Although, cell-surface expression of E-cad remained stable in HLADR+/CD14+ cells, or significantly decreased in HLADR+/CD16+ cells from acute Q fever patients (p = 0.0004), it was significantly increased in both the HLADR+/CD14+ (p = 0.0039) and HLADR+/CD16+ (p = 0.0039) cell subpopulations from persistent Q fever patients. The gene discussed is CDH1; the disease is Q fever.