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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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Burns RJ, Le KK, Siengsanun-Lamont J, Blacksell SD. A review of coxiellosis (Q fever) and brucellosis in goats and humans: Implications for disease control in smallholder farming systems in Southeast Asia. One Health 2023; 16:100568. [PMID: 37363211 PMCID: PMC10288130 DOI: 10.1016/j.onehlt.2023.100568] [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: 03/30/2023] [Revised: 05/19/2023] [Accepted: 05/20/2023] [Indexed: 06/28/2023] Open
Abstract
Coxiella burnetii and Brucella spp. are pathogenic bacteria that can cause large-scale outbreaks in livestock. Furthermore, these infectious agents are capable of causing zoonotic infections and therefore pose a risk to the close relationship between farm households and their livestock, especially goats. A review of seroprevalence studies of Coxiella burnetii and Brucella spp. in domestic goats demonstrated large differences in the total number of samples tested in different regions and countries. This review aims to provide information on coxiellosis (Q fever in humans) and brucellosis in goats concerning the characteristics of the causative agent, surveillance, and available prevention and control measures at a global level. Implications for Coxiella burnetii and Brucella spp. infections in domesticated goats in Southeast Asia are discussed.
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Affiliation(s)
- Rebekah J.L. Burns
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Kim Khanh Le
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Jarunee Siengsanun-Lamont
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Stuart D. Blacksell
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Mahosot Hospital, Vientiane, Lao Democratic People’s Republic
- Centre for Tropical Medicine & Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
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Mathews KO, Norris JM, Phalen D, Malikides N, Savage C, Sheehy PA, Bosward KL. Factors associated with Q fever vaccination in Australian wildlife rehabilitators. Vaccine 2023; 41:201-210. [PMID: 36424259 DOI: 10.1016/j.vaccine.2022.10.082] [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: 05/14/2022] [Revised: 10/10/2022] [Accepted: 10/31/2022] [Indexed: 11/23/2022]
Abstract
Australian wildlife rehabilitators (AWR) are at risk of contracting Q fever, a serious zoonotic disease caused by Coxiella burnetii. Despite Australian government recommendations for AWR to receive Q fever vaccination (QFV), and the availability of a safe and effective vaccine in Australia, shortfalls in vaccine uptake have been observed in AWR. This study aimed to determine factors associated with QFV status and describe AWR attitudes and potential barriers towards QFV. Data were obtained from a nationwide, online, cross-sectional survey of AWR undertaken in 2018. Approximately-three quarters (200/265; 75.5 %) of those that had heard of Q fever were also aware of the Q fever vaccine, and of those, 25.5 % (51/200) were vaccinated. Barriers to QFV, among unvaccinated respondents who had also heard of Q fever and the vaccine (149/200; 74.5 %), included concerns regarding the safety, efficacy, and importance of the Q fever vaccine. Complacency toward vaccination, convenience of vaccination, and a lack of Q fever knowledge were also notable barriers. Only 27.7 % (41/148) of respondents reported having had vaccination recommended to them. Multivariable logistic regression identified that vaccinated AWR were more likely to be aged ≤ 50 years (OR 4.51, 95 % CI: 2.14-10.11), have had a university level education (OR 2.78, 95 % CI: 1.39-5.73), have resided in New South Wales/Australian Capital Territory and Queensland than in other Australian jurisdictions (OR 2.9, 95 % CI: 1.10-8.83 and OR 4.82, 95 % CI: 1.64-16.00 respectively) and have attended an animal birth (OR 2.14, 95 % CI: 1.02-4.73). Knowledge gaps regarding Q fever and QFV in AWR demonstrated the need for interventions to raise the awareness of the potential health consequences of C. burnetii exposure and Q fever prevention. Education programs to allow AWR to develop an informed perspective of Q fever and QFV, coupled with improvements in vaccine affordability and the implementation of programs to enhance accessibility, may also increase vaccine uptake.
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Affiliation(s)
- Karen O Mathews
- The University of Sydney, Sydney School of Veterinary Science, Faculty of Science, Camden, NSW, Australia
| | - Jacqueline M Norris
- The University of Sydney, Sydney School of Veterinary Science, Faculty of Science, Camden, NSW, Australia; Sydney Institute for Infectious Diseases, University of Sydney, Sydney 2006, New South Wales, Australia
| | - David Phalen
- The University of Sydney, Sydney School of Veterinary Science, Faculty of Science, Camden, NSW, Australia
| | | | | | - Paul A Sheehy
- The University of Sydney, Sydney School of Veterinary Science, Faculty of Science, Camden, NSW, Australia
| | - Katrina L Bosward
- The University of Sydney, Sydney School of Veterinary Science, Faculty of Science, Camden, NSW, Australia; Sydney Institute for Infectious Diseases, University of Sydney, Sydney 2006, New South Wales, Australia.
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Hobbs MJ, Ketheesan N, Eastwood K, Massey P, Ranmuthugala G, Norton R, Quirk FH. Q Fever awareness and risk profiles among agricultural show attendees. Aust J Rural Health 2022; 30:601-607. [PMID: 35816572 PMCID: PMC9796403 DOI: 10.1111/ajr.12896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 04/15/2022] [Accepted: 05/09/2022] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE To assess awareness and risk of Q fever among agricultural show attendees. SETTING University of New England's Farm of the Future Pavilion, 2019, Sydney Royal Agricultural Show. PARTICIPANTS Participants were ≥18 years, fluent in English, Australian residents, and gave their informed consent. MAIN OUTCOME MEASURES Participants reported whether they had ever heard of Q fever and then completed the 'Q Tool' (www.qfevertool.com), which was used to assess participants' demographics and risk profiles. Cross-tabulations and logistic regression analyses were used to examine the relationship between these factors. RESULTS A total of 344 participants were recruited who, in general, lived in major NSW cities and were aged 40-59 years. 62% were aware of Q fever. Living in regional/remote areas and regular contact with livestock, farms, abattoirs and/or feedlots increased the likelihood of Q fever awareness. Direct or indirect contact with feral animals was not associated with Q fever awareness after controlling for the latter risk factors. 40% of participants had a high, 21% a medium, and 30% a low risk of exposure. Slightly less than 10% reported a likely existing immunity or vaccination against Q fever. Among those who were not immune, living in a regional or remote area and Q fever awareness were independently associated with increased likelihood of exposure. CONCLUSIONS Awareness of Q fever was relatively high. Although 61% of participants had a moderate to high risk of exposure to Q fever, they had not been vaccinated. This highlights the need to explore barriers to vaccination including accessibility of providers and associated cost.
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Affiliation(s)
- Megan J. Hobbs
- New England Institute of Healthcare Research, UNEArmidaleNSWAustralia,School of Rural Medicine, UNEArmidaleNSWAustralia
| | - Natkunam Ketheesan
- New England Institute of Healthcare Research, UNEArmidaleNSWAustralia,Q Fever Research Consortium, UNEArmidaleNSWAustralia,School of Science and Technology, UNEArmidaleNSWAustralia
| | - Keith Eastwood
- Q Fever Research Consortium, UNEArmidaleNSWAustralia,School of Medicine and Public HealthUniversity of NewcastleCallaghanNSWAustralia,Population HealthHunter New England Local Health DistrictNew LambtonNSWAustralia
| | - Peter Massey
- Q Fever Research Consortium, UNEArmidaleNSWAustralia,Population HealthHunter New England Local Health DistrictNew LambtonNSWAustralia
| | - Geetha Ranmuthugala
- New England Institute of Healthcare Research, UNEArmidaleNSWAustralia,School of Rural Medicine, UNEArmidaleNSWAustralia,Q Fever Research Consortium, UNEArmidaleNSWAustralia
| | - Robert Norton
- Q Fever Research Consortium, UNEArmidaleNSWAustralia,Townsville Hospital Health Service, Queensland HealthDouglasQldAustralia,School of Biomedical SciencesUniversity of QueenslandSt LuciaQldAustralia
| | - Frances H. Quirk
- New England Institute of Healthcare Research, UNEArmidaleNSWAustralia,School of Rural Medicine, UNEArmidaleNSWAustralia,Q Fever Research Consortium, UNEArmidaleNSWAustralia
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Profiling Risk Factors for Household and Community Spatiotemporal Clusters of Q Fever Notifications in Queensland between 2002 and 2017. Pathogens 2022; 11:pathogens11080830. [PMID: 35894053 PMCID: PMC9332293 DOI: 10.3390/pathogens11080830] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/07/2022] [Accepted: 07/20/2022] [Indexed: 02/05/2023] Open
Abstract
Q fever, caused by the bacterium Coxiella burnetii, is an important zoonotic disease worldwide. Australia has one of the highest reported incidences and seroprevalence of Q fever, and communities in the state of Queensland are at highest risk of exposure. Despite Australia’s Q fever vaccination programs, the number of reported Q fever cases has remained stable for the last few years. The extent to which Q fever notifications cluster in circumscribed communities is not well understood. This study aimed to retrospectively explore and identify the spatiotemporal variation in Q fever household and community clusters in Queensland reported during 2002 to 2017, and quantify potential within cluster drivers. We used Q fever notification data held in the Queensland Notifiable Conditions System to explore the geographical clustering patterns of Q fever incidence, and identified and estimated community Q fever spatiotemporal clusters using SatScan, Boston, MA, USA. The association between Q fever household and community clusters, and demographic and socioeconomic characteristics was explored using the chi-squared statistical test and logistic regression analysis. From the total 2175 Q fever notifications included in our analysis, we found 356 Q fever hotspots at a mesh-block level. We identified that 8.2% of Q fever notifications belonged to a spatiotemporal cluster. Within the spatiotemporal Q fever clusters, we found 44 (61%) representing household clusters and 20 (27.8%) were statistically significant with an average cluster size of 3 km radius. Our multivariable model shows statistical differences between cases belonging to clusters in comparison with cases outside clusters based on the type of reported exposure. In conclusion, our results demonstrate that clusters of Q fever notifications are temporally stable and geographically circumscribed, indicating a persistent common exposure. Furthermore, within individuals in household and community clusters, abattoir exposure (a traditional occupational exposure) was rarely reported by individuals.
