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Osbron CA, Lawson C, Hanna N, Koehler HS, Goodman AG. Caspase-8 activity mediates TNFα production and restricts Coxiella burnetii replication during murine macrophage infection. Infect Immun 2024; 92:e0005324. [PMID: 38837340 PMCID: PMC11238558 DOI: 10.1128/iai.00053-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 05/14/2024] [Indexed: 06/07/2024] Open
Abstract
Coxiella burnetii is an obligate intracellular bacteria that causes the global zoonotic disease Q Fever. Treatment options for chronic infection are limited, and the development of novel therapeutic strategies requires a greater understanding of how C. burnetii interacts with immune signaling. Cell death responses are known to be manipulated by C. burnetii, but the role of caspase-8, a central regulator of multiple cell death pathways, has not been investigated. In this research, we studied bacterial manipulation of caspase-8 signaling and the significance of caspase-8 to C. burnetii infection, examining bacterial replication, cell death induction, and cytokine signaling. We measured caspase, RIPK, and MLKL activation in C. burnetii-infected tumor necrosis factor alpha (TNFα)/cycloheximide-treated THP-1 macrophage-like cells and TNFα/ZVAD-treated L929 cells to assess apoptosis and necroptosis signaling. Additionally, we measured C. burnetii replication, cell death, and TNFα induction over 12 days in RIPK1-kinase-dead, RIPK3-kinase-dead, or RIPK3-kinase-dead-caspase-8-/- bone marrow-derived macrophages (BMDMs) to understand the significance of caspase-8 and RIPK1/3 during infection. We found that caspase-8 is inhibited by C. burnetii, coinciding with inhibition of apoptosis and increased susceptibility to necroptosis. Furthermore, C. burnetii replication was increased in BMDMs lacking caspase-8, but not in those lacking RIPK1/3 kinase activity, corresponding with decreased TNFα production and reduced cell death. As TNFα is associated with the control of C. burnetii, this lack of a TNFα response may allow for the unchecked bacterial growth we saw in caspase-8-/- BMDMs. This research identifies and explores caspase-8 as a key regulator of C. burnetii infection, opening novel therapeutic doors.
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Affiliation(s)
- Chelsea A. Osbron
- School of Molecular Biosciences, College of Veterinary Medicine, Washington State University, Pullman, Washington, USA
| | - Crystal Lawson
- School of Molecular Biosciences, College of Veterinary Medicine, Washington State University, Pullman, Washington, USA
| | - Nolan Hanna
- School of Molecular Biosciences, College of Veterinary Medicine, Washington State University, Pullman, Washington, USA
| | - Heather S. Koehler
- School of Molecular Biosciences, College of Veterinary Medicine, Washington State University, Pullman, Washington, USA
| | - Alan G. Goodman
- School of Molecular Biosciences, College of Veterinary Medicine, Washington State University, Pullman, Washington, USA
- Paul G. Allen School for Global Health, College of Veterinary Medicine, Washington State University, Pullman, Washington, USA
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2
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Kamau MW, Witte C, Goosen W, Mutinda M, Villinger J, Getange D, Khogali R, von Fricken ME, Fèvre EM, Zimmerman D, Linton YM, Miller M. Comparison of test performance of a conventional PCR and two field-friendly tests to detect Coxiella burnetii DNA in ticks using Bayesian latent class analysis. Front Vet Sci 2024; 11:1396714. [PMID: 38962707 PMCID: PMC11220323 DOI: 10.3389/fvets.2024.1396714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 06/10/2024] [Indexed: 07/05/2024] Open
Abstract
Introduction Coxiella burnetii (C. burnetii)-infected livestock and wildlife have been epidemiologically linked to human Q fever outbreaks. Despite this growing zoonotic threat, knowledge of coxiellosis in wild animals remains limited, and studies to understand their epidemiologic role are needed. In C. burnetii-endemic areas, ticks have been reported to harbor and spread C. burnetii and may serve as indicators of risk of infection in wild animal habitats. Therefore, the aim of this study was to compare molecular techniques for detecting C. burnetii DNA in ticks. Methods In total, 169 ticks from wild animals and cattle in wildlife conservancies in northern Kenya were screened for C. burnetii DNA using a conventional PCR (cPCR) and two field-friendly techniques: Biomeme's C. burnetii qPCR Go-strips (Biomeme) and a new C. burnetii PCR high-resolution melt (PCR-HRM) analysis assay. Results were evaluated, in the absence of a gold standard test, using Bayesian latent class analysis (BLCA) to characterize the proportion of C. burnetii positive ticks and estimate sensitivity (Se) and specificity (Sp) of the three tests. Results The final BLCA model included main effects and estimated that PCR-HRM had the highest Se (86%; 95% credible interval: 56-99%), followed by the Biomeme (Se = 57%; 95% credible interval: 34-90%), with the estimated Se of the cPCR being the lowest (24%, 95% credible interval: 10-47%). Specificity estimates for all three assays ranged from 94 to 98%. Based on the model, an estimated 16% of ticks had C. burnetii DNA present. Discussion These results reflect the endemicity of C. burnetii in northern Kenya and show the promise of the PCR-HRM assay for C. burnetii surveillance in ticks. Further studies using ticks and wild animal samples will enhance understanding of the epidemiological role of ticks in Q fever.
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Affiliation(s)
- Maureen W. Kamau
- Mpala Research Centre, Nanyuki, Kenya
- Division of Molecular Biology and Human Genetics, Department of Science, and Innovation – National Research Foundation Centre of Excellence for Biomedical Tuberculosis Research, Faculty of Medicine and Health Sciences, South African Medical Research Council Centre for Tuberculosis Research, Stellenbosch University, Stellenbosch, South Africa
- Global Health Program, Smithsonian National Zoo Conservation Biology Institute, Washington, DC, United States
| | - Carmel Witte
- Division of Molecular Biology and Human Genetics, Department of Science, and Innovation – National Research Foundation Centre of Excellence for Biomedical Tuberculosis Research, Faculty of Medicine and Health Sciences, South African Medical Research Council Centre for Tuberculosis Research, Stellenbosch University, Stellenbosch, South Africa
- The Center for Wildlife Studies, South Freeport, ME, United States
| | - Wynand Goosen
- Division of Molecular Biology and Human Genetics, Department of Science, and Innovation – National Research Foundation Centre of Excellence for Biomedical Tuberculosis Research, Faculty of Medicine and Health Sciences, South African Medical Research Council Centre for Tuberculosis Research, Stellenbosch University, Stellenbosch, South Africa
| | | | - Jandouwe Villinger
- International Centre of Insect Physiology and Ecology (ICIPE), Nairobi, Kenya
| | - Dennis Getange
- International Centre of Insect Physiology and Ecology (ICIPE), Nairobi, Kenya
| | - Rua Khogali
- International Centre of Insect Physiology and Ecology (ICIPE), Nairobi, Kenya
| | - Michael E. von Fricken
- College of Public Health and Health Professionals, Department of Environmental and Global Health University of Florida, Gainesville, FL, United States
| | - Eric Maurice Fèvre
- International Livestock Research Institute, Nairobi, Kenya
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Dawn Zimmerman
- Veterinary Initiative for Endangered Wildlife, Bozeman, MT, United States
| | - Yvonne-Marie Linton
- Walter Reed Biosystematics Unit (WRBU) Smithsonian Institution Museum Support Center, Suitland, MD, United States
- One Health Branch, Walter Reed Army Institute of Research (WRAIR), Silver Spring, MD, United States
- Department of Entomology, Smithsonian Institution, National Museum of Natural History (NMNH), Washington, DC, United States
| | - Michele Miller
- Division of Molecular Biology and Human Genetics, Department of Science, and Innovation – National Research Foundation Centre of Excellence for Biomedical Tuberculosis Research, Faculty of Medicine and Health Sciences, South African Medical Research Council Centre for Tuberculosis Research, Stellenbosch University, Stellenbosch, South Africa
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3
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Tan T, Heller J, Firestone S, Stevenson M, Wiethoelter A. A systematic review of global Q fever outbreaks. One Health 2024; 18:100667. [PMID: 39010957 PMCID: PMC11247264 DOI: 10.1016/j.onehlt.2023.100667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 12/15/2023] [Accepted: 12/18/2023] [Indexed: 07/17/2024] Open
Abstract
Q fever is an important zoonotic disease with a worldwide distribution. Outbreaks of Q fever are unpredictable and can affect many people, resulting in a significant burden on public health. The epidemiology of the disease is complex and substantial efforts are required to understand and control Q fever outbreaks. The purpose of this study was to systematically review previous investigations of outbreaks and summarise important epidemiological features. This will improve knowledge of the factors driving the occurrence of Q fever outbreaks and assist decision makers in implementing mitigation strategies. A search of four electronic databases identified 94 eligible articles published in English between 1990 and 2022 that related to 81 unique human Q fever outbreaks. Outbreaks were reported across 27 countries and mostly in industrialised nations. Documented Q fever outbreaks varied in size (2 to 4107 cases) and duration (4 to 1722 days). Most outbreaks (43/81) occurred in communities outside of traditional at-risk occupational settings and were frequently associated with living in proximity to livestock holdings (21/43). Indirect transmission via environmental contamination, windborne spread or fomites was the most common route of infection, particularly for large community outbreaks. Exposure to ruminants and/or their products were confirmed as the principal risk factors for infection, with sheep (28/81) as the most common source followed by goats (12/81) and cattle (7/81). Cooperation and data sharing between human and animal health authorities is valuable for outbreak investigation and control using public health and veterinary measures, but this multisectoral approach was seldom applied (14/81). Increased awareness of Q fever among health professionals and the public may facilitate the early detection of emerging outbreaks that are due to non-occupational, environmental exposures in the community.
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Affiliation(s)
- Tabita Tan
- Gulbali Institute, School of Agricultural, Environmental and Veterinary Sciences, Charles Sturt University, Wagga Wagga, NSW 2678, Australia
| | - Jane Heller
- Gulbali Institute, School of Agricultural, Environmental and Veterinary Sciences, Charles Sturt University, Wagga Wagga, NSW 2678, Australia
| | - Simon Firestone
- Melbourne Veterinary School, Faculty of Science, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Mark Stevenson
- Melbourne Veterinary School, Faculty of Science, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Anke Wiethoelter
- Melbourne Veterinary School, Faculty of Science, The University of Melbourne, Parkville, VIC 3010, Australia
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Miller HK, Branan M, Priestley RA, Álvarez-Alonso R, Cherry C, Smith C, Urie NJ, Wiedenheft A, Bliss C, Marshall K, Kersh GJ. Coxiella burnetii in domestic doe goats in the United States, 2019-2020. Front Vet Sci 2024; 11:1393296. [PMID: 38774910 PMCID: PMC11107086 DOI: 10.3389/fvets.2024.1393296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 04/12/2024] [Indexed: 05/24/2024] Open
Abstract
Coxiella burnetii is a bacterial pathogen capable of causing serious disease in humans and abortions in goats. Infected goats can shed C. burnetii through urine, feces, and parturient byproducts, which can lead to infections in humans when the bacteria are inhaled. Goats are important C. burnetii reservoirs as evidenced by goat-related outbreaks across the world. To better understand the current landscape of C. burnetii infection in the domestic goat population, 4,121 vaginal swabs from 388 operations across the United States were analyzed for the presence of C. burnetii by IS1111 PCR as part of the United States Department of Agriculture, Animal Plant Health Inspection Service, Veterinary Services' National Animal Health Monitoring System Goats 2019 Study. In total, 1.5% (61/4121) of swabs representing 10.3% (40/388) (weighted estimate of 7.8, 95% CI 4.4-13.5) of operations were positive for C. burnetii DNA. The quantity of C. burnetii on positive swabs was low with an average Ct of 37.9. Factors associated with greater odds of testing positive included suspected Q fever in the herd in the previous 3 years, the presence of wild deer or elk on the operation, and the utilization of hormones for estrus synchronization. Factors associated with reduced odds of testing positive include the presence of kittens and treatment of herds with high tannin concentrate plants, diatomaceous earth, and tetrahydropyrimidines. In vitro analysis demonstrated an inhibitory effect of the tetrahydropyrimidine, pyrantel pamoate, on the growth of C. burnetii in axenic media as low as 1 μg per mL. The final multivariable logistic regression modeling identified the presence of wild predators on the operation or adjacent property (OR = 9.0, 95% CI 1.3-61.6, p value = 0.0248) as a risk factor for C. burnetii infection.
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Affiliation(s)
- Halie K. Miller
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Matthew Branan
- United States Department of Agriculture, Animal and Plant Health Inspection Service, Center for Epidemiology and Animal Health, National Animal Health Monitoring System, Fort Collins, CO, United States
| | - Rachael A. Priestley
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Raquel Álvarez-Alonso
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, GA, United States
- Animal Health Department, NEIKER-Instituto Vasco de Investigación y Desarrollo Agrario, Derio, Spain
| | - Cara Cherry
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Cody Smith
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Natalie J. Urie
- United States Department of Agriculture, Animal and Plant Health Inspection Service, Center for Epidemiology and Animal Health, National Animal Health Monitoring System, Fort Collins, CO, United States
| | - Alyson Wiedenheft
- United States Department of Agriculture, Animal and Plant Health Inspection Service, Center for Epidemiology and Animal Health, National Animal Health Monitoring System, Fort Collins, CO, United States
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, United States
| | - Clayton Bliss
- United States Department of Agriculture, Animal and Plant Health Inspection Service, Center for Epidemiology and Animal Health, National Animal Health Monitoring System, Fort Collins, CO, United States
| | - Katherine Marshall
- United States Department of Agriculture, Animal and Plant Health Inspection Service, Center for Epidemiology and Animal Health, National Animal Health Monitoring System, Fort Collins, CO, United States
| | - Gilbert J. Kersh
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, GA, United States
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5
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Osbron CA, Lawson C, Hanna N, Koehler HS, Goodman AG. Caspase-8 activity mediates TNFα production and restricts Coxiella burnetii replication during murine macrophage infection. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.02.02.578698. [PMID: 38352389 PMCID: PMC10862817 DOI: 10.1101/2024.02.02.578698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
Coxiella burnetii is an obligate intracellular bacteria which causes the global zoonotic disease Q Fever. Treatment options for infection are limited, and development of novel therapeutic strategies requires a greater understanding of how C. burnetii interacts with immune signaling. Cell death responses are known to be manipulated by C. burnetii, but the role of caspase-8, a central regulator of multiple cell death pathways, has not been investigated. In this research, we studied bacterial manipulation of caspase-8 signaling and the significance of caspase-8 to C. burnetii infection, examining bacterial replication, cell death induction, and cytokine signaling. We measured caspase, RIPK, and MLKL activation in C. burnetii-infected TNFα/CHX-treated THP-1 macrophage-like cells and TNFα/ZVAD-treated L929 cells to assess apoptosis and necroptosis signaling. Additionally, we measured C. burnetii replication, cell death, and TNFα induction over 12 days in RIPK1-kinase-dead, RIPK3-kinase-dead, or RIPK3-kinase-dead-caspase-8-/- BMDMs to understand the significance of caspase-8 and RIPK1/3 during infection. We found that caspase-8 is inhibited by C. burnetii, coinciding with inhibition of apoptosis and increased susceptibility to necroptosis. Furthermore, C. burnetii replication was increased in BMDMs lacking caspase-8, but not in those lacking RIPK1/3 kinase activity, corresponding with decreased TNFα production and reduced cell death. As TNFα is associated with the control of C. burnetii, this lack of a TNFα response may allow for the unchecked bacterial growth we saw in caspase-8-/- BMDMs. This research identifies and explores caspase-8 as a key regulator of C. burnetii infection, opening novel therapeutic doors.
