Q fever diagnosis in domestic ruminants: comparison between complement fixation and commercial enzyme-linked immunosorbent assays

The use of a Bayesian latent class model to estimate the test characteristics of three liver fluke diagnostic tests under New Zealand field conditions

The liver fluke Fasciola hepatica is a trematode parasite of farmed livestock with worldwide distribution, causing chronic production losses and possible death from hepatobiliary damage. The effective management of liver fluke infection requires diagnostic tests which can accurately identify infected animals at both the individual and herd level. However, the accuracy of liver fluke diagnostic tests performed on individual New Zealand cattle is currently unknown. The aim of this study was to use a Bayesian latent class model (LCM) to estimate the test characteristics of three liver fluke diagnostic tests, the coproantigen ELISA, the IDEXX antibody ELISA and the faecal egg count. One hundred and twenty dairy cows each from two dairy farms were blood and faecal sampled in April 2021. The samples were transported to Massey University, Palmerston North, and the three diagnostic tests completed following the respective manufacturer instructions. A Bayesian LCM model, adapted from the original Hui and Walter 2 tests 2 populations model, was built to estimate the test characteristics of the three diagnostic tests in the two dairy herds. The model was implemented in JAGS using Markov chain Monte Carlo sampling. The first 30,000 iterations were discarded as burn-in, and the next 200,000 iterations were used to construct the posterior distributions. Uninformed priors, beta (1,1), were used as the prior distributions for the prevalence estimation and informed beta priors, based on published results, were used as the prior distributions for estimating the sensitivity and specificity of each diagnostic test. Model convergence was confirmed by inspection of trace plots and examination of the results of the Gelman and Rubin test. The results found that the coproantigen ELISA test was the most accurate for diagnosing liver fluke infection in individual animals with a sensitivity = 0.98 (95 % CI 0.95-1.00) and specificity = 0.95 (95 % CI 0.81-1.00) compared to the IDEXX antibody ELISA test, sensitivity = 0.39 (95 % CI 0.32-0.47) and specificity = 0.86 (95 % CI 0.75-0.96) or the FEC, sensitivity = 0.23 (95 % CI 0.17-0.30) and specificity = 0.92 (95 % CI 0.86-0.97). Based on these results clinicians should be encouraged to use the coproantigen ELISA test to diagnose liver fluke infection in individual cattle.

Efficiency of recombinant Ybgf in a double antigen-ELISA for the detection of Coxiella antibodies in ruminants

Q fever is a zoonosis whose main reservoirs are domestic ruminants. Surveillance in these species is carried out mainly with serological tests, which, however, have limited diagnostic performance, and their manufacturing requires laboratories equipped with high biosafety requirements for antigen production. Recombinant ELISAs do not depend on these requirements and, being based on a single antigen, can reduce potential false positivity by identifying antibodies specific to a phase of infection. The aim of this study was to apply a new technology (dual antigen test) to a recombinant protein (Ybgf), an antigen produced in recombinant form and already used in previous studies for the design of an indirect ELISA. The successfully produced recombinant antigen was used to coat 96-well plates and, at the same time, another antigen aliquot was conjugated with HRP to obtain an HRP-conjugated Ybgf. After setting the test conditions, the results obtained with the recombinant double antigen test were compared with those obtained with a commercial assay (considered as reference assay) testing a total of 514 ruminant samples (280 goats and 234 cattle). A concordance of 86.2 and a Cohen's Kappa value of 0.72 were obtained, with no significant difference between the two species tested. Notably, the test proved to be highly specific, having correctly identified 250 out of 253 animals. This research represents an additional effort to use recombinant antigens to enhance serological methods in veterinary medicine. In a "one-health scenario", improving the performance of serological tests used in veterinary practice also means improving the surveillance of this infection.

Multiple pathogens co-exposure and associated risk factors among cattle reared in a wildlife-livestock interface area in Kenya

Introduction

Understanding multi-pathogen infections/exposures in livestock is critical to inform prevention and control measures against infectious diseases. We investigated the co-exposure of foot-and-mouth disease virus (FMDV), Brucella spp., Leptospira spp., and Coxiella burnetii in cattle in three zones stratified by land use change and with different wildlife-livestock interactions in Narok county, Kenya. We also assessed potential risk factors associated with the transmission of these pathogens in cattle.

Methods

We identified five villages purposively, two each for areas with intensive (zone 1) and moderate wildlife-livestock interactions (zone 2) and one for locations with low wildlife-livestock interactions (zone 3). We sampled 1,170 cattle from 390 herds through a cross-sectional study and tested the serum samples for antibodies against the focal pathogens using enzyme-linked immunosorbent assay (ELISA) kits. A questionnaire was administered to gather epidemiological data on the putative risk factors associated with cattle's exposure to the investigated pathogens. Data were analyzed using the Bayesian hierarchical models with herd number as a random effect to adjust for the within-herd clustering of the various co-exposures among cattle.