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Surveillance of Coxiella burnetii Shedding in Three Naturally Infected Dairy Goat Herds after Vaccination, Focusing on Bulk Tank Milk and Dust Swabs. Vet Sci 2022; 9:vetsci9030102. [PMID: 35324830 PMCID: PMC8950187 DOI: 10.3390/vetsci9030102] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/12/2022] [Accepted: 02/23/2022] [Indexed: 02/05/2023] Open
Abstract
Q fever outbreaks on three dairy goat farms (A–C) were monitored after the animals had been vaccinated with an inactivated Coxiella burnetii phase I vaccine. The antibody response was measured before vaccination by serum samples with two C. burnetii phase-specific ELISAs to characterize the disease status. Shedding was determined by vaginal swabs during three kidding seasons and monthly bulk tank milk (BTM) samples. Dust swabs from one windowsill of each barn and from the milking parlors were collected monthly to evaluate the indoor exposure. These samples were analyzed by qPCR. The phase-specific serology revealed an acute Q fever infection in herd A, whereas herds B and C had an ongoing and past infection, respectively. In all three herds, vaginal shedders were present during three kidding seasons. In total, 50%, 69%, and 15% of all collected BTM samples were C. burnetii positive in herds A, B, and C, respectively. Barn dust contained C. burnetii DNA in 71%, 45%, and 50% of examined swabs collected from farms A, B, and C, respectively. The largest number of C. burnetii positive samples was obtained from the milking parlor (A: 91%, B: 72%, C: 73%), indicating a high risk for humans to acquire Q fever during milking activity.
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Yoo JR, Kim MS, Heo ST, Oh HJ, Oh JH, Ko SY, Kang JH, Lee SK, Jeong WS, Seong GM, Lee HJ, Kang CH, Moon JH, Lee KH, Song SW. Seroreactivity to Coxiella burnetii in an Agricultural Population and Prevalence of Coxiella burnetii Infection in Ticks of a Non-Endemic Region for Q Fever in South Korea. Pathogens 2021; 10:pathogens10101337. [PMID: 34684286 PMCID: PMC8538241 DOI: 10.3390/pathogens10101337] [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] [Received: 07/28/2021] [Revised: 09/25/2021] [Accepted: 10/13/2021] [Indexed: 12/13/2022] Open
Abstract
Coxiella burnetii infects humans and wild and domesticated animals. Although reported cases on Jeju Island, off the coast of South Korea, are rare, the region is considered to have a high potential for Q fever. We investigated the seroprevalence of antibodies to C. burnetii in 230 farmers living in ten rural areas on Jeju Island between January 2015 and December 2019. Blood samples were collected and examined for C. burnetii Phase I/II IgM and IgG antibodies. Trained researchers collected ticks from rural areas. Clone XCP-1 16S ribosomal RNA gene sequencing was performed to identify Coxiella species from the collected ticks. The overall seroprevalence of antibodies to C. burnetii in farmers was 35.7%. The seroprevalence was significantly higher in fruit farmers. Of the collected ticks, 5.4% (19/351) of the Haemaphysalis longicornis ticks harbored C. burnetti. A high seroprevalence of antibodies to C. burnetii was observed in this region of Jeju Island, confirming that C. burnetti is endemic. Physicians should thus consider Q fever in the differential diagnosis of patients that present with acute fever after participating in outdoor activities.
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Affiliation(s)
- Jeong-Rae Yoo
- Department of Internal Medicine, College of Medicine, Jeju National University, Jeju 63241, Korea; (J.-R.Y.); (S.-T.H.); (W.-S.J.); (G.-M.S.)
- Center for Farmers’ Safety and Health, Jeju National University Hospital, Jeju 63241, Korea; (J.-H.O.); (S.-Y.K.); (J.-H.K.); (S.-K.L.); (H.-J.L.); (C.-H.K.); (J.-H.M.)
| | - Mi-Sun Kim
- Department of Internal Medicine, Jeju National University Hospital, Jeju 63241, Korea; (M.-S.K.); (H.-J.O.)
| | - Sang-Taek Heo
- Department of Internal Medicine, College of Medicine, Jeju National University, Jeju 63241, Korea; (J.-R.Y.); (S.-T.H.); (W.-S.J.); (G.-M.S.)
- Center for Farmers’ Safety and Health, Jeju National University Hospital, Jeju 63241, Korea; (J.-H.O.); (S.-Y.K.); (J.-H.K.); (S.-K.L.); (H.-J.L.); (C.-H.K.); (J.-H.M.)
| | - Hyun-Joo Oh
- Department of Internal Medicine, Jeju National University Hospital, Jeju 63241, Korea; (M.-S.K.); (H.-J.O.)
| | - Jung-Hwan Oh
- Center for Farmers’ Safety and Health, Jeju National University Hospital, Jeju 63241, Korea; (J.-H.O.); (S.-Y.K.); (J.-H.K.); (S.-K.L.); (H.-J.L.); (C.-H.K.); (J.-H.M.)
- Department of Neurology, College of Medicine, Jeju National University, Jeju 63241, Korea
| | - Seo-Young Ko
- Center for Farmers’ Safety and Health, Jeju National University Hospital, Jeju 63241, Korea; (J.-H.O.); (S.-Y.K.); (J.-H.K.); (S.-K.L.); (H.-J.L.); (C.-H.K.); (J.-H.M.)
- Department of Emergency Medicine, College of Medicine, Jeju National University, Jeju 63241, Korea
| | - Jeong-Ho Kang
- Center for Farmers’ Safety and Health, Jeju National University Hospital, Jeju 63241, Korea; (J.-H.O.); (S.-Y.K.); (J.-H.K.); (S.-K.L.); (H.-J.L.); (C.-H.K.); (J.-H.M.)
- Department of Emergency Medicine, College of Medicine, Jeju National University, Jeju 63241, Korea
| | - Sung-Kgun Lee
- Center for Farmers’ Safety and Health, Jeju National University Hospital, Jeju 63241, Korea; (J.-H.O.); (S.-Y.K.); (J.-H.K.); (S.-K.L.); (H.-J.L.); (C.-H.K.); (J.-H.M.)
- Department of Emergency Medicine, College of Medicine, Jeju National University, Jeju 63241, Korea
| | - Woo-Seong Jeong
- Department of Internal Medicine, College of Medicine, Jeju National University, Jeju 63241, Korea; (J.-R.Y.); (S.-T.H.); (W.-S.J.); (G.-M.S.)
- Center for Farmers’ Safety and Health, Jeju National University Hospital, Jeju 63241, Korea; (J.-H.O.); (S.-Y.K.); (J.-H.K.); (S.-K.L.); (H.-J.L.); (C.-H.K.); (J.-H.M.)
| | - Gil-Myeong Seong
- Department of Internal Medicine, College of Medicine, Jeju National University, Jeju 63241, Korea; (J.-R.Y.); (S.-T.H.); (W.-S.J.); (G.-M.S.)
- Center for Farmers’ Safety and Health, Jeju National University Hospital, Jeju 63241, Korea; (J.-H.O.); (S.-Y.K.); (J.-H.K.); (S.-K.L.); (H.-J.L.); (C.-H.K.); (J.-H.M.)
| | - Hyun-Jung Lee
- Center for Farmers’ Safety and Health, Jeju National University Hospital, Jeju 63241, Korea; (J.-H.O.); (S.-Y.K.); (J.-H.K.); (S.-K.L.); (H.-J.L.); (C.-H.K.); (J.-H.M.)
- Department of Physical Medicine and Rehabilitation, Jeju National University Hospital, Jeju 63241, Korea
| | - Chul-Hoo Kang
- Center for Farmers’ Safety and Health, Jeju National University Hospital, Jeju 63241, Korea; (J.-H.O.); (S.-Y.K.); (J.-H.K.); (S.-K.L.); (H.-J.L.); (C.-H.K.); (J.-H.M.)
- Department of Neurology, Jeju National University Hospital, Jeju 63241, Korea
| | - Ji-Hyun Moon
- Center for Farmers’ Safety and Health, Jeju National University Hospital, Jeju 63241, Korea; (J.-H.O.); (S.-Y.K.); (J.-H.K.); (S.-K.L.); (H.-J.L.); (C.-H.K.); (J.-H.M.)
- Department of Family Medicine, College of Medicine, Jeju National University, Jeju 63241, Korea
| | - Keun-Hwa Lee
- Department of Microbiology, College of Medicine, Hanyang University, Seoul 04763, Korea;
| | - Sung-Wook Song
- Center for Farmers’ Safety and Health, Jeju National University Hospital, Jeju 63241, Korea; (J.-H.O.); (S.-Y.K.); (J.-H.K.); (S.-K.L.); (H.-J.L.); (C.-H.K.); (J.-H.M.)
- Department of Emergency Medicine, College of Medicine, Jeju National University, Jeju 63241, Korea
- Correspondence: ; Tel.: +82-64-717-2833
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Sabzevari S, Shoraka H, Seyyedin M. Seroepidemiological survey of brucellosis and Q fever among high-risk occupations in northeast of Iran for first time. IRANIAN JOURNAL OF MICROBIOLOGY 2021; 13:325-336. [PMID: 34540171 PMCID: PMC8416582 DOI: 10.18502/ijm.v13i3.6395] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background and Objectives: Brucellosis and Q fever are considered as occupational hazards to people in contact with domestic animals or their carcasses. The present cross-sectional study was carried out to determine the seroprevalence of brucellosis and Q fever among professions at risk in the North Khorasan Province, northeastern Iran during 2020. Materials and Methods: In this study, 185 sera samples were collected from butchers, slaughterhouse workers, farmers, and veterinarians in different counties of the province. The collected sera were tested by ELISA test for the detection of IgG antibodies against Coxiella burnetii and Brucella spp. A questionnaire was filled for each participant to investigate demographic characteristics information (i.e., age, gender, educational status, occupation, years of occupational experience, and location), and any exposure to risk factors (animals Keeping, consumption of unpasteurized dairy products, exposure to ill or dead animals, tick bite, splashing animal fluids, travel history, and use of personal protective equipment) that could be associated with these infections. Results: The seroprevalence of antibodies against C. burnetii and Brucella spp. were 17.2% and 19.4%, respectively. Twelve participants also had Q fever and brucellosis co-infection, with a prevalence of 6.4%. Conclusion: Based on the results, it is concluded that brucellosis and Q fever occur among the high-risk populations in this area and it needs more surveillance to control the diseases by public health and veterinary authorities.
