Diagnosis of acute Q fever with emphasis on enzyme-linked immunosorbent assay and nested polymerase chain reaction regarding the time of serum collection

Diagn Microbiol Infect Dis. 2010 Oct;68(2):110-6. doi: 10.1016/j.diagmicrobio.2010.06.001.


A commercially available enzyme-linked immunosorbent assay (ELISA) (Virion/Serion [Wuerzburg, Germany]), an indirect fluorescent antibody test (IFAT) (BIOS/Focus [Cypress, CA]), and a nested polymerase chain reaction (PCR) were explored for diagnosis of acute Q fever in reference to time of serum collection. Serum samples of 22 patients with acute Q fever collected around the fifth day of illness were included. A sensitivity of 30% by ELISA and 80% by IFAT (P = 0.1) was found for the first 5 days of illness and 92% by ELISA and 83% by IFAT during the sixth and eleventh day. PCR revealed a positive result in 8 cases (36%) with 6 cases deriving from the first 5 days of illness. We conclude that ELISA aids especially in the diagnosis of Q fever after 5 days of illness. The benefit of PCR as an additional tool to ELISA was especially evident in the early days of serum sampling.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Bacterial / blood
  • Base Sequence
  • Coxiella burnetii / immunology
  • Coxiella burnetii / isolation & purification
  • Enzyme-Linked Immunosorbent Assay*
  • Female
  • Fluorescent Antibody Technique, Indirect
  • Germany / epidemiology
  • Humans
  • Immunoglobulin G / blood
  • Immunoglobulin M / blood
  • Lipopolysaccharides / immunology
  • Male
  • Middle Aged
  • Polymerase Chain Reaction*
  • Q Fever / diagnosis*
  • Q Fever / epidemiology
  • Sensitivity and Specificity
  • Time Factors


  • Antibodies, Bacterial
  • Immunoglobulin G
  • Immunoglobulin M
  • Lipopolysaccharides