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Affiliation(s)
- Chelsea A. Osbron
- School of Molecular Biosciences, College of Veterinary Medicine, Washington State University, Pullman, WA, USA
| | - Crystal Lawson
- School of Molecular Biosciences, College of Veterinary Medicine, Washington State University, Pullman, WA, USA
| | - Nolan Hanna
- School of Molecular Biosciences, College of Veterinary Medicine, Washington State University, Pullman, WA, USA
| | - Heather S. Koehler
- School of Molecular Biosciences, College of Veterinary Medicine, Washington State University, Pullman, WA, USA
| | - Alan G. Goodman
- School of Molecular Biosciences, College of Veterinary Medicine, Washington State University, Pullman, WA, USA
- Paul G. Allen School for Global Health, College of Veterinary Medicine, Washington State University, Pullman, WA, USA
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6
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Ramirez A, Felgner J, Jain A, Jan S, Albin TJ, Badten AJ, Gregory AE, Nakajima R, Jasinskas A, Felgner PL, Burkhardt AM, Davies DH, Wang SW. Engineering Protein Nanoparticles Functionalized with an Immunodominant Coxiella burnetii Antigen to Generate a Q Fever Vaccine. Bioconjug Chem 2023; 34:1653-1666. [PMID: 37682243 PMCID: PMC10515490 DOI: 10.1021/acs.bioconjchem.3c00317] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 08/25/2023] [Indexed: 09/09/2023]
Abstract
Coxiella burnetii is the causative agent of Q fever, for which there is yet to be an FDA-approved vaccine. This bacterial pathogen has both extra- and intracellular stages in its life cycle, and therefore both a cell-mediated (i.e., T lymphocyte) and humoral (i.e., antibody) immune response are necessary for effective eradication of this pathogen. However, most proposed vaccines elicit strong responses to only one mechanism of adaptive immunity, and some can either cause reactogenicity or lack sufficient immunogenicity. In this work, we aim to apply a nanoparticle-based platform toward producing both antibody and T cell immune responses against C. burnetii. We investigated three approaches for conjugation of the immunodominant outer membrane protein antigen (CBU1910) to the E2 nanoparticle to obtain a consistent antigen orientation: direct genetic fusion, high affinity tris-NTA-Ni conjugation to polyhistidine-tagged CBU1910, and the SpyTag/SpyCatcher (ST/SC) system. Overall, we found that the ST/SC approach yielded nanoparticles loaded with the highest number of antigens while maintaining stability, enabling formulations that could simultaneously co-deliver the protein antigen (CBU1910) and adjuvant (CpG1826) on one nanoparticle (CBU1910-CpG-E2). Using protein microarray analyses, we found that after immunization, antigen-bound nanoparticle formulations elicited significantly higher antigen-specific IgG responses than soluble CBU1910 alone and produced more balanced IgG1/IgG2c ratios. Although T cell recall assays from these protein antigen formulations did not show significant increases in antigen-specific IFN-γ production compared to soluble CBU1910 alone, nanoparticles conjugated with a CD4 peptide epitope from CBU1910 generated elevated T cell responses in mice to both the CBU1910 peptide epitope and whole CBU1910 protein. These investigations highlight the feasibility of conjugating antigens to nanoparticles for tuning and improving both humoral- and cell-mediated adaptive immunity against C. burnetii.
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Affiliation(s)
- Aaron Ramirez
- Department
of Chemical and Biomolecular Engineering, Vaccine Research and Development
Center, Department of Physiology and Biophysics, Department of Chemistry, Department of Biomedical
Engineering, Chao Family Comprehensive Cancer Center, and Institute for Immunology, University of California, Irvine, California 92697, United States
| | - Jiin Felgner
- Department
of Chemical and Biomolecular Engineering, Vaccine Research and Development
Center, Department of Physiology and Biophysics, Department of Chemistry, Department of Biomedical
Engineering, Chao Family Comprehensive Cancer Center, and Institute for Immunology, University of California, Irvine, California 92697, United States
| | - Aarti Jain
- Department
of Chemical and Biomolecular Engineering, Vaccine Research and Development
Center, Department of Physiology and Biophysics, Department of Chemistry, Department of Biomedical
Engineering, Chao Family Comprehensive Cancer Center, and Institute for Immunology, University of California, Irvine, California 92697, United States
| | - Sharon Jan
- Department
of Chemical and Biomolecular Engineering, Vaccine Research and Development
Center, Department of Physiology and Biophysics, Department of Chemistry, Department of Biomedical
Engineering, Chao Family Comprehensive Cancer Center, and Institute for Immunology, University of California, Irvine, California 92697, United States
| | - Tyler J. Albin
- Department
of Chemical and Biomolecular Engineering, Vaccine Research and Development
Center, Department of Physiology and Biophysics, Department of Chemistry, Department of Biomedical
Engineering, Chao Family Comprehensive Cancer Center, and Institute for Immunology, University of California, Irvine, California 92697, United States
| | - Alexander J. Badten
- Department
of Chemical and Biomolecular Engineering, Vaccine Research and Development
Center, Department of Physiology and Biophysics, Department of Chemistry, Department of Biomedical
Engineering, Chao Family Comprehensive Cancer Center, and Institute for Immunology, University of California, Irvine, California 92697, United States
| | - Anthony E. Gregory
- Department
of Chemical and Biomolecular Engineering, Vaccine Research and Development
Center, Department of Physiology and Biophysics, Department of Chemistry, Department of Biomedical
Engineering, Chao Family Comprehensive Cancer Center, and Institute for Immunology, University of California, Irvine, California 92697, United States
| | - Rie Nakajima
- Department
of Chemical and Biomolecular Engineering, Vaccine Research and Development
Center, Department of Physiology and Biophysics, Department of Chemistry, Department of Biomedical
Engineering, Chao Family Comprehensive Cancer Center, and Institute for Immunology, University of California, Irvine, California 92697, United States
| | - Algimantas Jasinskas
- Department
of Chemical and Biomolecular Engineering, Vaccine Research and Development
Center, Department of Physiology and Biophysics, Department of Chemistry, Department of Biomedical
Engineering, Chao Family Comprehensive Cancer Center, and Institute for Immunology, University of California, Irvine, California 92697, United States
| | - Philip L. Felgner
- Department
of Chemical and Biomolecular Engineering, Vaccine Research and Development
Center, Department of Physiology and Biophysics, Department of Chemistry, Department of Biomedical
Engineering, Chao Family Comprehensive Cancer Center, and Institute for Immunology, University of California, Irvine, California 92697, United States
| | - Amanda M. Burkhardt
- Department
of Clinical Pharmacy, School of Pharmacy, University of Southern California, Los Angeles, California 90089, United States
| | - D. Huw Davies
- Department
of Chemical and Biomolecular Engineering, Vaccine Research and Development
Center, Department of Physiology and Biophysics, Department of Chemistry, Department of Biomedical
Engineering, Chao Family Comprehensive Cancer Center, and Institute for Immunology, University of California, Irvine, California 92697, United States
| | - Szu-Wen Wang
- Department
of Chemical and Biomolecular Engineering, Vaccine Research and Development
Center, Department of Physiology and Biophysics, Department of Chemistry, Department of Biomedical
Engineering, Chao Family Comprehensive Cancer Center, and Institute for Immunology, University of California, Irvine, California 92697, United States
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Christodoulou M, Malli F, Tsaras K, Billinis C, Papagiannis D. A Narrative Review of Q Fever in Europe. Cureus 2023; 15:e38031. [PMID: 37228530 PMCID: PMC10207987 DOI: 10.7759/cureus.38031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2023] [Indexed: 05/27/2023] Open
Abstract
Coxiella burnetii, the causative agent of Q fever, causes abortions in animals. Its effects on humans and the management of Q fever in certain conditions like pregnancy are undetermined. The World Health Organization has estimated that zoonotic diseases cause around one billion cases of infections and millions of deaths globally each year. It is worth noting that many emerging infectious diseases currently being reported worldwide are zoonoses. We reviewed studies reporting on Q fever prevalence and incidence in Europe. Articles from 1937 to 2023 with the following terms "Coxiella burnetii and Europe and Q fever, and seroprevalence studies" were identified in the PubMed database and reports by organizations such as the European Centre for Disease Prevention and Control (ECDC). We included randomized and observational studies, seroprevalence studies, case series, and case reports. According to the ECDC in 2019, 23 countries reported 1069 cases, the majority of which were classified as confirmed cases. The number of reports per 100,000 inhabitants in the EU/EEA was 0.2 for 2019, the same as the previous four years. The highest report rate (0.7 cases per 100,000 population) was observed in Spain, followed by Romania (0.6), Bulgaria (0.5), and Hungary. Considering the typically asymptomatic nature of Q fever infection, it is imperative to strengthen the existing systems to promote the rapid identification and reporting of Q fever outbreaks in animals, particularly in cases of abortion. It is also essential to consider the facilitation of early information exchange between veterinarians and public health counterparts to ensure the timely detection and prevention of potential zoonotic events, including Q fever.
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Affiliation(s)
| | - Foteini Malli
- Department of Nursing, University of Thessaly, Larissa, GRC
| | | | - Charalambos Billinis
- Department of Microbiology and Parasitology, Faculty of Veterinary Science, University of Thessaly, Karditsa, GRC
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Brus IM, Spronk I, Haagsma JA, Erasmus V, de Groot A, Olde Loohuis AGM, Bronner MB, Polinder S. Prerequisites, barriers and opportunities in care for Q-fever patients: a Delphi study among healthcare workers. BMC Health Serv Res 2023; 23:319. [PMID: 37004033 PMCID: PMC10064509 DOI: 10.1186/s12913-023-09269-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 03/10/2023] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND Q-fever is a zoonotic disease that can lead to illness, disability and death. This study aimed to provide insight into the perspectives of healthcare workers (HCWs) on prerequisites, barriers and opportunities in care for Q-fever patients. METHODS A two-round online Delphi study was conducted among 94 Dutch HCWs involved in care for Q-fever patients. The questionnaires contained questions on prerequisites for high quality, barriers and facilitators in care, knowledge of Q-fever, and optimization of care. For multiple choice, ranking and Likert scale questions, frequencies were reported, while for rating and numerical questions, the median and interquartile range (IQR) were reported. RESULTS The panel rated the care for Q-fever patients at a median score of 6/10 (IQR = 2). Sufficient knowledge of Q-fever among HCWs (36%), financial compensation of care (30%) and recognition of the disease by HCWs (26%) were considered the most important prerequisites for high quality care. A lack of knowledge was identified as the most important barrier (76%) and continuing medical education as the primary method for improving HCWs' knowledge (76%). HCWs rated their own knowledge at a median score of 8/10 (IQR = 1) and the general knowledge of other HCWs at a 5/10 (IQR = 2). According to HCWs, a median of eight healthcare providers (IQR = 4) should be involved in the care for Q-fever fatigue syndrome (QFS) and a median of seven (IQR = 5) in chronic Q-fever care. CONCLUSIONS Ten years after the Dutch Q-fever epidemic, HCWs indicate that the long-term care for Q-fever patients leaves much room for improvement. Facilitation of reported prerequisites for high quality care, improved knowledge among HCWs, clearly defined roles and responsibilities, and guidance on how to support patients could possibly improve quality of care. These prerequisites may also improve care for patients with persisting symptoms due to other infectious diseases, such as COVID-19.
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Affiliation(s)
- Iris M Brus
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000CA, Rotterdam, the Netherlands.
| | - Inge Spronk
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000CA, Rotterdam, the Netherlands
| | - Juanita A Haagsma
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000CA, Rotterdam, the Netherlands
| | - Vicki Erasmus
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000CA, Rotterdam, the Netherlands
| | | | | | - Madelon B Bronner
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000CA, Rotterdam, the Netherlands
| | - Suzanne Polinder
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000CA, Rotterdam, the Netherlands
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Pikoulas A, Arapi S, Kosta G, Lampropoulos C, Papaioannou I. Q Fever Severe Pericarditis With Cardiac Tamponade: A Case Report. Cureus 2023; 15:e34980. [PMID: 36938255 PMCID: PMC10019786 DOI: 10.7759/cureus.34980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2023] [Indexed: 02/16/2023] Open
Abstract
Q fever can present in acute or chronic form with a wide range of clinical symptoms and presentations. Here we report severe pericarditis with cardiac tamponade due to a chronic Coxiella burnetii (C. burnetii) infection. Our report emphasizes and justifies the importance of serological testing for chronic Q fever in patients with unexplained pericarditis, particularly in areas where C. burnetii is endemic.
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Affiliation(s)
- Antonios Pikoulas
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Athens, GRC
- Department of Medicine, University of Crete and Foundation for Research and Technology, Heraklion, GRC
| | - Sofia Arapi
- Cardiology, G. Gennimatas General Hospital, Athens, GRC
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10
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Sobotta K, Bonkowski K, Heydel C, Henning K, Menge C. Phenotype of Coxiella burnetii Strains of Different Sources and Genotypes in Bovine Mammary Gland Epithelial Cells. Pathogens 2022; 11:pathogens11121422. [PMID: 36558755 PMCID: PMC9786247 DOI: 10.3390/pathogens11121422] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 11/16/2022] [Accepted: 11/19/2022] [Indexed: 11/29/2022] Open
Abstract
Despite the high prevalence of C. burnetii in dairy herds and continuous shedding via milk by chronically infected cows, bovine milk is not recognized as a relevant source of human Q fever. We hypothesized that the bovine mammary gland epithelial cell line PS represents a suitable in vitro model for the identification of C. burnetii-strain-specific virulence properties that may account for this discrepancy. Fifteen C. burnetii strains were selected to represent different host species and multiple loci variable number of tandem repeat analysis (MLVA) genotypes (I, II, III and IV). The replication efficiencies of all strains were similar, even though strains of the MLVA-genotype II replicated significantly better than genotype I strains, and bovine and ovine isolates replicated better than caprine ones. Bovine milk isolates replicated with similar efficiencies to isolates from other bovine organs. One sheep isolate (Cb30/14, MLVA type I, isolated from fetal membranes) induced a remarkable up-regulation of IL-1β and TNF-α, whereas prototypic strains and bovine milk isolates tended to suppress pro-inflammatory responses. While infection with strain Nine Mile I rendered the cells partially refractory to re-stimulation with E. coli lipopolysaccharide, Cb30/14 exerted a selective suppressive effect which was restricted to IL-6 and TNF-α and spared IL-1β. PS cells support the replication of different strains of C. burnetii and respond in a strain-specific manner, but isolates from bovine milk did not display a common pattern, which distinguishes them from strains identified as a public health concern.