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Affiliation(s)
- Sadaf Sabzevari
- Vector-Borne Disease Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran.,Preclinical Core Facility, Infection Preclinical Imaging Group, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Shoraka
- Vector-Borne Disease Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Mohammad Seyyedin
- Department of Quality Control, Razi Vaccine and Serum Research Institute, Agricultural Research Education And Extention Organization, Mashhad Branch, Mashhad, Iran
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Rabaza A, Giannitti F, Fraga M, Macías-Rioseco M, Corbellini LG, Riet-Correa F, Hirigoyen D, Turner KME, Eisler MC. Serological Evidence of Human Infection with Coxiella burnetii after Occupational Exposure to Aborting Cattle. Vet Sci 2021; 8:196. [PMID: 34564590 PMCID: PMC8473284 DOI: 10.3390/vetsci8090196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/30/2021] [Accepted: 09/10/2021] [Indexed: 11/29/2022] Open
Abstract
Cattle are broadly deemed a source of Coxiella burnetii; however, evidence reinforcing their role in human infection is scarce. Most published human Q fever outbreaks relate to exposure to small ruminants, notably goats. Anti-phase II C. burnetii IgG and IgM were measured by indirect fluorescent antibody tests in 27 farm and veterinary diagnostic laboratory workers to ascertain whether occupational exposure to cattle aborting due to C. burnetii was the probable source of exposure. Four serological profiles were identified on the basis of anti-phase II IgG and IgM titres. Profile 1, characterised by high IgM levels and concurrent, lower IgG titres (3/27; 11.1%); Profile 2, with both isotypes with IgG titres higher than IgM (2/27; 7.4%); Profile 3 with only IgG phase II (5/27; 18.5%); and Profile 4, in which neither IgM nor IgG were detected (17/27; 63.0%). Profiles 1 and 2 are suggestive of recent C. burnetii exposure, most likely 2.5-4.5 months before testing and, hence, during the window of exposure to the bovine abortions. Profile 3 suggested C. burnetii exposure that most likely predated the window of exposure to aborting cattle, while Profile 4 represented seronegative individuals and, hence, likely uninfected. This study formally linked human Q fever to exposure to C. burnetii infected cattle as a specific occupational hazard for farm and laboratory workers handling bovine aborted material.
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Affiliation(s)
- Ana Rabaza
- Instituto Nacional de Investigación Agropecuaria, Plataforma de Investigación en Salud Animal, Estación Experimental La Estanzuela, Colonia 70000, Uruguay; (A.R.); (F.G.); (M.F.); (M.M.-R.); (L.G.C.); (F.R.-C.); (D.H.)
- Bristol Veterinary School, University of Bristol, Langford House, Langford, Bristol BS40 5DU, UK;
| | - Federico Giannitti
- Instituto Nacional de Investigación Agropecuaria, Plataforma de Investigación en Salud Animal, Estación Experimental La Estanzuela, Colonia 70000, Uruguay; (A.R.); (F.G.); (M.F.); (M.M.-R.); (L.G.C.); (F.R.-C.); (D.H.)
| | - Martín Fraga
- Instituto Nacional de Investigación Agropecuaria, Plataforma de Investigación en Salud Animal, Estación Experimental La Estanzuela, Colonia 70000, Uruguay; (A.R.); (F.G.); (M.F.); (M.M.-R.); (L.G.C.); (F.R.-C.); (D.H.)
| | - Melissa Macías-Rioseco
- Instituto Nacional de Investigación Agropecuaria, Plataforma de Investigación en Salud Animal, Estación Experimental La Estanzuela, Colonia 70000, Uruguay; (A.R.); (F.G.); (M.F.); (M.M.-R.); (L.G.C.); (F.R.-C.); (D.H.)
- California Animal Health & Food Safety Laboratory System, University of California-Davis, Tulare, CA 95616, USA
| | - Luis G. Corbellini
- Instituto Nacional de Investigación Agropecuaria, Plataforma de Investigación en Salud Animal, Estación Experimental La Estanzuela, Colonia 70000, Uruguay; (A.R.); (F.G.); (M.F.); (M.M.-R.); (L.G.C.); (F.R.-C.); (D.H.)
| | - Franklin Riet-Correa
- Instituto Nacional de Investigación Agropecuaria, Plataforma de Investigación en Salud Animal, Estación Experimental La Estanzuela, Colonia 70000, Uruguay; (A.R.); (F.G.); (M.F.); (M.M.-R.); (L.G.C.); (F.R.-C.); (D.H.)
- Programa de Pós Graduação em Ciência Animal nos Trópicos, Faculdade de Veterinária, Universidade Federal da Bahia, Ondina, Salvador 40170-290, Brazil
| | - Darío Hirigoyen
- Instituto Nacional de Investigación Agropecuaria, Plataforma de Investigación en Salud Animal, Estación Experimental La Estanzuela, Colonia 70000, Uruguay; (A.R.); (F.G.); (M.F.); (M.M.-R.); (L.G.C.); (F.R.-C.); (D.H.)
| | - Katy M. E. Turner
- Bristol Veterinary School, University of Bristol, Langford House, Langford, Bristol BS40 5DU, UK;
| | - Mark C. Eisler
- Bristol Veterinary School, University of Bristol, Langford House, Langford, Bristol BS40 5DU, UK;
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10
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Mathews KO, Toribio JA, Norris JM, Phalen D, Wood N, Graves SR, Sheehy PA, Bosward KL. Coxiella burnetii seroprevalence and Q fever in Australian wildlife rehabilitators. One Health 2021; 12:100197. [PMID: 33319024 PMCID: PMC7725937 DOI: 10.1016/j.onehlt.2020.100197] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 11/12/2020] [Accepted: 11/17/2020] [Indexed: 12/27/2022] Open
Abstract
Coxiella burnetii is the causative bacterium of the zoonotic disease Q fever, which is recognised as a public health concern globally. Macropods have been suggested as a potential source of C. burnetii infection for humans. The aim of this cross-sectional study was to determine the prevalence of C. burnetii exposure in a cohort of Australian wildlife rehabilitators (AWRs) and assess Q fever disease and vaccination status within this population. Blood samples were collected from adult participants attending the Australian Wildlife Rehabilitation Conference in Sydney in July 2018. Participants completed a questionnaire at the time of blood collection. Antibody titres (IgG, IgA and IgM) against phase I and phase II C. burnetii antigens as determined by immunofluorescence assay, revealed that of the unvaccinated participants, 6.1% (9/147) had evidence of exposure to C. burnetii. Of the total participants, 8.1% (13/160) had received Q fever vaccination, four of whom remained seropositive at the time of blood collection. Participants reporting occupational contact with ruminants, were eight times more likely to have been vaccinated against Q fever, than those reporting no occupational animal contact (OR 8.1; 95% CI 1.85-45.08). Three AWRs (2%) reported having had medically diagnosed Q fever, two of whom remained seropositive at the time of blood collection. Despite the lack of association between macropod contacts and C. burnetii seropositivity in this cohort, these findings suggest that AWRs are approximately twice as likely to be exposed to C. burnetii, compared with the general Australian population. This provides support for the recommendation of Q fever vaccination for this potentially 'at-risk' population. The role of macropods in human Q fever disease remains unclear, and further research into C. burnetii infection in macropods including: infection rate and transmission cycles between vectors, macropods as reservoirs, other animals and humans is required.
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Key Words
- Australia, wildlife rehabilitators
- Australian Statistical Geography Standard, ASGS
- Australian Wildlife Rehabilitation Conference, AWRC
- Australian wildlife rehabilitators, AWRs
- Coxiella burnetii
- Indirect immunofluorescence assay, IFA
- Macropods, kangaroos
- Personal protection equipment, PPE
- Q fever
- Q fever disease status, QFDS
- Q fever disease, QFD
- Q fever serostatus, QFSS
- Q fever vaccination status, QFVS
- Q fever vaccination, QFV
- Seroprevalence
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Affiliation(s)
- Karen O. Mathews
- The University of Sydney, Sydney School of Veterinary Science, Faculty of Science, Camden, NSW, Australia
| | - Jenny-Ann Toribio
- The University of Sydney, Sydney School of Veterinary Science, Faculty of Science, Camden, NSW, Australia
| | - Jacqueline M. Norris
- The University of Sydney, Sydney School of Veterinary Science, Faculty of Science, Camden, NSW, Australia
| | - David Phalen
- The University of Sydney, Sydney School of Veterinary Science, Faculty of Science, Camden, NSW, Australia
| | - Nicholas Wood
- The University of Sydney, Discipline of Paediatrics and Child Health, Sydney Medical School, Camperdown, NSW, Australia
- National Centre for Immunisation Research and Surveillance, Westmead, NSW, Australia
| | - Stephen R. Graves
- Australian Rickettsial Reference Laboratory, University Hospital Geelong, Victoria 3220, Australia
| | - Paul A. Sheehy
- The University of Sydney, Sydney School of Veterinary Science, Faculty of Science, Camden, NSW, Australia
| | - Katrina L. Bosward
- The University of Sydney, Sydney School of Veterinary Science, Faculty of Science, Camden, NSW, Australia
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11
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Clark NJ, Tozer S, Wood C, Firestone SM, Stevenson M, Caraguel C, Chaber AL, Heller J, Soares Magalhães RJ. Unravelling animal exposure profiles of human Q fever cases in Queensland, Australia, using natural language processing. Transbound Emerg Dis 2020; 67:2133-2145. [PMID: 32259390 DOI: 10.1111/tbed.13565] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 02/11/2020] [Accepted: 03/28/2020] [Indexed: 11/28/2022]
Abstract
Q fever, caused by the zoonotic bacterium Coxiella burnetii, is a globally distributed emerging infectious disease. Livestock are the most important zoonotic transmission sources, yet infection in people without livestock exposure is common. Identifying potential exposure pathways is necessary to design effective interventions and aid outbreak prevention. We used natural language processing and graphical network methods to provide insights into how Q fever notifications are associated with variation in patient occupations or lifestyles. Using an 18-year time-series of Q fever notifications in Queensland, Australia, we used topic models to test whether compositions of patient answers to follow-up exposure questionnaires varied between demographic groups or across geographical areas. To determine heterogeneity in possible zoonotic exposures, we explored patterns of livestock and game animal co-exposures using Markov Random Fields models. Finally, to identify possible correlates of Q fever case severity, we modelled patient probabilities of being hospitalized as a function of particular exposures. Different demographic groups consistently reported distinct sets of exposure terms and were concentrated in different areas of the state, suggesting the presence of multiple transmission pathways. Macropod exposure was commonly reported among Q fever cases, even when exposure to cattle, sheep or goats was absent. Males, older patients and those that reported macropod exposure were more likely to be hospitalized due to Q fever infection. Our study indicates that follow-up surveillance combined with text modelling is useful for unravelling exposure pathways in the battle to reduce Q fever incidence and associated morbidity.
