Time-course of antibody responses against Coxiella burnetii following acute Q fever

• Type of Material: Article
• Authors: Peter Teunis, Emory University; B Schimmer, National Institute for Public Health and the Environment; DW Notermans, National Institute for Public Health and the Environment; ACAP Leenders, Jeroen Bosch Hospital; PC Wever, Jeroen Bosch Hospital; MEE Kretzschmar, National Institute for Public Health and the Environment; PM Schneeberger, Jeroen Bosch Hospital
• Language: English
• Date: 2013-01-01
• Publisher: Cambridge University Press
• Publication Version: Final Published Version
• Copyright Statement: © Cambridge University Press 2012
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1017/S0950268812000404
• Title of Journal or Parent Work: Epidemiology and Infection
• Volume: 141
• Issue: 1
• Start Page: 62
• End Page: 73
• Keywords: Antibodies, Bacterial; Middle Aged; Immunoglobulin M; Antibody Formation; Aged, 80 and over; Adult; Bacterial Proteins; Young Adult; Female; Adolescent; Q Fever; Aged; Models, Theoretical; Child; Coxiella burnetii; Humans; Time Factors; Immunoglobulin G; Netherlands; Male; Fluorescent Antibody Technique, Indirect; Cohort Studies
• Research Categories: Health Sciences, Epidemiology; Health Sciences, Public Health

Abstract

SUMMARY Large outbreaks of Q fever in The Netherlands have provided a unique opportunity for studying longitudinal serum antibody responses in patients. Results are presented of a cohort of 344 patients with acute symptoms of Q fever with three or more serum samples per patient. In all these serum samples IgM and IgG against phase 1 and 2 Coxiella burnetii were measured by an immunofluorescence assay. A mathematical model of the dynamic interaction of serum antibodies and pathogens was used in a mixed model framework to quantitatively analyse responses to C. burnetii infection. Responses show strong heterogeneity, with individual serum antibody responses widely different in magnitude and shape. Features of the response, peak titre and decay rate, are used to characterize the diversity of the observed responses. Binary mixture analysis of IgG peak levels (phases 1 and 2) reveals a class of patients with high IgG peak titres that decay slowly and may represent potential chronic cases. When combining the results of mixture analysis into an odds score, it is concluded that not only high IgG phase 1 may be predictive for chronic Q fever, but also that high IgG phase 2 may aid in detecting such putative chronic cases. Copyright © Cambridge University Press 2012.