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Affiliation(s)
- Katharina Sobotta
- Institute of Molecular Pathogenesis, Friedrich-Loeffler-Institut, Naumburger Strasse 96a, 07743 Jena, Germany
| | - Katharina Bonkowski
- Institute of Molecular Pathogenesis, Friedrich-Loeffler-Institut, Naumburger Strasse 96a, 07743 Jena, Germany
| | - Carsten Heydel
- Institute for Hygiene and Infectious Diseases of Animals, Justus-Liebig-University (JLU), Frankfurter Strasse 85-89, 35392 Giessen, Germany
| | - Klaus Henning
- Institute of Bacterial Infections and Zoonoses, Friedrich-Loeffler-Institut, Naumburger Strasse 96a, 07743 Jena, Germany
| | - Christian Menge
- Institute of Molecular Pathogenesis, Friedrich-Loeffler-Institut, Naumburger Strasse 96a, 07743 Jena, Germany
- Correspondence:
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11
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Kwok KTT, de Rooij MMT, Messink AB, Wouters IM, Smit LAM, Cotten M, Heederik DJJ, Koopmans MPG, Phan MVT. Establishing farm dust as a useful viral metagenomic surveillance matrix. Sci Rep 2022; 12:16308. [PMID: 36175536 PMCID: PMC9521564 DOI: 10.1038/s41598-022-20701-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 09/16/2022] [Indexed: 11/26/2022] Open
Abstract
Farm animals may harbor viral pathogens, some with zoonotic potential which can possibly cause severe clinical outcomes in animals and humans. Documenting the viral content of dust may provide information on the potential sources and movement of viruses. Here, we describe a dust sequencing strategy that provides detailed viral sequence characterization from farm dust samples and use this method to document the virus communities from chicken farm dust samples and paired feces collected from the same broiler farms in the Netherlands. From the sequencing data, Parvoviridae and Picornaviridae were the most frequently found virus families, detected in 85-100% of all fecal and dust samples with a large genomic diversity identified from the Picornaviridae. Sequences from the Caliciviridae and Astroviridae familes were also obtained. This study provides a unique characterization of virus communities in farmed chickens and paired farm dust samples and our sequencing methodology enabled the recovery of viral genome sequences from farm dust, providing important tracking details for virus movement between livestock animals and their farm environment. This study serves as a proof of concept supporting dust sampling to be used in viral metagenomic surveillance.
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Affiliation(s)
- Kirsty T T Kwok
- Department of Viroscience, Erasmus Medical Center, Rotterdam, The Netherlands.
- MRC-University of Glasgow Centre for Virus Research, Glasgow, UK.
| | - Myrna M T de Rooij
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Aniek B Messink
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Inge M Wouters
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Lidwien A M Smit
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Matthew Cotten
- Department of Viroscience, Erasmus Medical Center, Rotterdam, The Netherlands
- MRC-University of Glasgow Centre for Virus Research, Glasgow, UK
- London School of Hygiene and Tropical Medicine, London, UK
| | - Dick J J Heederik
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Marion P G Koopmans
- Department of Viroscience, Erasmus Medical Center, Rotterdam, The Netherlands
| | - My V T Phan
- Department of Viroscience, Erasmus Medical Center, Rotterdam, The Netherlands.
- London School of Hygiene and Tropical Medicine, London, UK.
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12
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Alotaibi BH, Amor N, Merella P, Mohammed OB, Alagaili AN. Genetic diversity of wild rodents and detection of Coxiella burnetii, the causative agent of Q fever, in Saudi Arabia. Vet Res Commun 2022; 46:769-780. [PMID: 35132522 DOI: 10.1007/s11259-022-09897-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 01/30/2022] [Indexed: 10/19/2022]
Abstract
Throughout history, wildlife has been regarded as a major source of infectious diseases. Rodentia, the most speciose order of mammals, whose members are recognised hosts of more than 60 zoonotic diseases, represent a potential threat to human health. Recently, epidemiological data from Saudi Arabia indicated an actual growth in the number of emerging and/or re-emerging cases of several zoonoses. However, there is a lack of studies focusing on the molecular taxonomy of rodents and the pathogens they may harbour in this region. In this study, the first molecular characterisation of six rodent taxa in this region is provided, based on partial Cyt B and 16S genes. The data confirm the spread of rodent-associated C. burnetii strains in Jazan, southwestern Saudi Arabia. The PCR targeting IS111, the multi-copy transposase gene, revealed 17.5% (36/205) positive samples, whereas the second nested PCR, targeting the single-copy Com1 gene, revealed 16.6% (34/205) positive samples. Phylogenetic and network analyses indicated the presence of four haplotypes of C. burnetii within the studied localities. One major haplotype (H-2) was observed in all rodent species and from 18 localities. The infection rates of C. burnetii among studied species, localities and habitats were not significantly different (>0.05). Our results facilitate the assessment of the health risk associated with rodents and the development of strategies to control the increasing impacts of Q fever.
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Affiliation(s)
- Bandar H Alotaibi
- Department of Zoology, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Nabil Amor
- Department of Zoology, King Saud University, Riyadh, 11451, Saudi Arabia.
- Laboratory of Biodiversity, Parasitolgy and Ecology of Aquatic Ecosystems, Department of Biology - Faculty of Sciences of Tunis, University of Tunis El Manar, Tunis, Tunisia.
| | - Paolo Merella
- Parassitologia e Malattie Parassitarie, Dipartimento di Medicina Veterinaria, Università di Sassari, Via Vienna 2, 07100, Sassari, Italy
| | - Osama B Mohammed
- Department of Zoology, King Saud University, Riyadh, 11451, Saudi Arabia
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13
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Kersh GJ. Tropical Q Fever. Am J Trop Med Hyg 2022; 107:219-220. [PMID: 35977719 PMCID: PMC9393446 DOI: 10.4269/ajtmh.22-0372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 06/01/2022] [Indexed: 11/07/2022] Open
Affiliation(s)
- Gilbert J. Kersh
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
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14
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Serological Prevalence of and Risk Factors for Coxiella burnetti Infection in Women of Punjab Province, Pakistan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084576. [PMID: 35457443 PMCID: PMC9027314 DOI: 10.3390/ijerph19084576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 04/01/2022] [Accepted: 04/07/2022] [Indexed: 01/09/2023]
Abstract
Background: Coxiella burnetii, the etiological agent of Q (query) fever, provokes abortions in ruminants and is suspected to cause adverse pregnancy outcomes in women. Infection of pregnant women is linked with high mortality and morbidity of the fetus and the mother is at high risk to acquire chronic Q fever. This research was conducted to evaluate the prevalence of Q fever in women and to detect associated risk factors in four districts of Punjab Province, Pakistan. Methods: A total of 297 blood samples were obtained from 147 pregnant and 150 non-pregnant women of the districts Okara, Jhang, Chiniot and Faisalabad of Punjab, Pakistan. Data related to risk factors and demographic parameters were collected using a questionnaire. Serum samples were screened for phase I and phase II specific IgG antibodies for antigens of phase I and phase II using ELISA tests. Univariate and binary regression were used to analyze important risk factors of Q fever. Results: Twenty-five serum samples (8.4%) were found seropositive for Q fever. Seventeen women were positive for Phase-I and twenty-one were positive for phase-II antibodies. Highest and statistically significant (p < 0.05) seroprevalence of 17.1% was observed in Faisalabad. Age, urbanicity, living status, pregnancy status, abortion history, occupation, and consumption of tap water were positively correlated (p < 0.05) with Q fever, while being aged, urbanity, low income, contact with animals and consumption of tap water was identified as potential risk factors. Conclusions: Q fever is prevalent in women of Pakistan. There is a need for an awareness program about the importance of C. burnetii infections and prevention strategies in women during pregnancy to minimize adverse pregnancy outcomes.
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15
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Osbron CA, Goodman AG. To die or not to die: Programmed cell death responses and their interactions with Coxiella burnetii infection. Mol Microbiol 2022; 117:717-736. [PMID: 35020241 PMCID: PMC9018580 DOI: 10.1111/mmi.14878] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 01/04/2022] [Accepted: 01/09/2022] [Indexed: 12/01/2022]
Abstract
Coxiella burnetii is a Gram-negative, obligate intracellular, macrophage-tropic bacterium and the causative agent of the zoonotic disease Q fever. The epidemiology of Q fever is associated with the presence of infected animals; sheep, goats, cattle, and humans primarily become infected by inhalation of contaminated aerosols. In humans, the acute phase of the disease is characterized primarily by influenza-like symptoms, and approximately 3-5% of the infected individuals develop chronic infection. C. burnetii infection activates many types of immune responses, and the bacteria's genome encodes for numerous effector proteins that interact with host immune signaling mechanisms. Here, we will discuss two forms of programmed cell death, apoptosis and pyroptosis. Apoptosis is a form of non-inflammatory cell death that leads to phagocytosis of small membrane-bound bodies. Conversely, pyroptosis results in lytic cell death accompanied by the release of proinflammatory cytokines. Both apoptosis and pyroptosis have been implicated in the clearance of intracellular bacterial pathogens, including C. burnetii. Finally, we will discuss the role of autophagy, the degradation of unwanted cellular components, during C. burnetii infection. Together, the review of these forms of programmed cell death will open new research questions aimed at combating this highly infectious pathogen for which treatment options are limited.
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Affiliation(s)
- Chelsea A Osbron
- School of Molecular Biosciences, College of Veterinary Medicine, Washington State University, Pullman, WA, 99164
| | - Alan G Goodman
- School of Molecular Biosciences, College of Veterinary Medicine, Washington State University, Pullman, WA, 99164.,Paul G. Allen School of Global Health, College of Veterinary Medicine, Washington State University, Pullman, WA, 99164
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16
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Abstract
Coxiella burnetii, the causative agent of query (Q) fever in humans, is an obligate intracellular bacterium. C. burnetii can naturally infect a broad range of host organisms (e.g., mammals and arthropods) and cell types. This amphotropic nature of C. burnetii, in combination with its ability to utilize both glycolytic and gluconeogenic carbon sources, suggests that the pathogen relies on metabolic plasticity to replicate in nutritionally diverse intracellular environments. To test the significance of metabolic plasticity in C. burnetii host cell colonization, C. burnetii intracellular replication in seven distinct cell lines was compared between a metabolically competent parental strain and a mutant, CbΔpckA, unable to undergo gluconeogenesis. Both the parental strain and CbΔpckA mutant exhibited host cell-dependent infection phenotypes, which were influenced by alterations to host glycolytic or gluconeogenic substrate availability. Because the nutritional environment directly impacts host cell physiology, our analysis was extended to investigate the response of C. burnetii replication in mammalian host cells cultivated in a novel physiological medium based on the nutrient composition of mammalian interstitial fluid, interstitial fluid-modeled medium (IFmM). An infection model based on IFmM resulted in exacerbation of a replication defect exhibited by the CbΔpckA mutant in specific cell lines. The CbΔpckA mutant was also attenuated during infection of an animal host. Overall, the study underscores that gluconeogenic capacity aids C. burnetii amphotropism and that the amphotropic nature of C. burnetii should be considered when resolving virulence mechanisms in this pathogen.
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17
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Priestley RA, Smith CB, Miller HK, Kersh GJ. Coxiella burnetii infections in mice: Immunological responses to contemporary genotypes found in the US. Virulence 2021; 12:2461-2473. [PMID: 34516359 PMCID: PMC8451504 DOI: 10.1080/21505594.2021.1975527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Coxiella burnetii is an obligate intracellular bacterium that causes the human disease Q fever, which can manifest as an acute flu-like illness or a long-term chronic illness, such as endocarditis. Three genotypes (ST8, ST16, and ST20) of Coxiella burnetii are commonly found in the contemporary US and are associated with specific animal hosts. Although all three genotypes have been isolated from humans with Q fever, studies comparing virulence between C. burnetii sequence types have been rare. Here, groups of mice were infected via aerosol inoculation with isolates derived from cow's milk, environmental, animal, and human samples. Mice were monitored for weight loss and blood samples were takenweekly. Animals were euthanized at 2- and 12-weeks post-infection, and bacterial burden was determined for tissues by real-time PCR. The levels of anti-Coxiella antibodies and selected inflammatory cytokines were determined for serum samples. Weight loss and splenomegaly were observed in mice infected with ST20 and ST16 isolates but were absent in the mice infected with ST8 isolates. Bacterial concentrations in the tissues were lower in the ST8 isolates at 2 weeks post-infection relative to all other isolates. ST16 and ST20 isolates induced robust antibody and cytokine responses, while ST8 isolates produced significantly lower anti-C. burnetii titers early in the infection but saw increased titers in some animals several weeks post-infection. The data suggest that the ST8 isolates are less virulent in this mouse model, as they produce less robust antibody responses that are slow to develop, relative to the ST16 and ST20 isolates.
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Affiliation(s)
- Rachael A Priestley
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, United States
| | - Cody B Smith
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, United States
| | - Halie K Miller
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, United States
| | - Gilbert J Kersh
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, United States
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18
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Miller HK, Priestley RA, Kersh GJ. Q Fever: A troubling disease and a challenging diagnosis. CLINICAL MICROBIOLOGY NEWSLETTER 2021; 43:109-118. [PMID: 37701818 PMCID: PMC10493821 DOI: 10.1016/j.clinmicnews.2021.06.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/14/2023]
Abstract
Q fever is a disease caused by the bacterial pathogen Coxiella burnetii. This hardy organism can easily spread long distances in the wind, and only a few infectious aerosolized particles are necessary to cause serious illness. Presentations of Q fever disease can be wide-ranging, allowing it to masquerade as other illnesses and highlight the importance of laboratory testing for diagnosis and treatment. This review summarizes Q fever's epidemiology and clinical presentations and presents classical laboratory diagnostic assays and novel approaches to detecting this troubling disease.
