Epidemiological scenario of Q fever hospitalized patients in the Spanish Health System: What's new

Objectives: The objective of this study was to assess the epidemiology and burden of Q fever (QF) in Spain. Methods: We designed a retrospective descriptive study using the minimum basic data set in patients admitted to hospitals of the National Health System between 1998 and 2015 with a diagnosis of Q fever (ICD-9: 083.0.). Results: We found 4214 hospitalized patients with a mean age (+/- SD) of 50.9 +/- 19.3 years. The male/female ratio was 3:1. The incidence rate was between 0.41 and 0.65 cases per 100,000 person-years over the 18-year period. The highest incidence of cases was from March to August (p = 0.024). 21.1% patients had pneumonia, 17.5% had liver disease, and only 3.2% had endocarditis. The average hospital stay was 13.8 days (+/- 12.8). A total of 117 (2.8%) patients died. The total mean cost of QF is approximately (sic)154,232,779 ((sic)36,600 +/- 139,422 per patient). Conclusions: QF is an important zoonosis in Spain with a stable incidence rate and high cost for hospitalization. Older patients have a more severe clinical picture and higher mortality, which can be decreased with early clinical suspicion. (C) 2019 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.