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Affiliation(s)
- Nicholas J Clark
- UQ Spatial Epidemiology Laboratory, School of Veterinary Science, The University of Queensland, Qld, Australia
| | - Sarah Tozer
- Queensland Centre for Gynaecological Cancer, The University of Queensland, Qld, Australia
| | - Caitlin Wood
- UQ Spatial Epidemiology Laboratory, School of Veterinary Science, The University of Queensland, Qld, Australia
| | - Simon M Firestone
- Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Vic., Australia
| | - Mark Stevenson
- Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Vic., Australia
| | - Charles Caraguel
- School of Animal and Veterinary Science, The University of Adelaide, Adelaide, SA, Australia
| | - Anne-Lise Chaber
- School of Animal and Veterinary Science, The University of Adelaide, Adelaide, SA, Australia
| | - Jane Heller
- Graham Centre for Agricultural Innovation, School of Animal and Veterinary Sciences, Charles Sturt University, Wagga, NSW, Australia
| | - Ricardo J Soares Magalhães
- UQ Spatial Epidemiology Laboratory, School of Veterinary Science, The University of Queensland, Qld, Australia
- Children's Health and Environment Program, Child Health Research Centre, The University of Queensland, Qld, Australia
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12
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Woldeyohannes SM, Perkins NR, Baker P, Gilks CF, Knibbs LD, Reid SA. Q fever vaccine efficacy and occupational exposure risk in Queensland, Australia: A retrospective cohort study. Vaccine 2020; 38:6578-6584. [PMID: 32798141 DOI: 10.1016/j.vaccine.2020.08.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 07/28/2020] [Accepted: 08/03/2020] [Indexed: 11/18/2022]
Abstract
Q-VAX® is a vaccine used to prevent Q fever. Administration of the vaccine is complicated by the need to ensure, using intradermal and serological tests, that individuals have no prior immunity. Previous studies suggest that the vaccine is highly efficacious and long-lasting in adults. However, there has been no systematic follow-up of vaccine efficacy and the longevity of immunity using population-level data. We aimed to investigate the vaccine failure rate and duration of immunity in previously vaccinated individuals. We formulated a retrospective cohort study design within a linked data. We used a Q fever vaccination registry linked to Q fever notifications and hospital admissions (1991-2016) in the state of Queensland, which has Australia's highest incidence of Q fever. Q-VAX® failure was defined as occurrence of Q fever > 14 days' after vaccination. The incidence of Q fever in vaccinated and unvaccinated individuals was 5.40 (95% CI: 3.65, 7.72) and 89.50 (95% CI: 70.50, 112.00]) per 100,000 person-years of follow-up, respectively. The hazard ratio (HR) for Q fever was 0.07 (95% CI: 0.04, 0.10) in non-immune vaccinated compared with immune unvaccinated individuals. The overall vaccine effectiveness was found to be 94.37% suggesting that Q-VAX® is highly effective at preventing Q fever. However, the greater incidence observed in unvaccinated individuals considered immune during the pre-vaccination screening may suggest that pre-vaccination screening is sub-optimal among this study population.
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Affiliation(s)
- Solomon M Woldeyohannes
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Queensland 4006, Australia; School of Veterinary Science, Faculty of Science, The University of Queensland, Gatton, Queensland, Australia.
| | - Nigel R Perkins
- School of Veterinary Science, Faculty of Science, The University of Queensland, Gatton, Queensland, Australia
| | - Peter Baker
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Queensland 4006, Australia
| | - Charles F Gilks
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Queensland 4006, Australia
| | - Luke D Knibbs
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Queensland 4006, Australia
| | - Simon A Reid
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Queensland 4006, Australia
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13
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Abstract
Q fever (caused by Coxiella burnetii) is thought to have an almost world-wide distribution, but few countries have conducted national serosurveys. We measured Q fever seroprevalence using residual sera from diagnostic laboratories across Australia. Individuals aged 1–79 years in 2012–2013 were sampled to be proportional to the population distribution by region, distance from metropolitan areas and gender. A 1/50 serum dilution was tested for the Phase II IgG antibody against C. burnetii by indirect immunofluorescence. We calculated crude seroprevalence estimates by age group and gender, as well as age standardised national and metropolitan/non-metropolitan seroprevalence estimates. Of 2785 sera, 99 tested positive. Age standardised seroprevalence was 5.6% (95% confidence interval (CI 4.5%–6.8%), and similar in metropolitan (5.5%; 95% CI 4.1%–6.9%) and non-metropolitan regions (6.0%; 95%CI 4.0%–8.0%). More males were seropositive (6.9%; 95% CI 5.2%–8.6%) than females (4.2%; 95% CI 2.9%–5.5%) with peak seroprevalence at 50–59 years (9.2%; 95% CI 5.2%–13.3%). Q fever seroprevalence for Australia was higher than expected (especially in metropolitan regions) and higher than estimates from the Netherlands (2.4%; pre-outbreak) and US (3.1%), but lower than for Northern Ireland (12.8%). Robust country-specific seroprevalence estimates, with detailed exposure data, are required to better understand who is at risk and the need for preventive measures.
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14
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Sellens E, Bosward KL, Norris JM, Wood N, Heller J, Graves S, Gidding HF. Coxiella burnetii seroprevalence in unvaccinated veterinary workers in Australia: Evidence to support Q fever vaccination. Zoonoses Public Health 2019; 67:79-88. [PMID: 31677254 DOI: 10.1111/zph.12658] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 07/09/2019] [Accepted: 10/02/2019] [Indexed: 12/12/2022]
Abstract
Q fever (caused by Coxiella burnetii) is a serious zoonotic disease that occurs almost worldwide. Occupational contact with animals increases the risk of exposure, and Q fever vaccination is recommended for veterinary workers in Australia. This study aimed to investigate C. burnetii seroprevalence among unvaccinated veterinary workers in Australia and determine factors associated with a positive serological result. During 2014 and 2015, convenience sampling at veterinary conferences and workplace vaccination clinics was undertaken. Participants completed a questionnaire and provided a blood sample for C. burnetii serology. Participants were predominantly veterinarians (77%), but veterinary support staff, animal scientists, and administration workers also participated. Blood samples (n = 192) were analysed by an immunofluorescence assay and considered positive where the phase I or phase II IgG titre was ≥1/50. Seroprevalence was 19% (36/192; 95% CI 14%-25%). A positive serological result was significantly associated with (a) working in outer regional/remote areas (odds ratio [OR] 6.2; 95% CI 1.9-20.8; reference = major cities; p = .009) and (b) having spent more than 50% of total career working with ruminants (OR 4.8; 95% CI 1.7-13.5; reference = <15% of career; p = .025). These findings confirm an increased risk of exposure to C. burnetii compared to the general population, providing new evidence to support Q fever vaccination of veterinary workers in Australia.
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Affiliation(s)
- Emily Sellens
- Faculty of Science, Sydney School of Veterinary Science, The University of Sydney, Camperdown, NSW, Australia
| | - Katrina L Bosward
- Faculty of Science, Sydney School of Veterinary Science, The University of Sydney, Camperdown, NSW, Australia
| | - Jacqueline M Norris
- Faculty of Science, Sydney School of Veterinary Science, The University of Sydney, Camperdown, NSW, Australia
| | - Nicholas Wood
- Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Camperdown, NSW, Australia.,National Centre for Immunisation Research and Surveillance, Westmead, NSW, Australia
| | - Jane Heller
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, NSW, Australia
| | - Stephen Graves
- Australian Rickettsial Reference Laboratory, University Hospital Geelong, Geelong, Vic., Australia
| | - Heather F Gidding
- National Centre for Immunisation Research and Surveillance, Westmead, NSW, Australia.,School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales, Sydney, NSW, Australia.,Clinical and Population Perinatal Health Research, Kolling Institute, Northern Sydney Local Health District, St Leonards, NSW, Australia.,The University of Sydney Northern Clinical School, The University of Sydney, Sydney, NSW, Australia
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15
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Armstrong M, Francis J, Robson J, Graves S, Mills D, Ferguson J, Nourse C. Q fever vaccination of children in Australia: Limited experience to date. J Paediatr Child Health 2019; 55:1099-1102. [PMID: 30604569 DOI: 10.1111/jpc.14364] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 12/04/2018] [Accepted: 12/05/2018] [Indexed: 12/01/2022]
Abstract
AIM Q fever is a zoonotic disease caused by the bacterium Coxiella burnetii and is associated with significant morbidity and mortality in both adults and children. Australia is the only country that has produced and registered a Q fever vaccine for human use, but this vaccine is licenced only for people aged over 15 years as data and experience in children are limited. This review describes the experience of Q fever vaccination of known paediatric cases in Australia to date. METHODS Patients aged younger than 15 years who received the Q fever vaccination had data abstracted from medical records after consent was obtained from the relevant guardians. Data on risk factors for Q fever, skin testing procedure, dose of vaccination, adverse effects and follow-up assessment were obtained. RESULTS Twelve children were identified as having received the Q fever vaccination. Vaccination was feasible, with empirical weight-based dose adjustment performed for younger children. There were no significant adverse effects. CONCLUSIONS Q fever vaccine may be safe in children and should be considered in children who are at significant risk of Q fever infection. Safe vaccine protocols with proven efficacy will allow children of all ages to be protected. Prospective studies of vaccination in children are indicated. Expanding available Q fever registries to include children would allow outcomes to be systematically followed.