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Affiliation(s)
- Halie K. Miller
- Centers for Disease Control and Prevention, Atlanta, Georgia
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19
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Duplaix L, Turgeon P, Lévesque B, Rocheleau JP, Leboeuf A, Picard I, Manguiat K, Wood H, Arsenault J. Seroprevalence and risk factors of antibodies against Coxiella burnetii among dog owners in southwestern Québec, Canada. Epidemiol Infect 2021; 149:1-45. [PMID: 34176524 PMCID: PMC8314959 DOI: 10.1017/s0950268821001412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 05/13/2021] [Accepted: 06/22/2021] [Indexed: 11/18/2022] Open
Abstract
Coxiella burnetii is a zoonotic agent responsible for human Q fever, a potentially severe disease that can lead to persistent infection. This cross-sectional study aimed to estimate the seroprevalence to C. burnetii antibodies and its association with potential risk factors in the human population of five regions of Québec, Canada. A serum bank comprising sera from 474 dog owners was screened by an enzyme-linked immunosorbent assay followed by confirmation of positive or equivocal sera by an indirect immunofluorescence assay. Observed seroprevalences of 1.2% (95% confidence interval (CI): 0.0–6.6), 2.6% (95% CI: 0.5–7.4) and 5.9% (95% CI: 3.4–9.6) were estimated in the regions of Montréal, Lanaudière and Montérégie, respectively, which all included at least 83 samples. Having lived or worked on a small ruminant farm (prevalence odds ratio (POR) = 5.4; 95% CI: 1.6–17.7) and being a veterinarian or veterinary student (POR = 6.1; 95% CI: 1.6–24.0) were significantly associated with C. burnetii seropositivity. Antibodies against C. burnetii were detected in the human population of Québec. Although seropositivity to this agent was associated with occupational contact with domestic animals, antibodies were also detected in people with no reported professional exposure. No associations with ruminant farm proximity were identified.
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Affiliation(s)
- L. Duplaix
- Department of Pathology and Microbiology, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Québec, Canada
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Québec, Canada
| | - P. Turgeon
- Department of Pathology and Microbiology, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Québec, Canada
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Québec, Canada
- National Microbiology Laboratory, Public Health Agency of Canada (PHAC), Saint-Hyacinthe, Québec, Canada
| | - B. Lévesque
- Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Québec, Canada
| | - J.-P. Rocheleau
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Québec, Canada
- Cégep de Saint-Hyacinthe, Saint-Hyacinthe, Québec, Canada
| | - A. Leboeuf
- Ministère de l'Agriculture, des Pêcheries et de l'Alimentation du Québec (MAPAQ), ville de Québec, Québec, Canada
| | - I. Picard
- Ministère de l'Agriculture, des Pêcheries et de l'Alimentation du Québec (MAPAQ), ville de Québec, Québec, Canada
| | - K. Manguiat
- National Microbiology Laboratory, Public Health Agency of Canada (PHAC), Winnipeg, Manitoba, Canada
| | - H. Wood
- National Microbiology Laboratory, Public Health Agency of Canada (PHAC), Winnipeg, Manitoba, Canada
| | - J. Arsenault
- Department of Pathology and Microbiology, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Québec, Canada
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Québec, Canada
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20
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de Lange MMA, van der Hoek W, Schneeberger PM, Swart A, Heederik DJJ, Schimmer B, Wouters IM. High Coxiella burnetii Seroconversion Rate in Veterinary Students, the Netherlands, 2006-2010. Emerg Infect Dis 2021; 26:3086-3088. [PMID: 33219801 PMCID: PMC7706948 DOI: 10.3201/eid2612.200063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We examined Coxiella burnetii seroconversion rates by measuring C. burnetii IgG among 2 cohorts of veterinary students. During follow-up of 118 seronegative veterinary students, 23 students seroconverted. Although the clinical importance of the presence of antibodies is unknown, veterinary students should be informed about the potential risks for Q fever.
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21
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Körner S, Makert GR, Ulbert S, Pfeffer M, Mertens-Scholz K. The Prevalence of Coxiella burnetii in Hard Ticks in Europe and Their Role in Q Fever Transmission Revisited-A Systematic Review. Front Vet Sci 2021; 8:655715. [PMID: 33981744 PMCID: PMC8109271 DOI: 10.3389/fvets.2021.655715] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 02/22/2021] [Indexed: 01/09/2023] Open
Abstract
The zoonosis Q fever is caused by the obligate intracellular bacterium Coxiella burnetii. Besides the main transmission route via inhalation of contaminated aerosols, ticks are discussed as vectors since the first isolation of the pathogen from a Dermacentor andersonii tick. The rare detection of C. burnetii in ticks and the difficult differentiation of C. burnetii from Coxiella-like endosymbionts (CLEs) are questioning the relevance of ticks in the epidemiology of Q fever. In this review, literature databases were systematically searched for recent prevalence studies concerning C. burnetii in ticks in Europe and experimental studies evaluating the vector competence of tick species. A total of 72 prevalence studies were included and evaluated regarding DNA detection methods and collection methods, country, and tested tick species. Specimens of more than 25 different tick species were collected in 23 European countries. Overall, an average prevalence of 4.8% was determined. However, in half of the studies, no Coxiella-DNA was detected. In Southern European countries, a significantly higher prevalence was observed, possibly related to the abundance of different tick species here, namely Hyalomma spp. and Rhipicephalus spp. In comparison, a similar proportion of studies used ticks sampled by flagging and dragging or tick collection from animals, under 30% of the total tick samples derived from the latter. There was no significant difference in the various target genes used for the molecular test. In most of the studies, no distinction was made between C. burnetii and CLEs. The application of specific detection methods and the confirmation of positive results are crucial to determine the role of ticks in Q fever transmission. Only two studies were available, which assessed the vector competence of ticks for C. burnetii in the last 20 years, demonstrating the need for further research.
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Affiliation(s)
- Sophia Körner
- Institute of Bacterial Infections and Zoonoses (IBIZ), Friedrich-Loeffler-Institute, Federal Research Institute for Animal Health, Jena, Germany
| | - Gustavo R Makert
- Department of Immunology, Fraunhofer Institute for Cell Therapy and Immunology, Leipzig, Germany
| | - Sebastian Ulbert
- Department of Immunology, Fraunhofer Institute for Cell Therapy and Immunology, Leipzig, Germany
| | - Martin Pfeffer
- Institute of Animal Hygiene and Veterinary Public Health, University of Leipzig, Leipzig, Germany
| | - Katja Mertens-Scholz
- Institute of Bacterial Infections and Zoonoses (IBIZ), Friedrich-Loeffler-Institute, Federal Research Institute for Animal Health, Jena, Germany
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22
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Evaluation using latent class models of the diagnostic performances of three ELISA tests commercialized for the serological diagnosis of Coxiella burnetii infection in domestic ruminants. Vet Res 2021; 52:56. [PMID: 33853678 PMCID: PMC8048088 DOI: 10.1186/s13567-021-00926-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 03/19/2021] [Indexed: 12/20/2022] Open
Abstract
ELISA methods are the diagnostic tools recommended for the serological diagnosis of Coxiella burnetii infection in ruminants but their respective diagnostic performances are difficult to assess because of the absence of a gold standard. This study focused on three commercial ELISA tests with the following objectives (1) assess their sensitivity and specificity in sheep, goats and cattle, (2) assess the between- and within-herd seroprevalence distribution in these species, accounting for diagnostic errors, and (3) estimate optimal sample sizes considering sensitivity and specificity at herd level. We comparatively tested 1413 cattle, 1474 goat and 1432 sheep serum samples collected in France. We analyzed the cross-classified test results with a hierarchical zero-inflated beta-binomial latent class model considering each herd as a population and conditional dependence as a fixed effect. Potential biases and coverage probabilities of the model were assessed by simulation. Conditional dependence for truly seropositive animals was high in all species for two of the three ELISA methods. Specificity estimates were high, ranging from 94.8% [92.1; 97.8] to 99.2% [98.5; 99.7], whereas sensitivity estimates were generally low, ranging from 39.3 [30.7; 47.0] to 90.5% [83.3; 93.8]. Between- and within-herd seroprevalence estimates varied greatly among geographic areas and herds. Overall, goats showed higher within-herd seroprevalence levels than sheep and cattle. The optimal sample size maximizing both herd sensitivity and herd specificity varied from 3 to at least 20 animals depending on the test and ruminant species. This study provides better interpretation of three widely used commercial ELISA tests and will make it possible to optimize their implementation in future studies. The methodology developed may likewise be applied to other human or animal diseases.
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Buysse M, Duhayon M, Cantet F, Bonazzi M, Duron O. Vector competence of the African argasid tick Ornithodoros moubata for the Q fever agent Coxiella burnetii. PLoS Negl Trop Dis 2021; 15:e0009008. [PMID: 33406079 PMCID: PMC7815103 DOI: 10.1371/journal.pntd.0009008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 01/19/2021] [Accepted: 11/25/2020] [Indexed: 12/25/2022] Open
Abstract
Q fever is a widespread zoonotic disease caused by the intracellular bacterium Coxiella burnetii. While transmission is primarily but not exclusively airborne, ticks are usually thought to act as vectors on the basis of early microscopy studies. However, recent observations revealed that endosymbionts of ticks have been commonly misidentified as C. burnetii, calling the importance of tick-borne transmission into question. In this study, we re-evaluated the vector competence of the African soft tick Ornithodoros moubata for an avirulent strain of C. burnetii. To this end, we used an artificial feeding system to initiate infection of ticks, specific molecular tools to monitor further infections, and culture assays in axenic and cell media to check for the viability of C. burnetii excreted by ticks. We observed typical traits associated with vector competence: The exposure to an infected blood meal resulted in viable and persistent infections in ticks, trans-stadial transmissions of infection from nymphs to adults and the ability of adult ticks to transmit infectious C. burnetii. However, in contrast to early studies, we found that infection differed substantially between tick organs. In addition, while adult female ticks were infected, we did not observe C. burnetii in eggs, suggesting that transovarial transmission is not effective. Finally, we detected only a sporadic presence of C. burnetii DNA in tick faeces, but no living bacterium was further isolated in culture assays, suggesting that excretion in faeces is not a common mode of transmission in O. moubata. The intracellular bacterium Coxiella burnetii is the agent of Q fever, a widespread zoonotic disease. Some early detection reports and microscopy studies identified ticks as vectors of Q fever but more recent studies and molecular analyses revealed that endosymbionts of ticks have been commonly misidentified as C. burnetii: It raises questions of whether ticks play an important role in Q fever transmission. In our study, we therefore experimentally re-evaluate the vector competence of the African soft tick Ornithodoros moubata for C. burnetii. We found that O. moubata can be infected by C. burnetii after the exposure to an infected blood meal. It resulted in viable and persistent infections in ticks, a trans-stadial transmission and the ability of adult ticks to transmit infection when feeding. Infection was however not transmitted transovarially or by faeces as early reported. Overall, we conclude that O. moubata may act as a driver of the transmission and of the spatial dispersal of Q fever among vertebrates where this tick is present in Africa.
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Affiliation(s)
- Marie Buysse
- MIVEGEC (Maladies Infectieuses et Vecteurs: Ecologie, Génétique, Evolution et Contrôle), Centre National de la Recherche Scientifique (CNRS), Institut pour la Recherche et le Développement (IRD), Université de Montpellier (UM), Montpellier, France
- CREES (Centre de Recherche en Écologie et Évolution de la Santé), Montpellier, France
- * E-mail: (MB); (OD)
| | - Maxime Duhayon
- ASTRE, University of Montpellier, CIRAD, INRAE, Montpellier, France
- CIRAD, UMR ASTRE, 34398 Montpellier, France
| | - Franck Cantet
- IRIM, CNRS, Université de Montpellier, Montpellier, France
| | - Matteo Bonazzi
- IRIM, CNRS, Université de Montpellier, Montpellier, France
| | - Olivier Duron
- MIVEGEC (Maladies Infectieuses et Vecteurs: Ecologie, Génétique, Evolution et Contrôle), Centre National de la Recherche Scientifique (CNRS), Institut pour la Recherche et le Développement (IRD), Université de Montpellier (UM), Montpellier, France
- CREES (Centre de Recherche en Écologie et Évolution de la Santé), Montpellier, France
- * E-mail: (MB); (OD)
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Rahaman MR, Milazzo A, Marshall H, Chaber AL, Bi P. Q fever vaccination: Australian animal science and veterinary students' One Health perspectives on Q fever prevention. Hum Vaccin Immunother 2020; 17:1374-1381. [PMID: 33180660 DOI: 10.1080/21645515.2020.1829900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Unvaccinated animal science and veterinary students are at risk of Q fever, a vaccine-preventable zoonotic disease transmitted from animals to humans. We investigated students' perspectives on Q fever prevention using a One Health approach combining animal, human and environmental health. Animal science and veterinary students enrolled at the University of Adelaide in 2019 were invited to participate in an online survey to explore their perceptions about Q fever and prevention strategies. We undertook descriptive analysis and logistic regression. Overall, 46% of students reported little to no knowledge of Q fever. Over three-quarters of students reported transmission of Q fever via aerosol inhalation and animal culling, whilst other modes including sexual transmission between humans (7%) was poorly identified. The majority of students reported exposure to cattle, sheep and goats. Of those who reported vaccination status, 5% veterinary and 61% animal science students were unvaccinated for Q fever. Challenges concerning vaccination included cost, time and access to healthcare with strategies aimed at promoting awareness, improving healthcare access and subsidized and mass vaccination. Knowledge of Q fever among respondents, particularly about disease transmission was suboptimal. As a key principle to One Health approach, adherence to biosecurity guidelines during contact with animals could potentially reduce zoonoses including Q fever transmission. Improving access to Q fever vaccine for unvaccinated students is a priority. Findings underscore that university policy for Q fever vaccination needs to consider subsidized vaccination for both animal science and veterinary students.
