{
  "abstract": "Background\n\nQ fever is a zoonotic disease caused by Coxiella burnetii. In Italy, serologic evidence shows exposure in humans and livestock, but surveillance data are sparse, and underreporting is likely. We aimed to characterize Q fever-related hospitalizations in Italy during 2014-2023 and examine environmental risk correlates.Method\n\nWe conducted a nationwide retrospective study using the Italian National Hospital Discharge Database. Hospitalizations with ICD-9-CM code 083.0 as primary or secondary diagnosis were included. We calculated hospitalization rates by age, sex, and region and described clinical characteristics. We linked hospitalizations with climatic, livestock, and land-use data; for Sardinia, we fitted Bayesian spatial regression models including bovine, ovine, and caprine density, temperature, precipitation, and land use.Results\n\nWe identified 428 hospitalizations (67% male), corresponding to a rate of 0.07 per 100 000 person-years. Rates were highest in children and older adults. The overall case fatality ratio was 2.4%. The most frequent Q fever-related concomitant diagnosis was pneumonia. Sardinia had the highest case count and adjusted hospitalization rate, 7-fold the national rate (0.55 vs 0.07). Spatial models for Sardinia showed hotspots in the north of the island and a 12% increase in spatial hospitalization risk per 10 bovine heads/km² (adjusted relative risk 1.12, 95% credible interval 1.03-1.24).Conclusions\n\nQ fever causes an underrecognized burden of hospitalizations in Italy, with marked regional heterogeneity and a Sardinian hotspot associated with high cattle density areas. Clinical awareness, surveillance, and One Health interventions are warranted in high-risk areas.",
  "abstract_shown": true,
  "affiliations": [
    "Primary Care Research Unit, Madrid Health Service (SERMAS), Madrid, Spain.",
    "Biomedical Sciences and Public Health Doctorate Program, UNED - ENS Mixed Research Institute (IMIENS), Madrid, Spain.",
    "National Centre of Microbiology (ISCIII-CNM), Carlos III Health Institute, Madrid, Spain.",
    "Consortium for Biochemical Research in Infectious Diseases (CIBERINFEC), Madrid, Spain.",
    "Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy.",
    "European Commission, Joint Research Centre (JRC), Seville, Spain.",
    "Facultad de Veterinaria, Universidad Alfonso X el Sabio (UAX), Madrid, Spain.",
    "Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Italy.",
    "National Centre of Epidemiology (ISCIII-CNE), Carlos III Health Institute, Madrid, Spain.",
    "Consortium for Biochemical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Daniel Cifo",
      "orcid": "0000-0001-9339-3306"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "David González-Barrio",
      "orcid": "0000-0001-5083-8854"
    },
    {
      "affs": [
        4
      ],
      "name": "Alberto Mateo-Urdiales",
      "orcid": "0000-0002-0480-8723"
    },
    {
      "affs": [
        4
      ],
      "name": "Patrizio Pezzotti",
      "orcid": "0000-0002-0805-2927"
    },
    {
      "affs": [
        4
      ],
      "name": "Alessandra Ciervo",
      "orcid": "0000-0002-0664-9375"
    },
    {
      "affs": [
        5,
        6
      ],
      "name": "Angela Fanelli",
      "orcid": "0000-0002-8204-1230"
    },
    {
      "affs": [
        7
      ],
      "name": "Alda Natale",
      "orcid": "0000-0003-2104-4531"
    },
    {
      "affs": [
        8,
        9
      ],
      "name": "Diana Gómez-Barroso",
      "orcid": "0000-0001-7388-1767"
    },
    {
      "affs": [
        8,
        9
      ],
      "name": "Rosa M Estévez-Reboredo",
      "orcid": "0000-0001-5241-9725"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/67pn1s1xb9f6k.bib",
  "cited_by": 0,
  "doi": "10.1093/ofid/ofag667",
  "fulltext_url": "https://europepmc.org/articles/PMC13684407",
  "id": "67pn1s1xb9f6k",
  "issns": [
    "2328-8957"
  ],
  "landing_url": "https://europepmc.org/article/MED/42909273",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2405|Vector-borne infectious diseases"
    ]
  ],
  "openalex": "W7223087768",
  "pdf_url": "https://europepmc.org/articles/PMC13684407?pdf=render",
  "pmcid": "PMC13684407",
  "pmid": "42909273",
  "published": "2026-10-21",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/67pn1s1xb9f6k.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:10Z",
      "native_id": "MED:42909273",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42909273"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "openalex:2405|Vector-borne infectious diseases",
      "subfield": "microbiology"
    }
  ],
  "title": "Nationwide Q Fever Hospitalizations in Italy, 2014-2023: Evidence of Underrecognition and a Sardinian Hotspot.",
  "title_text": "Nationwide Q Fever Hospitalizations in Italy, 2014-2023: Evidence of Underrecognition and a Sardinian Hotspot.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:10Z",
  "url": "https://research.draconitic.com/paper/67pn1s1xb9f6k",
  "venue": "Open forum infectious diseases",
  "versions": []
}