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Affiliation(s)
- Mark Armstrong
- Infectious Diseases Unit, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Josh Francis
- Department of Paediatrics, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Jenny Robson
- Department of Microbiology, Sullivan and Nicolaides Pathology, Brisbane, Queensland, Australia
| | - Stephen Graves
- Australian Rickettsial Reference Laboratory, Geelong Hospital, Geelong, Victoria, Australia
| | - Deborah Mills
- The Travel Doctor, Travel Medicine Alliance Clinics Australia, Brisbane, Queensland, Australia
| | - John Ferguson
- Health Pathology New South Wales, John Hunter Hospital, Newcastle, New South Wales, Australia
| | - Clare Nourse
- Infection Management and Prevention Service, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia
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16
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Wood C, Muleme M, Tan T, Bosward K, Gibson J, Alawneh J, McGowan M, Barnes TS, Stenos J, Perkins N, Firestone SM, Tozer S. Validation of an indirect immunofluorescence assay (IFA) for the detection of IgG antibodies against Coxiella burnetii in bovine serum. Prev Vet Med 2019; 169:104698. [PMID: 31311644 DOI: 10.1016/j.prevetmed.2019.104698] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 04/16/2019] [Accepted: 05/21/2019] [Indexed: 01/07/2023]
Abstract
There is limited knowledge of the true prevalence and distribution of coxiellosis in dairy and beef cattle populations in Australia. For this to occur, apparent prevalence estimates need to be reliably adjusted, accounting for diagnostic sensitivity (DSe) and diagnostic specificity (DSp) of the test used. However, there are few tests available with known diagnostic specifications suitable to inform screening and surveillance activities in the Australian context. We initially modified and optimised a human indirect immunofluorescence assay (IFA) test for the detection of IgG antibodies against phase I and/or phase II Coxiella burnetii in bovine sera and determined an optimal screening dilution cut-off to be 1:160. Direct comparison of the modified IFA with the commercial IDEXX enzyme-linked immunosorbent assay (ELISA) kit (Q Fever Ab Test IDEXX Laboratories, United States of America) was performed by testing 458 serum samples from four distinct cattle populations across the east coast of Australia and New Zealand. Cross classified test results were then analysed using Bayesian latent class modelling, to validate the tests in the absence of a gold standard reference test. Results from this analysis indicate that the IFA, at a 1:160 serum dilution, has an estimated DSe of 73.6% (95% Credible Interval (CrI) 61.1, 85.9) and DSp of 98.2% (95% CrI 95.1, 99.7). The commercial IDEXX ELISA kit was found to have a higher DSe of 87.9% (95% CrI 73.9, 96.4) and similar DSp of 97.7% (95% CrI 93.2, 99.7). Evaluation of the diagnostic performance of the IFA and ELISA methods, specifically for use in cattle will enable more accurate interpretation of prevalence estimates of C. burnetii exposure to be reported for cattle in Australia and other countries.
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Affiliation(s)
- Caitlin Wood
- The University of Queensland, School of Veterinary Science, Gatton, Queensland, 4343, Australia; Centre for Children's Health Research, Queensland Paediatric Infectious Disease Laboratory, Lady Cilento Research Precinct, South Brisbane, Queensland, 4101, Australia.
| | - Michael Muleme
- The University of Melbourne, Asia-Pacific Centre for Animal Health, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, Parkville Victoria, 3010, Australia
| | - Tabita Tan
- The University of Melbourne, Asia-Pacific Centre for Animal Health, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, Parkville Victoria, 3010, Australia
| | - Katrina Bosward
- The University of Sydney, Sydney School of Veterinary Science, Faculty of Science, Camden, NSW, 2570, Australia
| | - Justine Gibson
- The University of Queensland, School of Veterinary Science, Gatton, Queensland, 4343, Australia
| | - John Alawneh
- The University of Queensland, School of Veterinary Science, Gatton, Queensland, 4343, Australia
| | - Michael McGowan
- The University of Queensland, School of Veterinary Science, Gatton, Queensland, 4343, Australia
| | - Tamsin S Barnes
- The University of Queensland, School of Veterinary Science, Gatton, Queensland, 4343, Australia; The University of Queensland, Queensland Alliance for Agriculture and Food Innovation, Gatton, Queensland, 4343, Australia
| | - John Stenos
- Australian Rickettsial Reference Laboratory, Bellarine Street, University Hospital Geelong, Victoria, 3220 Australia
| | - Nigel Perkins
- The University of Queensland, School of Veterinary Science, Gatton, Queensland, 4343, Australia
| | - Simon M Firestone
- The University of Melbourne, Asia-Pacific Centre for Animal Health, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, Parkville Victoria, 3010, Australia
| | - Sarah Tozer
- Centre for Children's Health Research, Queensland Paediatric Infectious Disease Laboratory, Lady Cilento Research Precinct, South Brisbane, Queensland, 4101, Australia
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17
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Gidding HF, Faddy HM, Durrheim DN, Graves SR, Nguyen C, Hutchinson P, Massey P, Wood N. Seroprevalence of Q fever among metropolitan and non‐metropolitan blood donors in New South Wales and Queensland, 2014–2015. Med J Aust 2019; 210:309-315. [DOI: 10.5694/mja2.13004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 09/13/2018] [Indexed: 02/06/2023]
Affiliation(s)
- Heather F Gidding
- Northern Clinical SchoolUniversity of Sydney Sydney NSW
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases Sydney NSW
| | | | | | - Stephen R Graves
- Australian Rickettsial Reference LaboratoryUniversity Hospital Geelong VIC
| | - Chelsea Nguyen
- Australian Rickettsial Reference LaboratoryUniversity Hospital Geelong VIC
| | | | - Peter Massey
- Hunter New England Local Health District Newcastle NSW
- University of New England Armidale NSW
| | - Nicholas Wood
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases Sydney NSW
- University of Sydney Sydney NSW
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18
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Frequency of Adverse Events Following Q Fever Immunisation in Young Adults. Vaccines (Basel) 2018; 6:vaccines6040083. [PMID: 30551615 PMCID: PMC6313871 DOI: 10.3390/vaccines6040083] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 10/08/2018] [Accepted: 12/08/2018] [Indexed: 12/14/2022] Open
Abstract
Q fever is a zoonosis of concern in many countries. Vaccination is the most effective means of prevention, and since 1989, Australia has had a licensed Q fever vaccine, Q-VAX®. This vaccine was also used in the Netherlands in 2011 following the largest recorded Q fever outbreak globally. There is a paucity of available data regarding adverse events following immunisation (AEFI) for young adult females. Such data are important for informing future vaccination recommendations both within Australia and internationally. This study collected Q fever vaccine (Q-VAX®) AEFI data in veterinary and animal science students at Australian universities. Students were enrolled at the time of vaccination and were emailed a link to an online AEFI survey one week later. Of the 60% (499/827) that responded, 85% were female and the median age was 18 years. Local injection site reactions (ISRs) occurred in 98% (95%; CI 96–99%) of respondents, of which 30% (95% CI 24–32%) were severe. Systemic AEFI occurred in 60% (95%; CI 55–64%) of respondents within the seven days following immunisation. Medical attention was sought by 19/499 (3.8%) respondents, of whom one sought treatment at a hospital emergency department. Females were more likely than males to experience any local ISR (odds ratio [OR] 9.3; 95% CI 2.5–33.8; p < 0.001), ISRs of greater severity (OR 2.5; 95% CI 1.5–4.2; p < 0.001), and any systemic AEFI (OR 1.9; 95% CI 1.1–3.1; p = 0.016). These safety data suggest that a high frequency of adverse events following immunisation should be expected in young adults, particularly females. However, the consequences of Q fever disease are potentially far more debilitating.
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19
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Das DP, Malik SVS, Sahu R, Yadav JP, Rawool DB, Barbuddhe SB. Loop-mediated isothermal amplification assay for detection of Coxiella burnetii targeting the com1 gene. J Microbiol Methods 2018; 155:55-58. [PMID: 30445112 DOI: 10.1016/j.mimet.2018.11.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 11/02/2018] [Accepted: 11/12/2018] [Indexed: 12/28/2022]
Abstract
We developed the com1 gene based loop-mediated isothermal amplification (LAMP) assay for the detection of Coxiella burnetii and validated it by screening DNA isolated from serum samples collected from animals and humans. The detection of Coxiella by LAMP assay was comparable with the com1 based-PCR.
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Affiliation(s)
- Durga Prasad Das
- Division of Veterinary Public Health, ICAR- Indian Veterinary Research Institute, Izatnagar 243 122, India
| | - Satya Veer Singh Malik
- Division of Veterinary Public Health, ICAR- Indian Veterinary Research Institute, Izatnagar 243 122, India
| | - Radhakrishna Sahu
- Division of Veterinary Public Health, ICAR- Indian Veterinary Research Institute, Izatnagar 243 122, India
| | - Jay Prakash Yadav
- Division of Veterinary Public Health, ICAR- Indian Veterinary Research Institute, Izatnagar 243 122, India
| | - Deepak B Rawool
- Division of Veterinary Public Health, ICAR- Indian Veterinary Research Institute, Izatnagar 243 122, India
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20
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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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Nokhodian Z, Ataei B, Moradi A, Yaran M, Hoseini SG, Feizi A, Sherkat R. Seroprevalence and risk factors of Coxiella burnetii infection among high-risk population in center of Iran, a neglected health problem. Acta Trop 2017; 169:107-111. [PMID: 28167053 DOI: 10.1016/j.actatropica.2017.02.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Revised: 02/02/2017] [Accepted: 02/02/2017] [Indexed: 12/27/2022]
Abstract
In order to evaluate the prevalence of antibodies against phase I and II antigens of Coxiella Burnetii and to identify related risk factors among high-risk groups in the center of Iran, a serological survey was performed in Isfahan County. In a cross-sectional study, 401 sera were collected from slaughterhouse workers, butchers, farmers and veterinarians in spring 2015. Samples were tested for specific immunoglobulin G (IgG) antibodies against phase I and II of C. burnetii by indirect immunofluorescence assay. A checklist was fulfilled to document demographic information. Univariate analysis and multivariable binary logistic regression model were used to analyze data. IgG antibodies against phases I and II of C. burnetii were detected in 19% and 36.9% of participants, respectively. The overall seropositivity (IgG against phase I and/or II) was 43.1%. The present study shows a high seroprevalence of C. burnetii infection among high-risk population in center of Iran. It is suggested to carry out occupational health monitoring programs for individuals who may be exposed to C. burnetii.