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Affiliation(s)
- Md R Rahaman
- School of Public Health, The University of Adelaide, Adelaide, Australia
| | - Adriana Milazzo
- School of Public Health, The University of Adelaide, Adelaide, Australia
| | - Helen Marshall
- Adelaide Medical School and Robinson Research Institute, The University of Adelaide, Adelaide, Australia.,Department of Pediatrics, Women's and Children's Health Network, Adelaide, Australia
| | - Anne-Lise Chaber
- School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy, Australia
| | - Peng Bi
- School of Public Health, The University of Adelaide, Adelaide, Australia
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Friedler A. Sociocultural, behavioural and political factors shaping the COVID-19 pandemic: the need for a biocultural approach to understanding pandemics and (re)emerging pathogens. Glob Public Health 2020; 16:17-35. [PMID: 33019889 DOI: 10.1080/17441692.2020.1828982] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Although there has been increasing focus in recent years on interdisciplinary approaches to health and disease, and in particular the dimension of social inequalities in epidemics, infectious diseases have been much less focused on. This is especially true in the area of cultural dynamics and their effects on pathogen behaviours, although there is evidence to suggest that this relationship is central to shaping our interactions with infectious disease agents on a variety of levels. This paper makes a case for a biocultural approach to pandemics such as COVID-19. It then uses this biocultural framework to examine the anthropogenic dynamics that influenced and continue to shape the COVID-19 pandemic, both during its initial phase and during critical intersections of the pandemic. Through this understanding of biocultural interactions between people, animals and pathogens, a broader societal and political dimension is drawn as a function of population level and international cultures, to reflect on the culturally mediated differential burden of the pandemic. Ultimately, it is argued that a biocultural perspective on infectious disease pandemics will allow for critical reflection on how culture shapes our behaviours at all levels, and how the effects of these behaviours are ultimately foundational to pathogen ecology and evolution.
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Affiliation(s)
- Anna Friedler
- Département des sciences humaines et sociales, École des Hautes Études en Santé Publique - Campus de Paris, Saint-Denis, France.,l'Unité des Virus Emergents, Aix-Marseille Université, Marseille, France
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26
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Sabin NS, Calliope AS, Simpson SV, Arima H, Ito H, Nishimura T, Yamamoto T. Implications of human activities for (re)emerging infectious diseases, including COVID-19. J Physiol Anthropol 2020; 39:29. [PMID: 32977862 PMCID: PMC7517057 DOI: 10.1186/s40101-020-00239-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 09/16/2020] [Indexed: 12/12/2022] Open
Abstract
Since 1980, the world has been threatened by different waves of emerging disease epidemics. In the twenty-first century, these diseases have become an increasing global concern because of their health and economic impacts in both developed and resource-constrained countries. It is difficult to stop the occurrence of new pathogens in the future due to the interconnection among humans, animals, and the environment. However, it is possible to face a new disease or to reduce the risk of its spread by implementing better early warning systems and effective disease control and prevention, e.g., effective global surveillance, development of technology for better diagnostics, effective treatments, and vaccines, the global political will to respond to any threats and multidisciplinary collaboration involving all sectors in charge of good health maintenance. In this review, we generally describe some factors related to human activities and show how they can play a role in the transmission and spread of infectious diseases by using some diseases as examples. Additionally, we describe and discuss major factors that are facilitating the spread of the new pandemic known as COVID-19 worldwide.
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Affiliation(s)
- Nundu Sabiti Sabin
- Department of International Health and Medical Anthropology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- Leading Program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Akintije Simba Calliope
- Department of International Health and Medical Anthropology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- Leading Program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Shirley Victoria Simpson
- Department of International Health and Medical Anthropology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- Leading Program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Hiroaki Arima
- Department of International Health and Medical Anthropology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Hiromu Ito
- Department of International Health and Medical Anthropology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
| | - Takayuki Nishimura
- Department of Human Science, Faculty of Design, Kyushu University, Fukuoka, Japan
- Department of Public Health, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Taro Yamamoto
- Department of International Health and Medical Anthropology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
- Leading Program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
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Abstract
Purpose of Review The non-specific presentation of acute Q fever makes it difficult to diagnose in children, but untreated Q fever can result in chronic infections that have severe complications. Recent Findings Pediatric Q fever cases continue to be infrequently reported in the literature, and primarily document cases of persistent infections with Coxiella burnetii. Standardized treatment protocols for chronic Q fever in children still do not exist. Doxycycline and hydroxychloroquine are the treatment combination most utilized by healthcare providers to treat Q fever endocarditis or osteomyelitis in children, but a variety of other antibiotic combinations have been reported with varying results. The use of adjunctive therapies, such as such as interferon gamma, has produced mixed outcomes. Summary The true impact of Coxiella burnetii on the health of children remains unknown; long-term longitudinal follow-up of children with acute or chronic Q fever has not been reported. Both the acute and chronic forms of Q fever are underreported and underdiagnosed. Healthcare providers should consider Q fever in pediatric patients with culture-negative endocarditis or osteomyelitis.
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Veltkamp HW, Akegawa Monteiro F, Sanders R, Wiegerink R, Lötters J. Disposable DNA Amplification Chips with Integrated Low-Cost Heaters. MICROMACHINES 2020; 11:E238. [PMID: 32106462 PMCID: PMC7143804 DOI: 10.3390/mi11030238] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 02/20/2020] [Accepted: 02/22/2020] [Indexed: 01/03/2023]
Abstract
Fast point-of-use detection of, for example, early-stage zoonoses, e.g., Q-fever, bovine tuberculosis, or the Covid-19 coronavirus, is beneficial for both humans and animal husbandry as it can save lives and livestock. The latter prevents farmers from going bankrupt after a zoonoses outbreak. This paper describes the development of a fabrication process and the proof-of-principle of a disposable DNA amplification chip with an integrated heater. Based on the analysis of the milling process, metal adhesion studies, and COMSOL MultiPhysics heat transfer simulations, the first batch of chips has been fabricated and successful multiple displacement amplification reactions are performed inside these chips. This research is the first step towards the development of an early-stage zoonoses detection device. Tests with real zoonoses and DNA specific amplification reactions still need to be done.
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Affiliation(s)
- Henk-Willem Veltkamp
- Department of Integrated Devices and Systems, University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands; (F.A.M.); (R.S.); (R.W.); (J.L.)
| | - Fernanda Akegawa Monteiro
- Department of Integrated Devices and Systems, University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands; (F.A.M.); (R.S.); (R.W.); (J.L.)
| | - Remco Sanders
- Department of Integrated Devices and Systems, University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands; (F.A.M.); (R.S.); (R.W.); (J.L.)
| | - Remco Wiegerink
- Department of Integrated Devices and Systems, University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands; (F.A.M.); (R.S.); (R.W.); (J.L.)
| | - Joost Lötters
- Department of Integrated Devices and Systems, University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands; (F.A.M.); (R.S.); (R.W.); (J.L.)
- Bronkhorst High-Tech BV, Nijverheidsstraat 1A, 7261 AK Ruurlo, The Netherlands
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de Lange MMA, Gijsen LEV, Wielders CCH, van der Hoek W, Scheepmaker A, Schneeberger PM. Should Acute Q-Fever Patients be Screened for Valvulopathy to Prevent Endocarditis? Clin Infect Dis 2019; 67:360-366. [PMID: 29471496 PMCID: PMC6051461 DOI: 10.1093/cid/ciy128] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 02/19/2018] [Indexed: 01/09/2023] Open
Abstract
Background Echocardiographic screening of acute Q-fever patients and antibiotic prophylaxis for patients with cardiac valvulopathy is considered an important approach to prevent chronic Q-fever-related endocarditis. During a large Q-fever epidemic in the Netherlands, routine screening echocardiography was discontinued, raising controversy in the international literature. We followed a cohort of acute Q-fever patients to estimate the risk for developing chronic Q-fever, and we evaluated the impact of screening in patients who were not yet known to have a valvulopathy. Methods The study population consisted of patients diagnosed with acute Q-fever in 2007 and 2008. We retrospectively reviewed all screening echocardiographs and checked for development of chronic Q-fever 8 years after the acute episode. Risks of developing chronic Q-fever in relation to the presence or absence of valvulopathy were analyzed with logistic regression. Results The cohort included 509 patients, of whom 306 received echocardiographic screening. There was no significant difference (P-value = .22) in occurrence of chronic Q-fever between patients with a newly detected valvulopathy (2/84, 2.4%) and those with no valvulopathy (12/202, 5.9%). Two patients with a newly detected valvulopathy, who did not receive antibiotic prophylaxis, developed chronic Q-fever at a later stage. Conclusions We found no difference in outcome between patients with and without a valvulopathy newly detected by echocardiographic screening. In retrospect, the 2 above-mentioned patients could have benefitted from antibiotic prophylaxis, but its omission must be weighed against the unnecessary large-scale and long-term use of antibiotics that would have resulted from universal echocardiographic screening.
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Affiliation(s)
- Marit M A de Lange
- Centre for Infectious Disease Control Netherlands, National Institute for Public Health and the Environment, Bilthoven
| | | | - Cornelia C H Wielders
- Centre for Infectious Disease Control Netherlands, National Institute for Public Health and the Environment, Bilthoven
| | - Wim van der Hoek
- Centre for Infectious Disease Control Netherlands, National Institute for Public Health and the Environment, Bilthoven
| | | | - Peter M Schneeberger
- Department of Medical Microbiology and Infection Control, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
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de Lange MMA, Scheepmaker A, van der Hoek W, Leclercq M, Schneeberger PM. Risk of chronic Q fever in patients with cardiac valvulopathy, seven years after a large epidemic in the Netherlands. PLoS One 2019; 14:e0221247. [PMID: 31437175 PMCID: PMC6705838 DOI: 10.1371/journal.pone.0221247] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 08/04/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND From 2007 through 2010, a large epidemic of acute Q fever occurred in the Netherlands. Patients with cardiac valvulopathy are at high risk to develop chronic Q fever after an acute infection. This patient group was not routinely screened, so it is unknown whether all their chronic infections were diagnosed. This study aims to investigate how many chronic Q fever patients can be identified by routinely screening patients with valvulopathy and to establish whether the policy of not screening should be changed. METHODS In a cross-sectional study (2016-2017) in a hospital at the epicentre of the Q fever epidemic, a blood sample was taken from patients 18 years and older who presented with cardiac valvulopathy. The sample was tested for IgG antibodies against phase I and II of Coxiella burnetii using an immunofluorescence assay. An IgG phase II titre of ≥1:64 was considered serological evidence of a previous Q fever infection. An IgG phase I titre of ≥1:512 was considered suspicious for a chronic infection, and these patients were referred for medical examination. RESULTS Of the 904 included patients, 133 (15%) had evidence of a previous C. burnetii infection, of whom 6 (5%) had a chronic infection on medical examination. CONCLUSIONS In a group of high-risk patients with a heart valve defect, we diagnosed new chronic Q fever infections seven years after the epidemic, emphasizing the need for screening of this group to prevent complications in those not yet diagnosed in epidemic areas.
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Affiliation(s)
- Marit M. A. de Lange
- Centre for Infectious Disease Control Netherlands, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
- * E-mail:
| | - Arko Scheepmaker
- Department of Cardiology, Bernhoven Hospital, Uden, the Netherlands
| | - Wim van der Hoek
- Centre for Infectious Disease Control Netherlands, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Monique Leclercq
- Department of Internal Medicine, Bernhoven Hospital, Uden, the Netherlands
| | - Peter M. Schneeberger
- Department of Medical Microbiology, Jeroen Bosch Hospital, ‘s-Hertogenbosch, the Netherlands
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Baliatsas C, Smit LAM, Dückers MLA, van Dijk CE, Heederik D, Yzermans CJ. Patients with overlapping diagnoses of asthma and COPD: is livestock exposure a risk factor for comorbidity and coexisting symptoms and infections? BMC Pulm Med 2019; 19:105. [PMID: 31182085 PMCID: PMC6558812 DOI: 10.1186/s12890-019-0865-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 05/21/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Epidemiological research on health effects of livestock exposure in population subgroups with compromised respiratory health is still limited. The present study explored the association between livestock exposure and comorbid/concurrent conditions in patients with overlapping diagnoses of asthma and COPD. METHODS Electronic health record data from 23 general practices in the Netherlands were collected from 425 patients diagnosed with both asthma and COPD, living in rural areas with high livestock density ("study area"). Data of 341 patients with the same overlapping diagnoses, living in rural areas with lower livestock density ("control areas") were obtained from 19 general practices. First, the prevalence of comorbid disorders and symptoms/infections were compared between the study and control area. Second, the examined health outcomes were analyzed in relation to measures of individual livestock exposure. RESULTS Pneumonia was twice as common among patients living in areas with a high livestock density (OR 2.29, 99% CI 0.96-5.47); however, there were generally no statistically significant differences in the investigated outcomes between the study and control area. Significant associations were observed between presence of goats within 1000 m and allergic rhinitis (OR 5.71, 99% CI 1.11-29.3, p < 0.01), number of co-occurring symptoms (IRR 1.69, 99% CI 1.03-2.77, p < 0.01) and anxiety (OR 8.18, 99% 1.5-44.7, p < 0.01). Presence of cattle within 500 m was associated with pneumonia prevalence (OR 2.48, 99% CI 1.05-5.84, p < 0.01). CONCLUSION Livestock exposure is not associated with comorbid chronic conditions but appears to be a risk factor for symptomatic effects in patients with overlapping diagnoses of asthma and COPD.
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Affiliation(s)
- Christos Baliatsas
- Netherlands Institute for Health Services Research (NIVEL), Otterstraat 118-124, 3513 CR Utrecht, The Netherlands
| | - Lidwien A. M. Smit
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Michel L. A. Dückers
- Netherlands Institute for Health Services Research (NIVEL), Otterstraat 118-124, 3513 CR Utrecht, The Netherlands
| | - Christel E. van Dijk
- Netherlands Institute for Health Services Research (NIVEL), Otterstraat 118-124, 3513 CR Utrecht, The Netherlands
| | - Dick Heederik
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - C. Joris Yzermans
- Netherlands Institute for Health Services Research (NIVEL), Otterstraat 118-124, 3513 CR Utrecht, The Netherlands
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Salifu SP, Bukari ARA, Frangoulidis D, Wheelhouse N. Current perspectives on the transmission of Q fever: Highlighting the need for a systematic molecular approach for a neglected disease in Africa. Acta Trop 2019; 193:99-105. [PMID: 30831112 DOI: 10.1016/j.actatropica.2019.02.032] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 02/28/2019] [Accepted: 02/28/2019] [Indexed: 01/08/2023]
Abstract
Q fever is a bacterial worldwide zoonosis (except New Zealand) caused by the Gram-negative obligate intracellular bacterium Coxiella burnetii (C. burnetii). The bacterium has a large host range including arthropods, wildlife and companion animals and is frequently identified in human and livestock populations. In humans, the disease can occur as either a clinically acute or chronic aetiology, affecting mainly the lungs and liver in the acute disease, and heart valves when chronic. In livestock, Q fever is mainly asymptomatic; however, the infection can cause abortion, and the organism is shed in large quantities, where it can infect other livestock and humans. The presence of Q fever in Africa has been known for over 60 years, however while our knowledge of the transmission routes and risk of disease have been well established in many parts of the world, there is a significant paucity of knowledge across the African continent, where it remains a neglected zoonosis. Our limited knowledge of the disease across the African sub-continent have relied largely upon observational (sero) prevalence studies with limited focus on the molecular epidemiology of the disease. This review highlights the need for systematic studies to understand the routes of C. burnetii infection, and understand the disease burden and risk factors for clinical Q fever in both humans and livestock. With such knowledge gaps filled, the African continent could stand a better chance of eradicating Q fever through formulation and implementation of effective public health interventions.
