Coxiella burnetti Infection in Children

Chronic Q Fever as Recurrent Osteoarticular Infection in Children: Case Report and Literature Review

Q fever osteomyelitis has been rarely reported in children. This infection has an unclear pathophysiology and the optimal therapy is unknown. We report a 2-year-old girl with Coxiella burnetti recurrent multifocal osteomyelitis: femur, metatarsal, cuneiform, and calcaneus. We highlight the complicated diagnosis and management of this case and the importance of considering Q fever in children with chronic-recurrent multifocal osteomyelitis.

Coxiella burnetii DNA in milk, milk products, and fermented dairy products

Introduction

Q fever in dairy cattle has been investigated in Latvia since 2012. In 2015, 10.7% of farms tested positive for the DNA of C. burnetii, its aetiological agent, in bulk tank milk. The presence of C. burnetii DNA and infectious bacteria in dairy products has been assessed in several countries, and because Latvian milk may contain them, parallel assessment in this country is recommended. Accordingly, the present study tested shop and farm retail dairy products from Latvia and included foreign products for comparison.

Material and Methods

Investigation was carried out of 187 samples of a diverse range of dairy products from 41 Latvian milk producers. Twenty-six comparable samples pooled from Estonia, France, Germany, Greece, Italy, Lithuania, the Netherlands, Poland and Spain were also included. The all-countries total number of fermented milk products was 160. Special attention was paid to products that could be more attractive to children because of their added chocolate, cacao, berry and fruit content. DNA was extracted and amplification of C. burnetii IS1111 was performed using a commercial PCR kit.

Results

Overall positivity was 60.56%. Domestic products were positive more often (60.96%) than foreign ones (57.69%). Only 26.67% of unpasteurised Latvian cow’s milk samples were positive whereas 76.47% of pasteurised equivalents and 63.13% of fermented milk products were. Sweetened and fruit-containing samples were 71.43% positive.

Conclusion

The shedding of C. burnetii via milk should be monitored and only milk from healthy animals allowed for sale for direct human consumption without pasteurisation. Raw milk quality and the effectiveness of industrial heat treatment and pasteurisation methods in Latvia and other countries should be carefully assessed to ensure adequate consumer health protection.