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Affiliation(s)
- Zary Nokhodian
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Behrooz Ataei
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abdolreza Moradi
- Isfahan Veterinary Office, Head of Public Health Supervision Section, Isfahan, Iran
| | - Majid Yaran
- Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shervin Gaffari Hoseini
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Roya Sherkat
- Acquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Mohabbati Mobarez A, Bagheri Amiri F, Esmaeili S. Seroprevalence of Q fever among human and animal in Iran; A systematic review and meta-analysis. PLoS Negl Trop Dis 2017; 11:e0005521. [PMID: 28394889 PMCID: PMC5398711 DOI: 10.1371/journal.pntd.0005521] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Revised: 04/20/2017] [Accepted: 03/23/2017] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Q fever is a main zoonotic disease around the world. The aim of this meta-analysis was to estimate the overall seroprevalence of Coxiella burnetii among human and animal population in Iran. METHODS Major national and international databases were searched from 2005 up to August 2016. We extracted the prevalence of Q fever antibodies (IgG) as the main primary outcome. We reported the prevalence of the seropositivity as point and 95% confidence intervals. RESULTS The overall seroprevalence of IgG phase I and II antibodies of Q fever in human was 19.80% (95% CI: 16.35-23.25%) and 32.86% (95% CI: 23.80-41.92%), respectively. The herd and individual prevalence of C. burnetii antibody in goat were 93.42% (95% CI: 80.23-100.00) and 31.97% (95% CI: 20.96-42.98%), respectively. The herd and individual prevalence of Q fever antibody in sheep's were 96.07% (95% CI: 89.11-100.00%) and 24.66% (95% CI: 19.81-29.51%), respectively. The herd and individual prevalence of C. burnetii antibody in cattle were 41.37% (95% CI: 17.88-64.86%) and 13.30% (95% CI: 2.98-23.62%), respectively. Individual seropositivity of Q fever in camel and dog were 28.26% (95% CI: 21.47-35.05) and 0.55% (0.03-2.68), respectively. CONCLUSION Seroprevalence of Q fever among human and domestic animals is considerable. Preventative planning and control of C. burnetii infections in Iran is necessary. Active surveillance and further research studies are recommended, to more clearly define the epidemiology and importance of C. burnetii infections in animals and people in Iran.
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Affiliation(s)
- Ashraf Mohabbati Mobarez
- Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Fahimeh Bagheri Amiri
- Department of Epidemiology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
- Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saber Esmaeili
- Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
- National Reference Laboratory of Plague, Tularemia and Q Fever, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Akanlu, Kabudar-Ahang, Hamadan, Iran
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SLOAN-GARDNER TS, MASSEY PD, HUTCHINSON P, KNOPE K, FEARNLEY E. Trends and risk factors for human Q fever in Australia, 1991-2014. Epidemiol Infect 2017; 145:787-795. [PMID: 27927265 PMCID: PMC9507770 DOI: 10.1017/s0950268816002843] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 10/14/2016] [Accepted: 11/07/2016] [Indexed: 12/13/2022] Open
Abstract
Australian abattoir workers, farmers, veterinarians and people handling animal birthing products or slaughtering animals continue to be at high risk of Q fever despite an effective vaccine being available. National Notifiable Diseases Surveillance System data were analysed for the period 1991-2014, along with enhanced risk factor data from notified cases in the states of New South Wales and Queensland, to examine changes in the epidemiology of Q fever in Australia. The national Q fever notification rate reduced by 20% [incident rate ratio (IRR) 0·82] following the end of the National Q fever Management Program in 2006, and has increased since 2009 (IRR 1·01-1·34). Highest rates were in males aged 40-59 years (5·9/100 000) and 87% of Q fever cases occurred in New South Wales and Queensland. The age of Q fever cases and proportion of females increased over the study period. Based on the enhanced risk factor data, the most frequently listed occupation for Q fever cases involved contact with livestock, followed by 'no known risk' occupations. More complete and comparable enhanced risk factor data, at the State/Territory and national levels, would aid in further understanding of the epidemiology of Q fever.
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Affiliation(s)
- T. S. SLOAN-GARDNER
- Office of Health Protection, Department of Health, Woden, ACT, Australia
- National Centre for Epidemiology & Population Health, Research School of Population Health, Australian National University, ACT, Australia
| | - P. D. MASSEY
- Hunter New England Population Health, NSW, Australia
- College of Medicine & Dentistry, James Cook University, QLD, Australia
| | | | - K. KNOPE
- Office of Health Protection, Department of Health, Woden, ACT, Australia
| | - E. FEARNLEY
- National Centre for Epidemiology & Population Health, Research School of Population Health, Australian National University, ACT, Australia
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Abstract
BACKGROUND Clinical disease caused by Coxiella burnetii occurs infrequently in children. Chronic Q fever is particularly uncommon and endocarditis is rarely seen. A small number of cases of Q fever osteomyelitis have been described but the pathophysiology is not well understood and optimal treatment is unknown. METHODS We describe a series of cases of chronic recurrent multifocal Q fever osteomyelitis cases diagnosed in children from a single region in Australia. RESULTS Between 2011 and 2014, 9 cases of chronic recurrent multifocal Q fever osteomyelitis were diagnosed based on clinical findings, suggestive serology and detection of C. burnetii DNA by polymerase chain reaction testing of biopsy samples (8/9). All required surgical management; antibiotic and adjuvant therapies did not appear to be consistently effective and 2 cases had clinical resolution in the absence of directed antimicrobial therapy. CONCLUSIONS Chronic recurrent multifocal osteomyelitis is a rare manifestation of chronic Q fever infection in children. The pathophysiology of this condition is poorly understood, and effective treatment options have not been established.
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Vincent G, Stenos J, Latham J, Fenwick S, Graves S. Novel genotypes of Coxiella burnetii identified in isolates from Australian Q fever patients. Int J Med Microbiol 2016; 306:463-70. [DOI: 10.1016/j.ijmm.2016.05.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 05/19/2016] [Accepted: 05/24/2016] [Indexed: 11/24/2022] Open
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Lau C, Musso D, Fournier PE, Parola P, Raoult D, Weinstein P. Absence of serological evidence of Rickettsia spp., Bartonella spp., Ehrlichia spp. and Coxiella burnetii infections in American Samoa. Ticks Tick Borne Dis 2016; 7:703-705. [PMID: 26965788 DOI: 10.1016/j.ttbdis.2016.02.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 02/15/2016] [Accepted: 02/25/2016] [Indexed: 11/30/2022]
Abstract
Little is known about the epidemiology of zoonotic diseases in American Samoa (Pacific). A review of literature did not identify any published information on human Rickettsia spp., Bartonella spp., Ehrlichia spp. or Coxiella burnetii infections in this country. To determine the presence of these diseases, we conducted a serosurvey of American Samoans. The presence of immunoglobulin G antibodies against Rickettsia felis, Rickettsia typhi, Rickettsia conorii, C. burnetii, Bartonella henselae, Bartonella quintana, and Ehrlichia chaffeensis was evaluated by indirect immunofluorescence assay in sera from 197 American Samoan adults. None of the samples had antibodies at a significant level against Rickettsia spp., Bartonella spp., Ehrlichia spp. or C. burnetii (seroprevalence 0%; one-tailed 95% CI 0-1.86%). We cannot conclude that these pathogens are absent in American Samoa but, if present, their prevalence is probably very low. Q fever has been reported worldwide except in New Zealand and French Polynesia; these new data suggest that the prevalence of Q fever is likely to be very low in the Pacific Islands.
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Affiliation(s)
- Colleen Lau
- Children's Health and Environment Program, Child Health Research Centre, The University of Queensland, Brisbane, QLD, Australia; Research School of Population Health, The Australian National University, Canberra, ACT, Australia.
| | - Didier Musso
- Pôle de Recherche et de Veille sur les Maladies Infectieuses Emergentes, Institut Louis Malardé, Tahiti, Polynésie Française
| | - Pierre-Edouard Fournier
- Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, UM63, CNRS7278, IRD198, Inserm U1095, Centre national de référence des rickettsies, Coxiella et Bartonella, Institut Hospitalo-Universitaire Méditerranée-infection, Marseille, France
| | - Philippe Parola
- Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, UM63, CNRS7278, IRD198, Inserm U1095, Centre national de référence des rickettsies, Coxiella et Bartonella, Institut Hospitalo-Universitaire Méditerranée-infection, Marseille, France
| | - Didier Raoult
- Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, UM63, CNRS7278, IRD198, Inserm U1095, Centre national de référence des rickettsies, Coxiella et Bartonella, Institut Hospitalo-Universitaire Méditerranée-infection, Marseille, France
| | - Philip Weinstein
- School of Biological Sciences, The University of Adelaide, Adelaide, SA, Australia
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Q Fever Knowledge, Attitudes and Vaccination Status of Australia's Veterinary Workforce in 2014. PLoS One 2016; 11:e0146819. [PMID: 26756210 PMCID: PMC4710533 DOI: 10.1371/journal.pone.0146819] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 12/22/2015] [Indexed: 12/03/2022] Open
Abstract
Q fever, caused by Coxiella burnetii, is a serious zoonotic disease in humans with a worldwide distribution. Many species of animals are capable of transmitting C. burnetii, and consequently all veterinary workers are at risk for this disease. An effective Q fever vaccine has been readily available and used in Australia for many years in at-risk groups, and the European Centre for Disease Prevention and Control has recently also called for the use of this vaccine among at-risk groups in Europe. Little is known about attitudes towards this vaccine and vaccine uptake in veterinary workers. This study aimed to determine the Q fever vaccination status of veterinarians and veterinary nurses in Australia and to assess and compare the knowledge and attitudes towards Q fever disease and vaccination of each cohort. An online cross-sectional survey performed in 2014 targeted all veterinarians and veterinary nurses in Australia. Responses from 890 veterinarians and 852 veterinary nurses were obtained. Binary, ordinal and multinomial logistic regression were used to make comparisons between the two cohorts. The results showed that 74% of veterinarians had sought vaccination compared to only 29% of veterinary nurses. Barriers to vaccination among those not vaccinated did not differ between cohorts, and included a lack of perceived risk, financial expense, time constraints, and difficulty in finding a vaccine provider. Poor knowledge and awareness of Q fever disease and vaccination were additional and notable barriers for the veterinary nursing cohort, suggesting veterinary clinics and veterinarians may not be meeting their legal responsibility to educate staff about risks and risk prevention. Further evaluation is needed to identify the drivers behind seeking and recommending vaccination so that recommendations can be made to improve vaccine uptake.