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Borlée F, Yzermans CJ, Oostwegel FSM, Schellevis F, Heederik D, Smit LAM. Attitude toward livestock farming does not influence the earlier observed association between proximity to goat farms and self-reported pneumonia. Environ Epidemiol 2019; 3:e041. [PMID: 33778336 PMCID: PMC7952105 DOI: 10.1097/ee9.0000000000000041] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 01/13/2019] [Indexed: 11/26/2022] Open
Abstract
Attitudes toward environmental risks may be a source of bias in environmental health studies because concerns about environmental hazards may influence self-reported outcomes. OBJECTIVE The main aim was to assess whether earlier observed associations between proximity to goat farms and self-reported pneumonia were biased by participants' attitude toward farming. METHODS We developed an attitude-score for 2,457 participants of the Dutch Livestock Farming and Neighbouring Residents' Health Study (veehouderij en gezondheid omwonenden) by factor analysis of 13 questionnaire items related to attitude toward livestock farming. Linear regression analysis was used to assess associations between attitude and potential determinants. The effect of attitude on the association between goat farm proximity and pneumonia was analyzed by evaluating (1) misclassification of the outcome, (2) effect modification by attitude, and (3) exclusion of participants reporting health problems due to farms in their environment. RESULTS In general, the study population had a positive attitude toward farming, especially if participants were more familiar with farming. Older participants, females, ex-smokers, and higher-educated individuals had a more negative attitude. Both self-reported respiratory symptoms and exposure to livestock farms were associated with a more negative attitude. Misclassification of self-reported pneumonia was nondifferential with regard to participants' attitude. Furthermore, no indication was found that the association between proximity to goat farms and pneumonia was modified by attitude. Excluding subjects who attributed their health symptoms to livestock farms did also not change the association. CONCLUSIONS The association between goat farm proximity and pneumonia was not substantially biased by study participants' attitude toward livestock farming.
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Affiliation(s)
- Floor Borlée
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
- Netherlands Institute for Health Services Research, NIVEL, Utrecht, The Netherlands
| | - C. Joris Yzermans
- Netherlands Institute for Health Services Research, NIVEL, Utrecht, The Netherlands
| | - Floor S. M. Oostwegel
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - François Schellevis
- Netherlands Institute for Health Services Research, NIVEL, Utrecht, The Netherlands
- Department of General Practice & Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Dick Heederik
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Lidwien A. M. Smit
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
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Nasir ZA, Hayes E, Williams B, Gladding T, Rolph C, Khera S, Jackson S, Bennett A, Collins S, Parks S, Attwood A, Kinnersley RP, Walsh K, Alcega SG, Pollard SJT, Drew G, Coulon F, Tyrrel S. Scoping studies to establish the capability and utility of a real-time bioaerosol sensor to characterise emissions from environmental sources. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 648:25-32. [PMID: 30107303 DOI: 10.1016/j.scitotenv.2018.08.120] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 08/08/2018] [Accepted: 08/09/2018] [Indexed: 05/21/2023]
Abstract
A novel dual excitation wavelength based bioaerosol sensor with multiple fluorescence bands called Spectral Intensity Bioaerosol Sensor (SIBS) has been assessed across five contrasting outdoor environments. The mean concentrations of total and fluorescent particles across the sites were highly variable being the highest at the agricultural farm (2.6 cm-3 and 0.48 cm-3, respectively) and the composting site (2.32 cm-3 and 0.46 cm-3, respectively) and the lowest at the dairy farm (1.03 cm-3 and 0.24 cm-3, respectively) and the sewage treatment works (1.03 cm-3 and 0.25 cm-3, respectively). In contrast, the number-weighted fluorescent fraction was lowest at the agricultural site (0.18) in comparison to the other sites indicating high variability in nature and magnitude of emissions from environmental sources. The fluorescence emissions data demonstrated that the spectra at different sites were multimodal with intensity differences largely at wavelengths located in secondary emission peaks for λex 280 and λex 370. This finding suggests differences in the molecular composition of emissions at these sites which can help to identify distinct fluorescence signature of different environmental sources. Overall this study demonstrated that SIBS provides additional spectral information compared to existing instruments and capability to resolve spectrally integrated signals from relevant biological fluorophores could improve selectivity and thus enhance discrimination and classification strategies for real-time characterisation of bioaerosols from environmental sources. However, detailed lab-based measurements in conjunction with real-world studies and improved numerical methods are required to optimise and validate these highly resolved spectral signatures with respect to the diverse atmospherically relevant biological fluorophores.
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Affiliation(s)
- Zaheer Ahmad Nasir
- School of Water, Energy and Environment, Cranfield University, Cranfield MK43 0AL, UK.
| | - Enda Hayes
- Air Quality Management Resource Centre, Faculty of Environment and Technology, University of the West of England, Bristol BS16 1QY, UK
| | - Ben Williams
- Air Quality Management Resource Centre, Faculty of Environment and Technology, University of the West of England, Bristol BS16 1QY, UK
| | - Toni Gladding
- STEM Faculty, Open University, Walton Hall, MK6 7AA, UK
| | | | - Shagun Khera
- School of Biomedical and Healthcare Sciences, Plymouth University, Drake Circus, Plymouth PL4 8AA, UK
| | - Simon Jackson
- School of Biomedical and Healthcare Sciences, Plymouth University, Drake Circus, Plymouth PL4 8AA, UK
| | - Allan Bennett
- Biosafety, Air and Water Microbiology Group, National Infection Service, Public Health England, Salisbury SP4 0JG, UK
| | - Samuel Collins
- Biosafety, Air and Water Microbiology Group, National Infection Service, Public Health England, Salisbury SP4 0JG, UK
| | - Simon Parks
- Biosafety, Air and Water Microbiology Group, National Infection Service, Public Health England, Salisbury SP4 0JG, UK
| | - Alexis Attwood
- Droplet Measurement Technologies, 2400 Trade Centre Avenue, Longmont, CO 80503, United States of America
| | | | - Kerry Walsh
- Environment Agency, Evidence Directorate, Deanery Road, Bristol BS1 5AH, UK
| | - Sonia Garcia Alcega
- School of Water, Energy and Environment, Cranfield University, Cranfield MK43 0AL, UK
| | - Simon J T Pollard
- School of Water, Energy and Environment, Cranfield University, Cranfield MK43 0AL, UK
| | - Gill Drew
- School of Water, Energy and Environment, Cranfield University, Cranfield MK43 0AL, UK
| | - Frederic Coulon
- School of Water, Energy and Environment, Cranfield University, Cranfield MK43 0AL, UK
| | - Sean Tyrrel
- School of Water, Energy and Environment, Cranfield University, Cranfield MK43 0AL, UK
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35
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Plummer PJ, McClure JT, Menzies P, Morley PS, Van den Brom R, Van Metre DC. Management of Coxiella burnetii infection in livestock populations and the associated zoonotic risk: A consensus statement. J Vet Intern Med 2018; 32:1481-1494. [PMID: 30084178 PMCID: PMC6189356 DOI: 10.1111/jvim.15229] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 04/30/2018] [Accepted: 05/02/2018] [Indexed: 01/02/2023] Open
Abstract
Infections caused by Coxiella burnetii, commonly referred to as coxiellosis when occurring in animals and Query fever when occurring in humans, are an important cause of abortions, decreased reproductive efficiency, and subclinical infections in ruminants. The organism also represents an important zoonotic concern associated with its ability to aerosolize easily and its low infectious dose. Available diagnostic tests have limited sensitivity, which combined with the absence of treatment options in animals and limited approaches to prevention, result in difficulty managing this agent for optimal animal health and zoonotic disease outcomes. The purpose of this consensus statement is to provide veterinarians and public health officials with a summary of the available information regarding management of C. burnetii infection in livestock populations. A discussion of currently available testing options and their interpretation is provided, along with recommendations on management practices that can be implemented on‐farm in the face of an outbreak to mitigate losses. Emphasis is placed on biosecurity measures that can be considered for minimizing the zoonotic transmission risk in both field and veterinary facilities.
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Affiliation(s)
- Paul J Plummer
- Department of Veterinary Diagnostic and Production Animal Medicine and the Department of Veterinary Microbiology and Preventative Medicine, College of Veterinary Medicine, Iowa State University, Ames, Iowa
| | - J Trenton McClure
- Dpeartment of Health Management, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward, Canada
| | - Paula Menzies
- Department Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Paul S Morley
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado.,Colorado School of Public Health, Fort Collins, Colorado
| | | | - David C Van Metre
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
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Petersen E, Petrosillo N, Koopmans M. Emerging infections-an increasingly important topic: review by the Emerging Infections Task Force. Clin Microbiol Infect 2018; 24:369-375. [PMID: 29155018 PMCID: PMC7129920 DOI: 10.1016/j.cmi.2017.10.035] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 10/20/2017] [Accepted: 10/30/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVES This paper review trends in emerging infections and the need for increased clinical and laboratory surveillance. METHODS Factors that contributed to the emergence of recent outbreaks have been reviewed. Known, major outbreaks over the past two decades were reviewed. RESULTS We identified at least four major drivers of emergent infections: (i) increasing density of the human population; (ii) stress from farmland expansion on the environment; (iii) globalization of the food market and manufacturing; (iv) environmental contamination. The factors creating new opportunities for emerging infections include: (i) population growth; (ii) spread in health care facilities; (iii) an ageing population; (iv) international travel; (v) changing and expanding vector habitats. CONCLUSIONS Emerging infections are unpredictable. In this review we argue that to discover new trends in infectious diseases, the clinicians have to look for the unusual and unexpected and ensure proper diagnostics and that syndromic surveillance must be supported by highly specialized laboratory services. Mathematical modeling has not been able to predict outbreaks More emphasis on the biology of evolution is needed. EID rarely stands out as unusual, and the continuous pressure on health care budgets forces clinicians and laboratories to prioritize their diagnostic work-up to common and treatable conditions. The European Society for Infectious Diseases and Clinical Microbiology, ESCMID, has established an Emerging Infections Task Force, EITaF, to strengthen the activities of the society on emerging infections and ensure that emerging infections is included in differential diagnostic considerations in everyday clinical practice.
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Affiliation(s)
- E Petersen
- Institute for Clinical Medicine, University of Aarhus, Denmark and Department of Infectious Diseases, The Royal Hospital, Muscat, Oman.
| | - N Petrosillo
- Clinical and Research Department, National Institute for Infectious Diseases 'Lazzaro Spallanzani', IRCCS, Rome, Italy
| | - M Koopmans
- Viroscience Department, Erasmus University of Rotterdam, The Netherlands
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37
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Alvarez J, Whitten T, Branscum AJ, Garcia-Seco T, Bender JB, Scheftel J, Perez A. Understanding Q Fever Risk to Humans in Minnesota Through the Analysis of Spatiotemporal Trends. Vector Borne Zoonotic Dis 2018; 18:89-95. [DOI: 10.1089/vbz.2017.2132] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Julio Alvarez
- Department of Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, St Paul, Minnesota
| | - Tory Whitten
- Minnesota Department of Health, St Paul, Minnesota
| | - Adam J. Branscum
- Biostatistics Program, Oregon State University, Corvallis, Oregon
| | | | - Jeff B. Bender
- Department of Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, St Paul, Minnesota
| | | | - Andres Perez
- Department of Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, St Paul, Minnesota
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38
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Khor CS, Mohd-Rahim NF, Hassan H, Chandren JR, Nore SS, Johari J, Loong SK, Abd-Jamil J, Khoo JJ, Lee HY, Pike BL, Wong LP, Lim YAL, Zandi K, AbuBakar S. Seroprevalence of Q Fever Among the Indigenous People (Orang Asli) of Peninsular Malaysia. Vector Borne Zoonotic Dis 2018; 18:131-137. [PMID: 29336685 DOI: 10.1089/vbz.2017.2153] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Q fever is a disease caused by Coxiella burnetii. It is a disease of public health concern in many parts of the world. In this study, we described the seroprevalence of Q fever among selected populations of Orang Asli (OA), indigenous people, many of whom live within the forest fringe areas of Peninsular Malaysia. Serum samples were obtained from 887 OA participants from selected villages. Samples were analyzed for the presence of IgG antibodies reactive against C. burnetii by enzyme-linked immunosorbent assay. Statistical methods were used to identify possible associations between seropositivity for C. burnetii and a number of demographic variables obtained from the questionnaires. In total, 9.6% (n = 85/887) of the serum samples were reactive to C. burnetii. Statistical results suggest that elderly male OA residing in OA village, Bukit Payung, were most likely to be tested seropositive for C. burnetii. This study suggests that OA are at a significant risk of contracting C. burnetii infection, and both demographic and geographic factors are important contributors to this risk. Further prospective studies are needed to establish the true burden of C. burnetii infection within the indigenous population as well as within Peninsular Malaysia as a whole.
