Prevalence of Acute Q Fever Among High‐Risk Patients With Fever and Pneumonia Symptoms in Western Iran

<b>Background:</b> Q fever is a zoonotic bacterial infection with worldwide distribution. Based on seroepidemiology studies among the human population and also serological and molecular surveys of animals, Q fever is an endemic disease in Iran. However, the status of acute Q fever in many parts of Iran is still unknown. This study aimed to investigate acute Q fever among high-risk patients with fever and pneumonia symptoms in Western Iran. <b>Methods:</b> In this survey, 96 patients were included in the study in Kurdistan Province who had symptoms of suspected pneumonia or acute Q fever and epidemiological evidence for the risk of Q fever. From each individual, paired acute and convalescent serum samples were taken, and the elevation of the phase II IgG antibody titer against <i>Coxiella burnetii</i> was traced by ELISA. Also, molecular detection of <i>C. burnetii</i> was done in acute blood samples by real-time PCR. <b>Results:</b> Seven patients (7.3%) were diagnosed with acute Q fever who had seroconversion and a four-fold rise in the phase II IgG antibody titer against <i>C. burnetii</i> in their paired sera samples. Also, 22 of 89 (24.7%) individuals with a negative result for acute Q fever had a previous history of exposure to <i>C. burnetii</i>. There was a significant relationship between sheep husbandry and a previous history of exposure to <i>C. burnetii</i> (<i>p</i>=0.04). All molecular tests were negative. <b>Conclusion:</b> The results of this study showed that there are cases of acute Q fever in Western Iran, but it is not considered by the healthcare system or clinicians.