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Khatami A, Sparks RT, Marais BJ. A Case of Pediatric Q Fever Osteomyelitis Managed Without Antibiotics. Pediatrics 2015; 136:e1629-31. [PMID: 26574586 DOI: 10.1542/peds.2015-0024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/14/2015] [Indexed: 11/24/2022] Open
Abstract
Q fever osteomyelitis, caused by infection with Coxiella burnetti, is rare but should be included in the differential diagnosis of children with culture-negative osteomyelitis, particularly if there is a history of contact with farm animals, and/or granulomatous change on histologic examination of a bone biopsy specimen. We describe a case of Q fever osteomyelitis in a 6-year-old boy in which a decision was made not to treat the patient with combination antimicrobial agents, balancing possible risks of recurrence against potential side effects of prolonged antibiotic treatment. The patient had undergone surgical debridement of a single lesion and was completely asymptomatic after recovery from surgery. This case suggests that a conservative approach of watchful waiting in an asymptomatic patient with chronic Q fever osteomyelitis may be warranted in select cases when close follow-up is possible.
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Affiliation(s)
- Ameneh Khatami
- Department of Microbiology and Infectious Diseases, The Children's Hospital at Westmead, Sydney, Australia; and University of Sydney, School of Medicine, Sydney, Australia
| | | | - Ben J Marais
- Department of Microbiology and Infectious Diseases, The Children's Hospital at Westmead, Sydney, Australia; and University of Sydney, School of Medicine, Sydney, Australia
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Hackert VH, Dukers-Muijrers NHTM, van Loo IHM, Wegdam-Blans M, Somers C, Hoebe CJPA. Coxiella burnetii Infection Is Lower in Children than in Adults After Community Exposure: Overlooked Cause of Infrequent Q Fever Reporting in the Young. Pediatr Infect Dis J 2015; 34:1283-8. [PMID: 26252570 DOI: 10.1097/inf.0000000000000871] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Q fever is rarely reported in children/adolescents. Although lower reporting rates are commonly attributed to milder disease and subsequent underdiagnosis in infected children/adolescents, pertinent evidence is scarce. We present data from a large, well-defined single-point source outbreak of Q fever to fill this gap. METHODS We compared (A) Q fever testing and notification rates in children/adolescents who were 0-19 years of age with those in adults 20+ years of age in October 2009; (B) serological attack rates of acute Q fever in children/adolescents with the rates in adults after on-source exposure on the outbreak farm's premises; (C) incidence of Q fever infection in children/adolescents with that in adults after off-source exposure in the municipality located closest to the farm. RESULTS (A) Children/adolescents represented 19.3% (59,404 of 307,348) of the study area population, 12.1% (149 of 1217) of all subjects tested in October 2009 and 4.3% (11 of 253) of notified laboratory-confirmed community cases. (B) Serological attack rate of acute Q fever in children with on-source exposure was 71% (12 of 17), similar to adults [68% (40 of 59)]. (C) Incidence of infection in children/adolescents after community (off-source) exposure was 4.5% (13 of 287) versus 11.0% (12 of 109) in adults (adjusted odds ratio: 0.36; 95% confidence interval: 0.16-0.84; P = 0.02). No children/adolescents reported clinical symptoms. Proportion of notified infections was significantly lower in children/adolescents (2.5%) than in adults (10.4%; risk ratio: 0.26; 95% confidence interval: 0.08-0.80, P = 0.02). CONCLUSION Notified Q fever was less frequent in children/adolescents than in adults. Although underrecognition contributed to this phenomenon, lower rates of infection in children after community exposure played an unexpected major role. On-source (presumed high-dose) exposure, by contrast, was associated with high serological and clinical attack rates not only in adults but also in children/adolescents. Our findings allow for improved age-specific clinical and public health risk assessment in Q fever outbreaks.
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Affiliation(s)
- Volker H Hackert
- From the *Department of Sexual Health, Infectious Diseases, and Environmental Health, South Limburg Public Health Service, Geleen, The Netherlands; †Department of Medical Microbiology, School of Public Health and Primary Care, Maastricht University Medical Center, Maastricht, The Netherlands; and ‡Department of Medical Microbiology, Laboratory for Pathology and Medical Microbiology (PAMM), Veldhoven, The Netherlands
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Slok ENE, Dijkstra F, de Vries E, Rietveld A, Wong A, Notermans DW, van Steenbergen JE. Estimation of acute and chronic Q fever incidence in children during a three-year outbreak in the Netherlands and a comparison with international literature. BMC Res Notes 2015; 8:456. [PMID: 26384483 PMCID: PMC4575485 DOI: 10.1186/s13104-015-1389-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 08/24/2015] [Indexed: 11/23/2022] Open
Abstract
Background In the Dutch 2007–2009 Q fever outbreak Coxiella burnetii was transmitted aerogenically from dairy goat farms to those living in the surrounding areas. Relatively few children were reported. The true number of pediatric infections is unknown. In this study, we estimate the expected number of acute and chronic childhood infections. Methods As Coxiella was transmitted aerogenic to those living near infected dairy goat farms, we could use adult seroprevalence data to estimate infection risk for inhabitants, children and
adults alike. Using Statistics Netherlands data we estimated the number of children at (high) risk for developing chronic Q fever. Literature was reviewed for childhood (0–15 years) Q fever reports and disease rates. We compared this with Dutch reported and our estimated data for 2007–2009. Results In The Netherlands epidemic, 44 children were reported (1.2 % of total notifications). The childhood incidence was 0.15 compared to 2.6 per 10,000 inhabitants for adults. No complications were reported. Based on the expected similarity in childhood and adult exposure we assume that 9.8 % of children in the high-risk area had Q fever infection, resulting
in 1562 acute infections during the Q fever epidemic interval. Based on the prevalence of congenital heart disease, at least 13 children are at high risk for developing chronic Q fever. In medical literature, 42 case reports described 140 childhood Q fever cases with a serious outcome (four deaths). In chronic Q fever, cardiac infections were predominant. Four outbreaks were reported involving children, describing 11 childhood cases. 36 National and/or regional studies reported seroprevalences varying between 0 and 70 %. Conclusion In the 3-year Dutch epidemic, few childhood cases were reported, with pulmonary symptoms leading, and none with a serious presentation. With an estimated 13 high-risk children for chronic infection in the high exposure area, and probably forty in the whole country, we may expect several chronic Q fever complications in the coming years in paediatric practice. Electronic supplementary material The online version of this article (doi:10.1186/s13104-015-1389-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Edwin N E Slok
- National Institute for Public Health and the Environment, Centre for Infectious Disease Control, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands.
| | - Frederika Dijkstra
- National Institute for Public Health and the Environment, Centre for Infectious Disease Control, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands.
| | - Esther de Vries
- Department of Paediatrics, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.
| | - Ariene Rietveld
- Department of Infectious Disease Control, Municipal Health Service 'Hart voor Brabant', 's-Hertogenbosch, The Netherlands.
| | - Albert Wong
- National Institute for Public Health and the Environment, Centre for Infectious Disease Control, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands. .,Department of Statistics, Mathematical Modelling and Data Logistics, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands.
| | - Daan W Notermans
- National Institute for Public Health and the Environment, Centre for Infectious Disease Control, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands.
| | - Jim E van Steenbergen
- National Institute for Public Health and the Environment, Centre for Infectious Disease Control, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands. .,Centre for Infectious Diseases, Leiden University Medical Centre, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.
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Carbonero A, Guzmán LT, Montaño K, Torralbo A, Arenas-Montes A, Saa LR. Coxiella burnetii seroprevalence and associated risk factors in dairy and mixed cattle farms from Ecuador. Prev Vet Med 2015; 118:427-35. [PMID: 25623969 DOI: 10.1016/j.prevetmed.2015.01.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 01/07/2015] [Accepted: 01/09/2015] [Indexed: 11/27/2022]
Abstract
Q fever is a zoonotic disease caused by Coxiella burnetii, a bacterial agent for which ruminants are the main reservoir. An extensive cross-sectional study to determine the seroprevalence of and associated risk factors for Q fever was performed in dairy and mixed (dairy-beef) cattle herds in Ecuador. A total of 2668 serum samples from 386 herds were analyzed using an ELISA. In addition, a questionnaire with 57 variables related to management, feeding, facilities, biosecurity and animal health was completed for every cattle farm. A Generalized Estimating Equations model was used to determine the factors associated with C. burnetii seropositivity. The true prevalence of C. burnetii seropositivity in dairy and mixed cattle from Ecuador reached 12.6% (CI95%: 11.3-13.9%). The herd prevalence was 46.9% (181/386) (CI95%: 41.9-51.9%), and the within herd prevalence ranged between 8% and 100% (mean: 25.0%; Q1: 12.5%, Q2: 25.0%, Q3: 37.5%). Four factors were included in the GEE model for C. burnetii seropositivity: age of the cattle (OR: 1.01; CI95%: 1.006-1.014), feeding of calves with milk replacers (OR: 1.94; CI95%: 1.1-3.3), bovine respiratory syncytial virus seropositivity (OR: 1.54; CI95%: 1.1-2.3), and disinfection of the umbilical cord (OR: 0.60; CI95%: 0.4-0.9).