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Affiliation(s)
- Chee-Sieng Khor
- 1 Tropical Infectious Diseases Research & Education Centre (TIDREC), University of Malaya , Kuala Lumpur, Malaysia
| | - Nurul-Farhana Mohd-Rahim
- 1 Tropical Infectious Diseases Research & Education Centre (TIDREC), University of Malaya , Kuala Lumpur, Malaysia .,2 Department of Medical Microbiology, Faculty of Medicine, University of Malaya , Kuala Lumpur, Malaysia
| | - Habibi Hassan
- 1 Tropical Infectious Diseases Research & Education Centre (TIDREC), University of Malaya , Kuala Lumpur, Malaysia .,2 Department of Medical Microbiology, Faculty of Medicine, University of Malaya , Kuala Lumpur, Malaysia
| | - Josephine Rebecca Chandren
- 3 Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya , Kuala Lumpur, Malaysia
| | - Siti-Sarah Nore
- 1 Tropical Infectious Diseases Research & Education Centre (TIDREC), University of Malaya , Kuala Lumpur, Malaysia
| | - Jefree Johari
- 1 Tropical Infectious Diseases Research & Education Centre (TIDREC), University of Malaya , Kuala Lumpur, Malaysia
| | - Shih-Keng Loong
- 1 Tropical Infectious Diseases Research & Education Centre (TIDREC), University of Malaya , Kuala Lumpur, Malaysia
| | - Juraina Abd-Jamil
- 1 Tropical Infectious Diseases Research & Education Centre (TIDREC), University of Malaya , Kuala Lumpur, Malaysia
| | - Jing-Jing Khoo
- 1 Tropical Infectious Diseases Research & Education Centre (TIDREC), University of Malaya , Kuala Lumpur, Malaysia
| | - Hai-Yen Lee
- 1 Tropical Infectious Diseases Research & Education Centre (TIDREC), University of Malaya , Kuala Lumpur, Malaysia
| | - Brian L Pike
- 4 U.S. Naval Medical Research Center-Asia , Singapore, Singapore
| | - Li Ping Wong
- 3 Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya , Kuala Lumpur, Malaysia
| | - Yvonne Ai-Lian Lim
- 5 Department of Parasitology, Faculty of Medicine, University of Malaya , Kuala Lumpur, Malaysia
| | - Keivan Zandi
- 1 Tropical Infectious Diseases Research & Education Centre (TIDREC), University of Malaya , Kuala Lumpur, Malaysia .,6 Laboratory of Biochemical Pharmacology, Department of Pediatrics, Center for AIDS Research, Emory University School of Medicine , Atlanta, Georgia
| | - Sazaly AbuBakar
- 1 Tropical Infectious Diseases Research & Education Centre (TIDREC), University of Malaya , Kuala Lumpur, Malaysia .,2 Department of Medical Microbiology, Faculty of Medicine, University of Malaya , Kuala Lumpur, Malaysia
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Sobotta K, Hillarius K, Jiménez PH, Kerner K, Heydel C, Menge C. Interaction of Coxiella burnetii Strains of Different Sources and Genotypes with Bovine and Human Monocyte-Derived Macrophages. Front Cell Infect Microbiol 2018; 7:543. [PMID: 29379776 PMCID: PMC5771007 DOI: 10.3389/fcimb.2017.00543] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 12/26/2017] [Indexed: 11/13/2022] Open
Abstract
Most human Q fever infections originate from small ruminants. By contrast, highly prevalent shedding of Coxiella (C.) burnetii by bovine milk rarely results in human disease. We hypothesized that primary bovine and human monocyte-derived macrophages (MDM) represent a suitable in vitro model for the identification of strain-specific virulence properties at the cellular level. Twelve different C. burnetii strains were selected to represent different host species and multiple loci variable number of tandem repeat analysis (MLVA) genotypes. Infection efficiency and replication of C. burnetii were monitored by cell culture re-titration and qPCR. Expression of immunoregulatory factors after MDM infection was measured by qRT-PCR and flow cytometry. Invasion, replication and MDM response differed between C. burnetii strains but not between MDMs of the two hosts. Strains isolated from ruminants were less well internalized than isolates from humans and rodents. Internalization of MLVA group I strains was lower compared to other genogroups. Replication efficacy of C. burnetii in MDM ranged from low (MLVA group III) to high (MLVA group IV). Infected human and bovine MDM responded with a principal up-regulation of pro-inflammatory cytokines such as IL-1β, IL-12, and TNF-α. However, MLVA group IV strains induced a pronounced host response whereas infection with group I strains resulted in a milder response. C. burnetii infection marginally affected polarization of MDM. Only one C. burnetii strain of MLVA group IV caused a substantial up-regulation of activation markers (CD40, CD80) on the surface of bovine and human MDM. The study showed that replication of C. burnetii in MDM and the subsequent host cell response is genotype-specific rather than being determined by the host species pointing to a clear distinction in C. burnetii virulence between the genetic groups.
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Affiliation(s)
- Katharina Sobotta
- Friedrich-Loeffler-Institut, Institute of Molecular Pathogenesis, Jena, Germany
| | - Kirstin Hillarius
- Friedrich-Loeffler-Institut, Institute of Molecular Pathogenesis, Jena, Germany
| | - Pablo H Jiménez
- Chemisches und Veterinäruntersuchungsamt Karlsruhe, Karlsruhe, Germany
| | - Katharina Kerner
- Institute for Hygiene and Infectious Diseases of Animals, Justus-Liebig-University, Giessen, Germany
| | - Carsten Heydel
- Institute for Hygiene and Infectious Diseases of Animals, Justus-Liebig-University, Giessen, Germany
| | - Christian Menge
- Friedrich-Loeffler-Institut, Institute of Molecular Pathogenesis, Jena, Germany
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40
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Benaissa MH, Ansel S, Mohamed-Cherif A, Benfodil K, Khelef D, Youngs CR, Kaidi R, Ait-Oudhia K. Seroprevalence and risk factors for Coxiella burnetii, the causative agent of Q fever in the dromedary camel ( Camelus dromedarius) population in Algeria. Onderstepoort J Vet Res 2017; 84:e1-e7. [PMID: 28893076 PMCID: PMC6238797 DOI: 10.4102/ojvr.v84i1.1461] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 07/07/2017] [Accepted: 07/09/2017] [Indexed: 01/24/2023] Open
Abstract
Query (Q) fever is a globally distributed zoonotic disease caused by Coxiella burnetii, a bacterial agent for which ruminants are the most prevalent natural reservoir. Data regarding Q fever infection in camels in Algeria are limited. Therefore, a survey to detect seroprevalence of C. burnetii antibodies was conducted among healthy camel populations in a vast area in southeastern Algeria to determine distribution of the Q fever causative organism and to identify risk factors associated with infection. Between January and March 2016, blood samples were collected from 184 camels and serum samples were subsequently analysed using a commercial Enzyme-Linked Immunosorbent Assay (ELISA) kit. At the time of blood collection, a questionnaire investigating 13 potential predisposing factors associated with C. burnetii seropositivity was completed for every dromedary camel and herd. Results were analysed by a chi-square (χ2) test and multivariate logistic regression. The seroprevalence of C. burnetii at the animal level was 71.2% (95% CI: 65.2-78.3) and 85.3% (95% CI: 72.8-97.8) at the herd level. At the animal level, differences in seroprevalence were observed because of herd size, animal age, animal sex, presence of ticks and contact with other herds. A multivariable logistic regression model identified three main risk factors associated with individual seropositivity: (1) age class > 11 years (OR = 8.81, 95% CI: 2.55-30.41), (2) herd size > 50 head (OR = 4.46, 95% CI: 1.01-19.59) and (3) infestation with ticks (OR 2.2; 95% CI: 1.1-4.5). This study of seroprevalence of C. burnetii infection in camels in Algeria revealed a high seroprevalence of Q fever in camel populations in southeastern Algeria and provided strong evidence that Q fever represents an economic, public health and veterinary concern. Appropriate measures should be taken to prevent the spread of C. burnetii and to reduce the risk of Q fever in farm animals and humans in this agro-ecologically and strategically important region of North Africa.
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Affiliation(s)
- Mohammed H Benaissa
- Scientific and Technical Research Centre for Arid Areas (CRSTRA), Touggourt.
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41
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Sobotta K, Bonkowski K, Liebler-Tenorio E, Germon P, Rainard P, Hambruch N, Pfarrer C, Jacobsen ID, Menge C. Permissiveness of bovine epithelial cells from lung, intestine, placenta and udder for infection with Coxiella burnetii. Vet Res 2017; 48:23. [PMID: 28403908 PMCID: PMC5389005 DOI: 10.1186/s13567-017-0430-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 03/12/2017] [Indexed: 02/23/2023] Open
Abstract
Ruminants are the main source of human infections with the obligate intracellular bacterium Coxiella (C.) burnetii. Infected animals shed high numbers of C. burnetii by milk, feces, and birth products. In goats, shedding by the latter route coincides with C. burnetii replication in epithelial (trophoblast) cells of the placenta, which led us to hypothesize that epithelial cells are generally implicated in replication and shedding of C. burnetii. We therefore aimed at analyzing the interactions of C. burnetii with epithelial cells of the bovine host (1) at the entry site (lung epithelium) which govern host immune responses and (2) in epithelial cells of gut, udder and placenta decisive for the quantity of pathogen excretion. Epithelial cell lines [PS (udder), FKD-R 971 (small intestine), BCEC (maternal placenta), F3 (fetal placenta), BEL-26 (lung)] were inoculated with C. burnetii strains Nine Mile I (NMI) and NMII at different cultivation conditions. The cell lines exhibited different permissiveness for C. burnetii. While maintaining cell viability, udder cells allowed the highest replication rates with formation of large cell-filling Coxiella containing vacuoles. Intestinal cells showed an enhanced susceptibility to invasion but supported C. burnetii replication only at intermediate levels. Lung and placental cells also internalized the bacteria but in strikingly smaller numbers. In any of the epithelial cells, both Coxiella strains failed to trigger a substantial IL-1β, IL-6 and TNF-α response. Epithelial cells, with mammary epithelial cells in particular, may therefore serve as a niche for C. burnetii replication in vivo without alerting the host’s immune response.
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Affiliation(s)
- Katharina Sobotta
- Institute of Molecular Pathogenesis, Friedrich-Loeffler-Institut (FLI), Naumburger Strasse 96a, 07743, Jena, Germany
| | - Katharina Bonkowski
- Institute of Molecular Pathogenesis, Friedrich-Loeffler-Institut (FLI), Naumburger Strasse 96a, 07743, Jena, Germany
| | - Elisabeth Liebler-Tenorio
- Institute of Molecular Pathogenesis, Friedrich-Loeffler-Institut (FLI), Naumburger Strasse 96a, 07743, Jena, Germany
| | - Pierre Germon
- ISP, INRA, Université Tours, UMR 1282, 37380, Nouzilly, France
| | - Pascal Rainard
- ISP, INRA, Université Tours, UMR 1282, 37380, Nouzilly, France
| | - Nina Hambruch
- Department of Anatomy, University of Veterinary Medicine Hannover, Bischofsholer Damm 15, 30173, Hannover, Germany
| | - Christiane Pfarrer
- Department of Anatomy, University of Veterinary Medicine Hannover, Bischofsholer Damm 15, 30173, Hannover, Germany
| | - Ilse D Jacobsen
- Research Group Microbial Immunology, Leibniz Institute for Natural Product Research and Infection Biology/Hans Knoell Institute, Beutenbergstrasse 11a, 07745, Jena, Germany
| | - Christian Menge
- Institute of Molecular Pathogenesis, Friedrich-Loeffler-Institut (FLI), Naumburger Strasse 96a, 07743, Jena, Germany.
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Freidl GS, Spruijt IT, Borlée F, Smit LAM, van Gageldonk-Lafeber AB, Heederik DJJ, Yzermans J, van Dijk CE, Maassen CBM, van der Hoek W. Livestock-associated risk factors for pneumonia in an area of intensive animal farming in the Netherlands. PLoS One 2017; 12:e0174796. [PMID: 28362816 PMCID: PMC5376295 DOI: 10.1371/journal.pone.0174796] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 03/15/2017] [Indexed: 01/05/2023] Open
Abstract
Previous research conducted in 2009 found a significant positive association between pneumonia in humans and living close to goat and poultry farms. However, as this result might have been affected by a large goat-related Q fever epidemic, the aim of the current study was to re-evaluate this association, now that the Q-fever epidemic had ended. In 2014/15, 2,494 adults (aged 20–72 years) living in a livestock-dense area in the Netherlands participated in a medical examination and completed a questionnaire on respiratory health, lifestyle and other items. We retrieved additional information for 2,426/2,494 (97%) participants from electronic medical records (EMR) from general practitioners. The outcome was self-reported, physician-diagnosed pneumonia or pneumonia recorded in the EMR in the previous three years. Livestock license data was used to determine exposure to livestock. We quantified associations between livestock exposures and pneumonia using odds ratios adjusted for participant characteristics and comorbidities (aOR). The three-year cumulative frequency of pneumonia was 186/2,426 (7.7%). Residents within 2,000m of a farm with at least 50 goats had an increased risk of pneumonia, which increased the closer they lived to the farm (2,000m aOR 1.9, 95% CI 1.4–2.6; 500m aOR 4.4, 95% CI 2.0–9.8). We found no significant associations between exposure to other farm animals and pneumonia. However, when conducting sensitivity analyses using pneumonia outcome based on EMR only, we found a weak but statistically significant association with presence of a poultry farm within 1,000m (aOR: 1.7, 95% CI 1.1–2.7). Living close to goat and poultry farms still constitute risk factors for pneumonia. Individuals with pneumonia were not more often seropositive for Coxiella burnetii, indicating that results are not explained by Q fever. We strongly recommend identification of pneumonia causes by the use of molecular diagnostics and investigating the role of non-infectious agents such as particulate matter or endotoxins.
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Affiliation(s)
- Gudrun S. Freidl
- Centre for Infectious Diseases, Epidemiology and Surveillance, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
- * E-mail:
| | - Ineke T. Spruijt
- Centre for Infectious Diseases, Epidemiology and Surveillance, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Floor Borlée
- Institute for Risk Assessment Sciences (IRAS), Division of Environmental Epidemiology, Utrecht University, Utrecht, the Netherlands
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, Netherlands
| | - Lidwien A. M. Smit
- Institute for Risk Assessment Sciences (IRAS), Division of Environmental Epidemiology, Utrecht University, Utrecht, the Netherlands
| | - Arianne B. van Gageldonk-Lafeber
- Centre for Infectious Diseases, Epidemiology and Surveillance, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Dick J. J. Heederik
- Institute for Risk Assessment Sciences (IRAS), Division of Environmental Epidemiology, Utrecht University, Utrecht, the Netherlands
| | - Joris Yzermans
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, Netherlands
| | - Christel E. van Dijk
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, Netherlands
| | - Catharina B. M. Maassen
- Centre for Infectious Diseases, Epidemiology and Surveillance, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Wim van der Hoek
- Centre for Infectious Diseases, Epidemiology and Surveillance, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
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43
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van Schaik EJ, Case ED, Martinez E, Bonazzi M, Samuel JE. The SCID Mouse Model for Identifying Virulence Determinants in Coxiella burnetii. Front Cell Infect Microbiol 2017; 7:25. [PMID: 28217558 PMCID: PMC5289997 DOI: 10.3389/fcimb.2017.00025] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 01/19/2017] [Indexed: 01/09/2023] Open
Abstract
Coxiella burnetii is an intracellular, zoonotic pathogen that is the causative agent of Q fever. Infection most frequently occurs after inhalation of contaminated aerosols, which can lead to acute, self-limiting febrile illness or more serve chronic infections such as hepatitis or endocarditis. Macrophages are the principal target cells during infection where C. burnetii resides and replicates within a unique phagolysosome-like compartment, the Coxiella-containing vacuole (CCV). The first virulence determinant described as necessary for infection was full-length lipopolysaccarride (LPS); spontaneous rough mutants (phase II) arise after passage in immuno-incompetent hosts. Phase II C. burnetii are attenuated in immuno-competent animals, but are fully capable of infecting a variety of host cells in vitro. A clonal strain of the Nine Mile isolate (RSA439, clone 4), has a 26 KDa chromosomal deletion that includes LPS biosynthetic genes and is uniquely approved for use in BL2/ABL2 conditions. With the advances of axenic media and genetic tools for C. burnetii research, the characterization of novel virulence determinants is ongoing and almost exclusively performed using this attenuated clone. A major problem with predicting essential virulence loci with RSA439 is that, although some cell-autonomous phenotypes can be assessed in tissue culture, no animal model for assessing pathogenesis has been defined. Here we describe the use of SCID mice for predicting virulence factors of C. burnetii, in either independent or competitive infections. We propose that this model allows for the identification of mutations that are competent for intracellular replication in vitro, but attenuated for growth in vivo and predict essential innate immune responses modulated by the pathogen during infection as a central pathogenic strategy.