Results

Overall, 88.0% (95% CI: 85.0-90.5) of the cattle tested positive for at least one of the targeted pathogens, while 41.7% (95% CI: 37.7-45.8) were seropositive to at least two pathogens. FMDV and Brucella spp. had the highest co-exposure at 33.7% (95% CI: 30.9-36.5), followed by FMDV and Leptospira spp. (21.8%, 95% CI: 19.5-24.4), Leptospira spp. and Brucella spp. (8.8%, 95% CI: 7.2-10.6), FMDV and C. burnetii (1.5%, 95% CI: 0.7-2.8), Brucella spp. and C. burnetii (1.0%, 95% CI: 0.3-2.2), and lowest for Leptospira spp. and C. burnetii (0.3%, 95% CI: 0.0-1.2). Cattle with FMDV and Brucella spp., and Brucella spp. and Leptospira spp. co-exposures and those simultaneously exposed to FMDV, Brucella spp. and Leptospira spp. were significantly higher in zone 1 than in zones 2 and 3. However, FMDV and Leptospira spp. co-exposure was higher in zones 1 and 2 than zone 3.

Discussion/conclusion

We recommend the establishment of a One Health surveillance system in the study area to reduce the morbidity of the targeted zoonotic pathogens in cattle and the risks of transmission to humans.

Global and regional seroprevalence of coxiellosis in small ruminants: A systematic review and meta-analysis

BACKGROUND

Coxiellosis is a neglected zoonosis for occupationally exposed people in many parts of the world. Sheep and goats are two important small ruminants that act as reservoirs for human contamination; however, there is a lack of comprehensive data on the epidemiological aspects of coxiellosis in sheep and goats at regional and global levels. The aim of this study was to systematically review the available articles on seroprevalence of coxiellosis in sheep and goats and estimate the overall seroprevalence in different regions.

METHODS

A systematic search strategy was performed in five electronic repositories for articles published until December 2021. Relevant data were extracted from the selected articles based on the inclusion criteria. A random effect meta-analysis model was used to analyse the data. Results are presented as the prevalence of seropositivity as a percentage and 95% confidence intervals.

RESULTS

The global pooled seroprevalence of coxiellosis in sheep was 17.38% (95% confidence interval [CI]: 15.59%-19.17%). Overall, the regional level pooled prevalence estimates in sheep ranged from 15.04% (95% CI: 7.68%-22.40%) to 19.14% (95% CI: 15.51%-22.77%), depending on region. The global pooled seroprevalence of coxiellosis in goats was 22.60% (95% CI: 19.54%-25.66%). Overall, the regional level pooled prevalence estimates in goats ranged from 6.33% (95% CI: 2.96%-9.71%) to 55.13% (95% CI: 49.61%-60.65%), depending on the region. The prevalence estimates also varied significantly in both sheep and goats depending on age, sex, and rearing systems of the animals (p < 0.001).

CONCLUSION

Seroprevalence of coxiellosis in both sheep and goats is considerable. Routine monitoring of the sheep and goat populations is needed to prevent spillover infection in other livestock and humans.

Susceptibility, Immunity, and Persistent Infection Drive Endemic Cycles of Coxiellosis on Dairy Farms

Coxiella (C.) burnetii, a zoonotic bacterium, is prevalent in dairy farms. Some cows develop a persistent infection and shed C. burnetii into milk and occasionally by amniotic fluid at calving. Serological diagnosis of Q fever in humans is performed by phase (Ph)-specific antibody tests; PhII antibodies usually indicate an acute infection, while the development of a chronic infection is characterised by elevated PhI antibody titres. Phase-specific tests have now been established for diagnosis of coxiellosis in cattle. Additionally, an interferon-γ (IFN-γ) recall assay has been implemented to assess cellular immunity to C. burnetii in cattle. Milk samples from all lactating cows (n = 2718) of 49 Bavarian dairy farms were collected through a convenience sample and analysed for phase-specific antibodies. Antibody profiles were evaluated by age. Based on the seropositivity of first-lactation cows, three distinct herd profiles were observed: an 'acute' state of herd infection was characterised by a PhI-/PhII+ pattern. The detection of PhI antibodies (PhI+/PhII+) characterised the 'chronic' state, and seronegative results defined the 'silent' state of herd infection. If antibodies had not been detected in multiparous cows, the herd was considered as probably free of coxiellosis. The analysed cattle herds were noted to have an 'acute' (n = 12, 24.5%), 'chronic' (n = 18, 36.8%), or 'silent' state of herd infection (n = 16, 32.6%). Only three farms (6.1%) were classified as 'free' of C. burnetii. The detection of these herd states over a time period of 4 years in one farm indicated that the described states occur in a cyclical manner. Frequently, a wave-like profile was seen, i.e., a circumscribed seronegative age group was flanked by seropositive age groups. In seronegative animals, IFN-γ reactivity was demonstrated. Seroconversion after vaccination was observed by day 7 post-vaccination in chronically infected herds, whereas in the case of silent infection, it started by day 14. These data indicated a pre-existing immunity in seronegative animals in chronically infected herds. Additionally, IFN-γ reactivity was detected in seronegative calves (>3 months) and heifers from chronically infected farms compared to a negative farm. An infection prior to 3 months of age resulted in cellular immunity in the absence of detectable antibodies. An infection around calving would explain this. The aforementioned circumscribed seronegative age groups are, therefore, explained by an infection early in life during active shedding at calving. Based on these results, an endemic cycle of coxiellosis is proposed: Susceptible young heifers get infected by persistently infected cows. Subsequently, shedding of C. burnetii at calving results in infection and then in cellular immunity in offspring. When these calves enter the cow herd two years later, a maximum of herd immunity is achieved, shedding ceases, and new susceptible animals are raised. In an acutely infected dairy farm, the PhI+/PhII+ serological pattern prevailed in second-lactation cows. In this study, stored sera collected since birth were analysed retrospectively. From the earliest seroconversion, the peak of seroconversion took about 33 months. These data suggested a slow spread of infection within herds. The classification of dairy cow herds is a promising basis for further analysis of the clinical impact of coxiellosis.

