Re: Q fever CFS

[Guest guest]

Yah- there's great research about Q fever and HCQ/Doxy.

I used that combo based for Lyme based on the Q fever research.

Barb

>

> I think this subject may have been discussed long ago at another

site.

> Apparantly ~20% of people with acute Q fever end up sick.

>

> This review hits several very interesting points and I was glad to

> have read it:

>

> http://qjmed.oxfordjournals.org/cgi/reprint/91/8/549

>

[Guest guest]

Intern Med. 2004 Jan;43(1):49-54. Related Articles, Links

Comment in:

Intern Med. 2004 Jan;43(1):1-2.

Improvement of chronic nonspecific symptoms by long-term minocycline

treatment in Japanese patients with iella burnetii infection

considered to have post-Q fever fatigue syndrome.

Arashima Y, Kato K, Komiya T, Kumasaka K, Matsukawa Y, Murakami M,

Takahashi K, Ikeda T, Arakawa Y.

Department of Laboratory Medicine, Nihon University School of

Medicine, Tokyo,

OBJECTIVE: To address the presence of post-Q fever fatigue syndrome

(post-QFS) in Japan, and to evaluate the efficacy of minocycline for

this condition. PATIENTS AND METHODS: In 20 iella burnetii (C.

burnetii) seropositive patients with persistent nonspecific symptoms

including general fatigue, low-grade fever, myalgia and arthralgia,

changes in subjective symptoms, C. burnetii antibody titers and C.

burnetii DNA were evaluated after antibiotic treatment. RESULTS:

After treatment mainly with minocycline (100 mg/day for 3 months),

the clinical picture improved in all 20 patients as evidenced by

decreases in body temperature (13/17), general fatigue (20/20) and

headache (9/12). The mean performance status (PS) score improved from

5.0 to 1.8 (p<0.01). All 7 who had been positive for C. burnetii DNA,

became negative together with an improvement in subjective symptoms.

Indirect immunofluorescence tests demonstrated 6 of the 20 patients

to be positive for C. burnetii IgM antibody to phase II antigen

(1:32), and 18 to be positive for IgG antibody (1:128, 1:256).

Antibody titers of both IgM (6/6, 1:16) and IgG (18/18, 1:16)

decreased markedly after treatment. CONCLUSION: These results of an

open label study in Japan suggest that minocycline administration is

useful for improving chronic nonspecific symptoms considered to be

post-Q fever fatigue syndrome caused by C. burnetii infection.

PMID: 14964579 [PubMed - indexed for MEDLINE]

=====================

QJM. 2005 Jan;98(1):7-20. Related Articles, Links

Erratum in:

QJM. 2005 Mar;98(3):237.

Comment in:

QJM. 2005 Aug;98(8):615-7; author reply 617-20.

Long-term persistence of iella burnetii after acute primary Q

fever.

Marmion BP, Storm PA, Ayres JG, Semendric L, Mathews L, Winslow W,

Turra M, RJ.

Q Fever Research Group, Infectious Diseases LAboratories, IMVS and

Hanson Institute, Adelaide, South Australia.

chris.nikolaou@...

BACKGROUND: Long-term persistence of C. burnetii in infected animals

was established in the 1950s and 60s, but the implications for human

Q fever are not fully explored. AIM: To compare the prevalence of

markers of infection in a cohort of Q fever patients in Australia (up

to 5 years after infection) with those in the 1989 Birmingham cohort

(12 years after infection). DESIGN: Case follow-up study. METHODS: C.

burnetii was tested for by: (i) antibodies to Phase 1 and 2 antigens

in the three immunoglobulin classes; (ii) detection of DNA in bone

marrow and peripheral blood mononuclear cells by PCR assays directed

against several different targets in the genome; and (iii) attempts

to isolate coxiellas in cell culture or mice from PCR-positive

samples. Amplicon specificity was verified by fluorometric probing

and by sequencing. Cross-contamination was excluded by extensive use

of non-template controls, and in particular by the use of certain

IS1111a target sequences. RESULTS: Irrespective of clinical state,

both groups remained seropositive, principally exhibiting medium

levels of IgG antibody against C. burnetii Phase 2 antigen. C.

burnetii genomic DNA was detected by PCR in 65% of bone marrow

aspirates from Australian patients and approximately 88% of

Birmingham patients. No coxiella were isolated from PCR positive

samples. DISCUSSION: We propose a provisional model for persistence.

In Q fever without sequelae, the process is largely confined to the

bone marrow. In Q fever fatigue syndrome (QFS), it is modulated by

the patient's immunogenetic background to give higher levels of

coxiella genomes in bone marrow and increased shedding into the

peripheral blood. In Q fever endocarditis, late pregnancy, or during

iatrogenic or other immunosuppression, the multiplication cycle is

prolonged, and a potential source of live organisms.

PMID: 15625349 [PubMed - indexed for MEDLINE]