Identifying scenarios and risk factors for Q fever outbreaks using qualitative analysis of expert opinion

A systematic review of global Q fever outbreaks

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.

Detection and seroprevalence of Q fever infection in dairy goats in Besut district, Malaysia

Objective

This study aimed to investigate the seroprevalence of Q fever and its association with age and gender among Saanen dairy goats in Malaysia.

Materials and Methods

One hundred dairy goats (n = 100) aged 6 months to 6 years were randomly selected, and blood samples were collected for serological analysis using the enzyme-linked immunosorbent assay technique.

Results

The results revealed a seropositive rate of 70% among the goats, with medium-positive titers being the most common. The prevalence of Q fever varied among different age groups, with higher rates observed in adult goats aged between 5 and 6 years. Gender analysis showed that males had a higher positive rate (p < 0.05) of Q fever compared to females.

Conclusion

These findings strongly indicate the presence of Coxiella burnetii in the dairy goat population and highlight the importance of implementing biosecurity measures and control strategies to prevent further transmission of this disease. This research has contributed to a better understanding of Q fever epidemiology and provides insights for effective control and prevention strategies in dairy goat populations.

Molecular prevalence of Coxiella burnetii in cheese samples: Systematic review and meta-analysis

BACKGROUND

Cheese is a popular dairy product consumed worldwide, and it has been implicated as a source of Coxiella burnetii infections.

OBJECTIVES

The present study aimed to describe the molecular prevalence and source analysis of C. burnetii in cheese samples.

METHODS

A systematic literature search was conducted using the Medline/PubMed, Science Direct, Web of Science, Scopus, and Google Scholar databases to identify studies reporting the molecular prevalence of C. burnetii in cheese samples. The pooled prevalence of C. burnetii in cheese samples was estimated using a random-effects model.

RESULTS

A meta-analysis was conducted using the mean and standard deviation values obtained from 13 original studies. The overall molecular prevalence of C. burnetii in cheese was estimated to be 25.2% (95% confidence interval [CI]: 13.1%-39.7%). The I2 value of 96.3% (CI95% 94.9-97.3) suggested high heterogeneity, with a τ2 of 0.642 (CI95% -0.141 to 0.881), and an χ2 statistic of 323.77 (p < 0.0001).

CONCLUSIONS

In conclusion, our meta-analysis provides a thorough assessment of the molecular prevalence and source analysis of C. burnetii in cheese samples.

First report of an outbreak of "Q" fever IN an abattoir from Argentina

In late October 2021, one of the veterinarians and the occupational physician of a bovine and swine abattoir from Entre Ríos Province, Argentina were alerted about workers with atypical pneumonia symptoms, raising suspicious of a possible Q fever outbreak. An outbreak epidemiological investigation was carried out. Analysis was based on the description of the study population, according to gender, age, symptoms, and position within the abattoir, as well as on outbreak epidemic curve and its probable origin. Cases of Q fever in the workers were confirmed by serology. Measurements of the association between the evaluated variables and the risk of exposure were investigated and calculated as attack rates. The outbreak occurred between October and November 2021, symptomatically affecting 11 workers, out of a total exposed population of 49 individuals. The index case was a 33-year-old male who started with symptoms on 27 October 2021, and the outbreak extended for at least 17 days. Workers in the clean zone of the slaughter floor had a 4.68 times higher risk of contracting Q fever than people located in other areas. Importantly, two pregnant cows were slaughtered a few days before the outbreak began, which could have been the origin of the outbreak. The present study demonstrates the urgent need to consider Q fever when diagnosing abortive diseases of ruminants in Argentina, as well as in zoonotic disease epidemiological surveillance to inform all actors of the health system.