical Microbiology and Immunology, St. Antonius Hospital, Nieuwegein, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik J.","family":"van Hannen","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Infection Control"},{"name":"Department of Molecular Diagnostics, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands"},{"name":"Department of Medical Microbiology and Immunology, St. Antonius Hospital, Nieuwegein, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeroen J. A.","family":"Schellekens","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Infection Control"},{"name":"Department of Molecular Diagnostics, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands"},{"name":"Department of Medical Microbiology and Immunology, St. Antonius Hospital, Nieuwegein, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander C. A. P.","family":"Leenders","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Infection Control"},{"name":"Department of Molecular Diagnostics, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands"},{"name":"Department of Medical Microbiology and Immunology, St. Antonius Hospital, Nieuwegein, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter C.","family":"Wever","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Infection Control"},{"name":"Department of Molecular Diagnostics, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands"},{"name":"Department of Medical Microbiology and Immunology, St. Antonius Hospital, Nieuwegein, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","first-page":"1407","volume":"47","year":"2009","unstructured":"de Wit, N. C. J., C. P. C. de Jager, J. C. E. Meekelenkamp, M. Schoorl, A. B. Gageldonk-Lafeber, A. C. A. P. Leenders, et al. 2009. Markers of infection in inpatients and outpatiens with acute Q-fever. Clin. Chem. Lab. Med.47:1407-1409.","journal-title":"Clin. Chem. Lab. Med."},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1128\/cdli.1.2.189-196.1994"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.41.11.5094-5098.2003"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.45.12.3644-3646.2001"},{"key":"e_1_3_2_6_2","first-page":"E070809.2","volume":"12","year":"2007","unstructured":"Karagiannis, I., G. Morroy, A. Rietveld, A. M. Horrevorts, M. Hamans, P. Francken, et al. 2007. Q fever outbreak in the Netherlands: a preliminary report. Euro Surveill.12:E070809.2.","journal-title":"Euro Surveill."},{"key":"e_1_3_2_7_2","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1196\/annals.1374.111","volume":"1078","year":"2006","unstructured":"Klee, S. R., H. Ellerbrok, J. Tyczka, T. Franz, and B. Appel. 2006. Evaluation of a real-time PCR assay to detect Coxiella burnetii. Ann. N. Y. Acad. Sci.1078:563-565.","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"e_1_3_2_8_2","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1183\/09031936.03.00099703","volume":"21","year":"2003","unstructured":"Marrie, T. J. 2003. Coxiella burnetii pneumonia. Eur. Respir. J.21:713-719.","journal-title":"Eur. Respir. J."},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.12.4.518"},{"key":"e_1_3_2_10_2","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1016\/S0140-6736(06)68266-4","volume":"367","year":"2006","unstructured":"Parker, N. R., J. H. Barralet, and A. M. Bell. 2006. Q fever. Lancet367:679-688.","journal-title":"Lancet"},{"key":"e_1_3_2_11_2","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/S1473-3099(05)70052-9","volume":"5","year":"2005","unstructured":"Raoult, D., T. Marrie, and J. Mege. 2005. Natural history and pathophysiology of Q fever. Lancet Infect. Dis.5:219-226.","journal-title":"Lancet Infect. Dis."},{"key":"e_1_3_2_12_2","first-page":"18939","volume":"13","year":"2008","unstructured":"Schimmer, B., G. Morroy, F. Dijkstra, P. M. Schneeberger, G. Weers-Pothoff, A. Timen, et al. 2008. Large ongoing Q fever outbreak in the south of The Netherlands, 2008. Euro Surveill.13:18939.","journal-title":"Euro Surveill."},{"key":"e_1_3_2_13_2","first-page":"19210","volume":"14","year":"2009","unstructured":"Schimmer, B., F. Dijkstra, P. Vellema, P. M. Schneeberger, V. Hackert, R. ter Schegget, et al. 2009. Sustained intensive transmission of Q fever in the south of the Netherlands, 2009. Euro Surveill.14:19210.","journal-title":"Euro Surveill."},{"key":"e_1_3_2_14_2","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1196\/annals.1374.112","volume":"1078","year":"2006","unstructured":"Turra, M., G. Chang, D. Whybrow, G. Higgins, and M. Qiao. 2006. 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