Lack of knowledge among health professionals troubles the diagnostic of Q fever

Although the amount of positive samples for Q fever may seem inexpressive, the correlation health professionals made with dengue fever at clinical diagnostic draws attention

One of the great difficulties of the Brazilian health system is the not inclusion, especially during outbreaks, of other diagnostic hypothesis. This is the case of Q fever, a disease many time reported as dengue fever, for its similar clinical manifestations. The problem is, that if incorrectly diagnosed, this disease can cause severe complications and pneumonia and damage the liver and heart tissues.

“The lack of knowledge of information about the possibility of incidence [of the Q fever] among health professionals is the greatest problem”, acknowledges Dr Elba Lemos, head of the Hantavirus and Rickett diseases Laboratory at the Oswaldo Cruz Institute (IOC/Fiocruz).

She alerts a physician should have a high suspicion level, based on epidemiological data, to identify the disease that could strike in an acute or chronic forms. If correctly treated in the first three days of the acute form, the clinical manifestations, as fever, can cease within 72 hours.

The specialist also says it is important to perform a differential diagnostic and always consider the hypothesis of other causing agents, and not only Q fever. “Especially in those situations where we can find a large number of suspicious cases of Dengue without confirmations and ‘atypical’ cases. Within this same context, only to reinforce, it is important to report that all death cases for spotted fever in Rio de Janeiro, for example, were initially suspected for dengue”, she said.

A research on the matter was conducted by Fiocruz among 272 patients held for dengue. From these, 166 were confirmed for dengue and nine were diagnosed as having Q fever. One of the patients was confirmed by both diseases. All entries were reported in a hospital in Itaboraí, Rio de Janeiro State, from March 2013 to October 2014.

“Although the amount of positive samples for Q fever may seem inexpressive, the correlation the health professionals made with dengue fever at the moment of diagnosis draws attention”, said Dr Elba.

The most common infection form for humans is by inhaling particles of the Coxiella burnetii bacteria from the air, which is extremely resistant to heath, drought and several chemicals, becoming able to resist for long periods of time in the environment. The disease can also be transmitted by contact with milk, faeces, urine, vaginal fluid and semen from cattle, sheep, goats, dogs, cats and other domestic animals, when infected, what relates its incidence with rural environments.

Investigations of the disease are recent

Identified for the first time in Brazil in the 1950s and despite not being common in the large cities, the Q fever has been studied in the South-eastern states, although rare, according to Dr Elba.

She regrets the information about the disease in Brazil, currently, are from published articles and research projects. This way, there are no precise data able to and the understanding of Q fever in the health system.

“Our need to investigate and research is very clear in order to gather a little more information”, said the researcher while revealing her expectation to identify and treat acute and chronic cases of Q fever with a greater understanding and inclusion in differential treatment. With this, according to Doctor Elba, it will be possible to evaluate the real frequency of the disease in the Country.…