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Affiliation(s)
- Erin J. van Schaik
- Department of Microbial Pathogenesis and Immunology, College of Medicine, Texas A&M UniversityBryan, TX, USA
| | - Elizabeth D. Case
- Department of Microbial Pathogenesis and Immunology, College of Medicine, Texas A&M UniversityBryan, TX, USA
| | - Eric Martinez
- Centre National de la Recherche Scientifique, Formation de Recherche en Évolution 3689, Centre d'études d'agents Pathogènes et Biotechnologies Pour la Santé, Université MontpellierMontpellier, France
| | - Matteo Bonazzi
- Centre National de la Recherche Scientifique, Formation de Recherche en Évolution 3689, Centre d'études d'agents Pathogènes et Biotechnologies Pour la Santé, Université MontpellierMontpellier, France
| | - James E. Samuel
- Department of Microbial Pathogenesis and Immunology, College of Medicine, Texas A&M UniversityBryan, TX, USA
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van Gageldonk-Lafeber AB, van der Hoek W, Borlée F, Heederik DJJ, Mooi SH, Maassen CBM, Yzermans CJ, Rockx B, Smit LAM, Reimerink JHJ. Hepatitis E virus seroprevalence among the general population in a livestock-dense area in the Netherlands: a cross-sectional population-based serological survey. BMC Infect Dis 2017; 17:21. [PMID: 28056844 PMCID: PMC5217153 DOI: 10.1186/s12879-016-2160-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 12/22/2016] [Indexed: 02/06/2023] Open
Abstract
Background Recent serological studies indicate that hepatitis E virus (HEV) is endemic in industrialised countries. The increasing trend in the number of autochthonous cases of HEV genotype 3 in Western European countries, stresses the importance to get insight in the exact routes of exposure. Pigs are the main animal reservoir, and zoonotic food-borne transmission of HEV is proven. However, infected pigs can excrete large amounts of virus via their faeces enabling environmental transmission of HEV to humans. This might pose a risk for of neighbouring residents of livestock farming. Methods Within a large study on the health of people living in the vicinity of livestock farming we performed a cross-sectional population-based serological survey among 2,494 non-farming adults from the general population in a livestock-dense area in the south of the Netherlands. Participants completed risk factor questionnaires and blood samples of 2,422 subjects (median age 58 years, range 20–72) were tested for anti-HEV IgG using an enzyme immune assay (Wantai). The aim of this study was to determine the HEV seroprevalence and to assess whether seropositivity in adults was associated with living in the vicinity of pig farms. Results The average seroprevalence of HEV was 28.7% (95% CI: 26.9–30.5). Determinants associated with an increased risk for HEV seropositivity were male gender and low level of education. There was a clear trend of increasing prevalence with increasing age (Chi-square test for linear trend, X2 = 83.1; p < 0.001). A high number of pigs within 1,000 m of the residential address was not a risk factor for seropositivity. Conclusions This study confirmed the high HEV seroprevalence (29%) in the general population of the Netherlands, but presence of antibodies was not associated with residential proximity to pig farms. The prevalence increased with age from 10% in adolescents to 33% among those aged 50 and above, supporting the assumption of a cumulative lifetime exposure to HEV in the Netherlands as well as a higher infection pressure in the past. Our findings cannot refute the assumption that transmission is primarily food-borne.
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Affiliation(s)
| | - Wim van der Hoek
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Floor Borlée
- Institute for Risk Assessment Sciences, IRAS, Utrecht University, Utrecht, The Netherlands.,Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - Dick J J Heederik
- Institute for Risk Assessment Sciences, IRAS, Utrecht University, Utrecht, The Netherlands
| | - Sofie H Mooi
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Catharina B M Maassen
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - C Joris Yzermans
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - Barry Rockx
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Lidwien A M Smit
- Institute for Risk Assessment Sciences, IRAS, Utrecht University, Utrecht, The Netherlands
| | - Johan H J Reimerink
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
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45
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The European Union summary report on trends and sources of zoonoses, zoonotic agents and food‐borne outbreaks in 2015. EFSA J 2016. [DOI: 10.2903/j.efsa.2016.4634] [Citation(s) in RCA: 151] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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Battisti JM, Watson LA, Naung MT, Drobish AM, Voronina E, Minnick MF. Analysis of the Caenorhabditis elegans innate immune response to Coxiella burnetii. Innate Immun 2016; 23:111-127. [PMID: 27884946 DOI: 10.1177/1753425916679255] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The nematode Caenorhabditis elegans is well established as a system for characterization and discovery of molecular mechanisms mediating microbe-specific inducible innate immune responses to human pathogens. Coxiella burnetii is an obligate intracellular bacterium that causes a flu-like syndrome in humans (Q fever), as well as abortions in domesticated livestock, worldwide. Initially, when wild type C. elegans (N2 strain) was exposed to mCherry-expressing C. burnetii (CCB) a number of overt pathological manifestations resulted, including intestinal distension, deformed anal region and a decreased lifespan. However, nematodes fed autoclave-killed CCB did not exhibit these symptoms. Although vertebrates detect C. burnetii via TLRs, pathologies in tol-1(-) mutant nematodes were indistinguishable from N2, and indicate nematodes do not employ this orthologue for detection of C. burnetii. sek-1(-) MAP kinase mutant nematodes succumbed to infection faster, suggesting that this signaling pathway plays a role in immune activation, as previously shown for orthologues in vertebrates during a C. burnetii infection. C. elegans daf-2(-) mutants are hyper-immune and exhibited significantly reduced pathological consequences during challenge. Collectively, these results demonstrate the utility of C. elegans for studying the innate immune response against C. burnetii and could lead to discovery of novel methods for prevention and treatment of disease in humans and livestock.
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Affiliation(s)
- James M Battisti
- Program in Cellular, Molecular and Microbial Biology, Division of Biological Sciences, University of Montana, Missoula, MT, USA
| | - Lance A Watson
- Program in Cellular, Molecular and Microbial Biology, Division of Biological Sciences, University of Montana, Missoula, MT, USA
| | - Myo T Naung
- Program in Cellular, Molecular and Microbial Biology, Division of Biological Sciences, University of Montana, Missoula, MT, USA
| | - Adam M Drobish
- Program in Cellular, Molecular and Microbial Biology, Division of Biological Sciences, University of Montana, Missoula, MT, USA
| | - Ekaterina Voronina
- Program in Cellular, Molecular and Microbial Biology, Division of Biological Sciences, University of Montana, Missoula, MT, USA
| | - Michael F Minnick
- Program in Cellular, Molecular and Microbial Biology, Division of Biological Sciences, University of Montana, Missoula, MT, USA
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Newton P, Latomanski EA, Newton HJ. Applying Fluorescence Resonance Energy Transfer (FRET) to Examine Effector Translocation Efficiency by Coxiella burnetii during siRNA Silencing. J Vis Exp 2016. [PMID: 27501079 DOI: 10.3791/54210] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Coxiella burnetii, the causative agent of Q fever, is an intracellular pathogen that relies on a Type IV Dot/Icm Secretion System to establish a replicative niche. A cohort of effectors are translocated through this system into the host cell to manipulate host processes and allow the establishment of a unique lysosome-derived vacuole for replication. The method presented here involves the combination of two well-established techniques: specific gene silencing using siRNA and measurement of effector translocation using a FRET-based substrate that relies on β-lactamase activity. Applying these two approaches, we can begin to understand the role of host factors in bacterial secretion system function and effector translocation. In this study we examined the role of Rab5A and Rab7A, both important regulators of the endocytic trafficking pathway. We demonstrate that silencing the expression of either protein results in a decrease in effector translocation efficiency. These methods can be easily modified to examine other intracellular and extracellular pathogens that also utilize secretion systems. In this way, a global picture of host factors involved in bacterial effector translocation may be revealed.
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Affiliation(s)
- Patrice Newton
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, University of Melbourne
| | - Eleanor A Latomanski
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, University of Melbourne
| | - Hayley J Newton
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, University of Melbourne;
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Kersh GJ, Priestley RA, Hornstra HM, Self JS, Fitzpatrick KA, Biggerstaff BJ, Keim P, Pearson T, Massung RF. Genotyping and Axenic Growth of Coxiella burnetii Isolates Found in the United States Environment. Vector Borne Zoonotic Dis 2016; 16:588-94. [PMID: 27304166 DOI: 10.1089/vbz.2016.1972] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Coxiella burnetii is a gram-negative bacterium that is the etiologic agent of the zoonotic disease Q fever. Common reservoirs of C. burnetii include sheep, goats, and cattle. These animals shed C. burnetii into the environment, and humans are infected by inhalation of aerosols. A survey of 1622 environmental samples taken across the United States in 2006-2008 found that 23.8% of the samples contained C. burnetii DNA. To identify the strains circulating in the U.S. environment, DNA from these environmental samples was genotyped using an SNP-based approach to derive sequence types (ST) that are also compatible with multispacer sequence typing methods. Three different sequence types were observed in 31 samples taken from 19 locations. ST8 was associated with goats and ST20 with dairy cattle. ST16/26 was detected in locations with exposure to various animals and also in locations with no direct animal contact. Viable isolates were obtained for all three sequence types, but only the ST20 and ST16/26 isolates grew in acidified citrate cysteine medium (ACCM)-2 axenic media. Examination of a variety of isolates with different sequence types showed that ST8 and closely related isolates did not grow in ACCM-2. These results suggest that a limited number of C. burnetii sequence types are circulating in the U.S. environment and these strains have close associations with specific reservoir species. Growth in ACCM-2 may not be suitable for isolation of many C. burnetii strains.
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Affiliation(s)
- Gilbert J Kersh
- 1 Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Rachael A Priestley
- 1 Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Heidie M Hornstra
- 2 Center for Microbial Genetics and Genomics, Northern Arizona University , Flagstaff, Arizona
| | - Joshua S Self
- 1 Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Kelly A Fitzpatrick
- 1 Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Brad J Biggerstaff
- 3 Division of Vector-Borne Diseases, Centers for Disease Control and Prevention , Ft. Collins, Colorado
| | - Paul Keim
- 2 Center for Microbial Genetics and Genomics, Northern Arizona University , Flagstaff, Arizona
| | - Talima Pearson
- 2 Center for Microbial Genetics and Genomics, Northern Arizona University , Flagstaff, Arizona
| | - Robert F Massung
- 1 Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention , Atlanta, Georgia
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de Rooij MMT, Borlée F, Smit LAM, de Bruin A, Janse I, Heederik DJJ, Wouters IM. Detection of Coxiella burnetii in Ambient Air after a Large Q Fever Outbreak. PLoS One 2016; 11:e0151281. [PMID: 26991094 PMCID: PMC4798294 DOI: 10.1371/journal.pone.0151281] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 02/25/2016] [Indexed: 11/18/2022] Open
Abstract
One of the largest Q fever outbreaks ever occurred in the Netherlands from 2007-2010, with 25 fatalities among 4,026 notified cases. Airborne dispersion of Coxiella burnetii was suspected but not studied extensively at the time. We investigated temporal and spatial variation of Coxiella burnetii in ambient air at residential locations in the most affected area in the Netherlands (the South-East), in the year immediately following the outbreak. One-week average ambient particulate matter < 10 μm samples were collected at eight locations from March till September 2011. Presence of Coxiella burnetii DNA was determined by quantitative polymerase chain reaction. Associations with various spatial and temporal characteristics were analyzed by mixed logistic regression. Coxiella burnetii DNA was detected in 56 out of 202 samples (28%). Airborne Coxiella burnetii presence showed a clear seasonal pattern coinciding with goat kidding. The spatial variation was significantly associated with number of goats on the nearest goat farm weighted by the distance to the farm (OR per IQR: 1.89, CI: 1.31-2.76). We conclude that in the year after a large Q fever outbreak, temporal variation of airborne Coxiella burnetii is suggestive to be associated with goat kidding, and spatial variation with distance to and size of goat farms. Aerosol measurements show to have potential for source identification and attribution of an airborne pathogen, which may also be applicable in early stages of an outbreak.
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Affiliation(s)
- Myrna M. T. de Rooij
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
- * E-mail:
| | - Floor Borlée
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Lidwien A. M. Smit
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Arnout de Bruin
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Ingmar Janse
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Dick J. J. Heederik
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Inge M. Wouters
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
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Altered interferon-γ response in patients with Q-fever fatigue syndrome. J Infect 2016; 72:478-85. [PMID: 26820634 DOI: 10.1016/j.jinf.2016.01.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 12/21/2015] [Accepted: 01/14/2016] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Whether immunological mechanisms underlie Q-fever fatigue syndrome (QFS) remains unclear. For acute Q-fever, the antigen-specific interferon-γ (IFNγ) response may be a useful tool for diagnosis, and the IFNγ/interleukin(IL)-2 production ratio may be a marker for chronic Q-fever and treatment monitoring. Here we explored the specific IFNγ production and IFNγ/IL-2 ratio in QFS patients. METHODS IFNγ and IL-2 production were tested in ex-vivo stimulated whole blood of QFS patients (n = 20), and compared to those previously determined in seropositive controls (n = 135), and chronic Q-fever patients (n = 28). Also, the correlation between patient characteristics and IFNγ, IL-2, and IFNγ/IL-2 ratio was determined. RESULTS QFS patients were younger (p < 0.001), but gender distribution was similar to seropositive controls and chronic Q-fever patients. Coxiella burnetii Nine Mile stimulation revealed a higher IFNγ production in QFS (median 319.5 pg/ml) than in seropositive controls (120 pg/ml, p < 0.01), but comparable to chronic Q-fever (2846 pg/ml). The IFNγ/IL-2 ratio was similar to that in seropositive controls, but lower than in chronic Q-fever patients (p < 0.01). Symptom duration was positively correlated with IL-2 production, and negatively correlated with the IFNγ/IL-2 ratio. CONCLUSIONS These results point to an altered cell-mediated immunity in QFS, and suggest a different immune response than in chronic Q-fever.
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