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Affiliation(s)
- Alfonso Carbonero
- Department of Animal Health, Veterinary Faculty, Campus de Excelencia Internacional Agroalimentario ceiA3, University of Cordoba, Córdoba 14014, Spain.
| | - Lucía T Guzmán
- Departamento de Ciencias Agropecuarias y de Alimentos, Laboratorio de Sanidad Animal y Zoonosis, Universidad Técnica Particular de Loja, Loja 110150, Ecuador
| | - Karen Montaño
- Departamento de Ciencias Agropecuarias y de Alimentos, Laboratorio de Sanidad Animal y Zoonosis, Universidad Técnica Particular de Loja, Loja 110150, Ecuador
| | - Alicia Torralbo
- Department of Animal Health, Veterinary Faculty, Campus de Excelencia Internacional Agroalimentario ceiA3, University of Cordoba, Córdoba 14014, Spain
| | - Antonio Arenas-Montes
- Department of Animal Health, Veterinary Faculty, Campus de Excelencia Internacional Agroalimentario ceiA3, University of Cordoba, Córdoba 14014, Spain
| | - Luis R Saa
- Departamento de Ciencias Agropecuarias y de Alimentos, Laboratorio de Sanidad Animal y Zoonosis, Universidad Técnica Particular de Loja, Loja 110150, Ecuador
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Ruiz S, Wolfe DN. Vaccination against Q fever for biodefense and public health indications. Front Microbiol 2014; 5:726. [PMID: 25566235 PMCID: PMC4267281 DOI: 10.3389/fmicb.2014.00726] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 12/03/2014] [Indexed: 01/02/2023] Open
Abstract
Coxiella burnetii is the etiological agent of Q fever, a disease that is often spread to humans via inhalational exposure to the bacteria from contaminated agricultural sources. Outbreaks have been observed all over the world with larger foci generating interest in vaccination programs, most notably in Australia and the Netherlands. Importantly, exposure rates among military personnel deployed to the Middle East can be relatively high as measured by seroconversion to C. burnetii-specific antibodies. Q fever has been of interest to the biodefense community over the years due to its low infectious dose and environmental stability. Recent advances in cell-free growth and genetics of C. burnetii also make this organism easier to culture and manipulate. While there is a vaccine that is licensed for use in Australia, the combination of biodefense- and public health-related issues associated with Q fever warrant the development of a safer and more effective vaccine against this disease.
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Affiliation(s)
- Sara Ruiz
- Center for Aerobiological Sciences, U.S. Army Medical Research Institute of Infectious Diseases Fort Detrick, MD USA
| | - Daniel N Wolfe
- Chemical and Biological Technologies Department, Defense Threat Reduction Agency Fort Belvoir, VA USA
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Different serologic behavior of MCPyV, TSPyV, HPyV6, HPyV7 and HPyV9 polyomaviruses found on the skin. PLoS One 2013; 8:e81078. [PMID: 24278381 PMCID: PMC3836759 DOI: 10.1371/journal.pone.0081078] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Accepted: 10/08/2013] [Indexed: 12/31/2022] Open
Abstract
The polyomavirus family is rapidly expanding with twelve new human viruses identified since 2007. A significant number of the new human polyomaviruses (HPyV) has been found on the skin. Whether these viruses share biological properties and should be grouped together is unknown. Here we investigated the serological behavior of cutaneous HPyVs in a general population. 799 sera from immunocompetent Australian individuals aged between 0-87 were analyzed with a Luminex xMAP technology-based immunoassay for the presence of VP1-directed IgG antibodies against MCPyV, HPyV6, HPyV7, TSPyV, HPyV9, and BKPyV as a control. Except for HPyV9, overall seropositivity was high for the cutanous polyomaviruses (66-81% in adults), and gradually increased with age. Children below 6 months displayed seropositivity rates comparable to the adults, indicative of maternal antibodies. TSPyV seroreactivity levels strongly increased after age 2 and waned later in life comparable to BKPyV, whereas MCPyV, HPyV6 and HPyV7 seroreactivity remained rather stable throughout. Based on the identified serologic profiles, MCPyV seems to cluster with HPyV6 and HPyV7, and TSPyV and HPyV9 by themselves. These profiles indicate heterogeneity among cutaneous polyomaviruses and probably reflect differences in exposure and pathogenic behavior of these viruses.
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Royal J, Riddle MS, Mohareb E, Monteville MR, Porter CK, Faix DJ. Seroepidemiologic survey for Coxiella burnetii among US military personnel deployed to Southwest and Central Asia in 2005. Am J Trop Med Hyg 2013; 89:991-5. [PMID: 24043692 DOI: 10.4269/ajtmh.12-0174] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
We used a seroepidemiologic study to estimate Q fever (Coxiella burnetii) seroprevalence, seroincidence, and risk factors for seroconversion in two deployed military populations in 2005. The first study group resided in an area with a known Q fever outbreak history (Al Asad, Iraq). Of this population, 7.2% seroconverted for an incidence rate of 10.6 seroconversions per 1,000 person-months. The second population included personnel transiting through Qatar on mid-deployment leave from southwest/central Asia. In this group, we found 2.1% prevalence with 0.92 seroconversions per 1,000 person-months. However, no significant risk factors for Q fever seroconversion were found in either population.
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Affiliation(s)
- Joseph Royal
- Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland; Naval Medical Research Center, Silver Spring, Maryland; US Naval Medical Research Unit, No. 3, Cairo, Egypt; Naval Health Research Center, San Diego, California
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Tozer SJ, Lambert SB, Strong CL, Field HE, Sloots TP, Nissen MD. Potential Animal and Environmental Sources of Q Fever Infection for Humans in Queensland. Zoonoses Public Health 2013; 61:105-12. [DOI: 10.1111/zph.12051] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Indexed: 11/30/2022]
Affiliation(s)
- S. J. Tozer
- Queensland Paediatric Infectious Diseases Laboratory; Queensland Children's Medical Research Institute; Children's Health Queensland Hospitals and Health Service ; The University of Queensland; Brisbane Qld Australia
| | - S. B. Lambert
- Queensland Children's Medical Research Institute; Children's Health Queensland Hospitals and Health Service; The University of Queensland; Brisbane Qld Australia
- Immunisation Program, Communicable Diseases Branch; Queensland Health; Brisbane Qld Australia
| | - C. L. Strong
- Atmospheric Environment Research Centre; Griffith University; Brisbane Qld Australia
| | - H. E. Field
- Queensland Department of Agriculture, Fisheries & Forestry; Queensland Centre for Emerging Infectious Diseases; Biosecurity; Brisbane Qld Australia
| | - T. P. Sloots
- Queensland Paediatric Infectious Diseases Laboratory; Queensland Children's Medical Research Institute; Children's Health Queensland Hospitals and Health Service ; The University of Queensland; Brisbane Qld Australia
| | - M. D. Nissen
- Queensland Paediatric Infectious Diseases Laboratory; Queensland Children's Medical Research Institute; Children's Health Queensland Hospitals and Health Service ; The University of Queensland; Brisbane Qld Australia
- Microbiology Division; Pathology Queensland Central Laboratory; Queensland Health; Brisbane Qld Australia
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Newcombe JP, Gray PEA, Palasanthiran P, Snelling TL. Q Fever with transient antiphospholipid antibodies associated with cholecystitis and splenic infarction. Pediatr Infect Dis J 2013; 32:415-6. [PMID: 23271442 DOI: 10.1097/inf.0b013e3182843d7e] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
We describe a case of Q fever associated with the transient presence of antiphospholipid antibodies in a 9-year-old boy presenting with acalculous cholecystitis and splenic infarction. Antiphospholipid antibodies are commonly associated with acute Q fever in adults but have previously been thought to be of little clinical significance. Recent data suggest that antiphospholipid antibodies may be responsible for certain clinical manifestations of acute Q fever.
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Affiliation(s)
- James P Newcombe
- Department of Immunology and Infectious Diseases, Sydney Children's Hospital, New South Wales, Australia.
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de Rooij MMT, Schimmer B, Versteeg B, Schneeberger P, Berends BR, Heederik D, van der Hoek W, Wouters IM. Risk factors of Coxiella burnetii (Q fever) seropositivity in veterinary medicine students. PLoS One 2012; 7:e32108. [PMID: 22363803 PMCID: PMC3283734 DOI: 10.1371/journal.pone.0032108] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2011] [Accepted: 01/23/2012] [Indexed: 11/18/2022] Open
Abstract
Background Q fever is an occupational risk for veterinarians, however little is known about the risk for veterinary medicine students. This study aimed to assess the seroprevalence of Coxiella burnetii among veterinary medicine students and to identify associated risk factors. Methods A cross-sectional study with questionnaire and blood sample collection was performed among all veterinary medicine students studying in the Netherlands in 2006. Serum samples (n = 674), representative of all study years and study directions, were analyzed for C. burnetii IgG and IgM phase I and II antibodies with an immunofluorescence assay (IFA). Seropositivity was defined as IgG phase I and/or II titer of 1∶32 and above. Results Of the veterinary medicine students 126 (18.7%) had IgG antibodies against C. burnetii. Seropositivity associated risk factors identified were the study direction ‘farm animals’ (Odds Ratio (OR) 3.27 [95% CI 2.14–5.02]), advanced year of study (OR year 6: 2.31 [1.22–4.39] OR year 3–5 1.83 [1.07–3.10]) having had a zoonosis during the study (OR 1.74 [1.07–2.82]) and ever lived on a ruminant farm (OR 2.73 [1.59–4.67]). Stratified analysis revealed study direction ‘farm animals’ to be a study-related risk factor apart from ever living on a farm. In addition we identified a clear dose-response relation for the number of years lived on a farm with C. burnetii seropositivity. Conclusions C. burnetii seroprevalence is considerable among veterinary medicine students and study related risk factors were identified. This indicates Q fever as an occupational risk for veterinary medicine students.
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Affiliation(s)
- Myrna M. T. de Rooij
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht, the Netherlands
| | - Barbara Schimmer
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Bart Versteeg
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
- Department of Medical Microbiology and Infection Control, Jeroen Bosch Hospital, ‘s-Hertogenbosch, the Netherlands
| | - Peter Schneeberger
- Department of Medical Microbiology and Infection Control, Jeroen Bosch Hospital, ‘s-Hertogenbosch, the Netherlands
| | - Boyd R. Berends
- Division of Veterinary Public Health, Institute for Risk Assessment Sciences, Utrecht, the Netherlands
| | - Dick Heederik
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht, the Netherlands
| | - Wim van der Hoek
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Inge M. Wouters
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht, the Netherlands
- * E-mail:
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