Epidemiological investigation of Coxiella burnetii in cattle and its association with Ixodid tick infestation in different agro-ecological zones of Southwest Ethiopia

Coxiella burnetii is a serious zoonotic disease that causes significant economic losses in cattle production, including abortion, stillbirth, infertility, and reduced milk yield. However, little is known about the epidemiology of C. burnetii in Ethiopia. From November 2020 to November 2021, a cross-sectional study was conducted to estimate the seroprevalence and associated risk factors of C. burnetii in cattle in various agro-ecologies of Southwest Ethiopia. Blood samples were collected from 461 cattle, and the serum samples were tested for the presence of C. burnetii antibodies using an indirect ELISA. To identify potential risk factors for C. burnetii seropositivity, a multivariable mixed-effect logistic regression analysis was used. The study found an overall seroprevalence of 8.68% (95% CI: 6.11-11.25) and 13.57% (95% CI: 9.56-17.58) at the animal and herd levels, respectively, in the study areas. The results of the study indicated that C. burnetii infection was a widespread disease in the study areas. C. burnetii seropositivity at the animal level was significantly associated with age (OR = 4.1, 95%CI: 1.47-10.92), herd size (OR = 3.9, 95%CI: 1.21-12.66), management system (OR = 9.7, 95%CI: 1.27-27.25), cattle access to dogs, cats, and mice (OR = 2.5, 95%CI: 1.21-5.28), accessibility of cattle to wild animals (OR = 4.2, 95%CI: 1.01-17.18), presence of ticks on cattle (OR = 2.3, 95%CI: 1.12-4.83), and history of abortion (OR = 3.8, 95%CI: 1.78-8.23). A herd level analysis identified several risk factors for C. burnetii infection, including the management system (OR = 3.8, 95%CI: 1.59-8.98), agro-ecology (OR = 2.8, 95%CI: 1.43-7.21), herd size (OR = 4.3, 95%CI: 1.69-9.76), and accessibility of cattle to dogs, cats, and mice (OR = 2.6, 95%CI: 1.18-3.96). Therefore, it is important to implement appropriate control methods and raise public awareness about C. burnetii zoonotic transmission. Moreover, further studies should be conducted to isolate and characterize C. burnetii as a cause of reproductive problems and in disease reservoirs such as ticks and wildlife in the study areas.

Detection of Coxiella antibodies in ruminants using a SucB recombinant antigen

The detection of Coxiella burnetii in ruminants remains challenging despite the use of new technology and the accumulation of novel knowledge. Serology tools, the primary methods of infection surveillance in veterinary medicine, have limitations. We used recombinant antigen production to develop an ELISA based on the SucB protein, one of the major immunodominant antigens described in humans and laboratory animals. We produced the antigen successfully in an Escherichia coli heterologous system, confirmed by sequencing and mass spectrometry, and seen as a band of ~50 kDa in SDS-PAGE and on western blot analysis. We compared the performance of the recombinant ELISA with a commercial ELISA. We observed agreement of 83.5% and a substantial Cohen κ value of 0.67 in our pilot study.

Sero-epidemiological study of zoonotic bacterial abortifacient agents in small ruminants

Abortion is one of the leading causes of economic losses in the livestock industry worldwide. Chlamydia abortus, Coxiella burnetii, and Brucella spp. are the leading cause of late fetal loss in small ruminants. This study determined the seroprevalence of these agents in small ruminants in district Jhang. A total of 385 serum samples were taken from the sheep and goats from different flocks with a history of abortion and subjected to i-ELISA. Further, samples were analysed for liver enzymes and total serum protein using a semi-automated chemistry analyzer. The result of indirect commercial ELISA showed 13.0, 4.2 and 11.2% prevalence for Coxiella burnetii, Chlamydia abortus, and Brucella spp., respectively. Values of different serum parameters (ALT, AST, and total protein) of seropositive animals were also determined. There was a significant rise in AST and ALT values of infected animals (p ≤ 0.05). Total protein decreased for all three infections, but a significant drop was noted in Brucella positive sheep serum samples. Various risk factors were studied. Binary logistic regression proved a significant role of ticks for coxiellosis and brucellosis. Age, parity, and species did not impact the prevalence of diseases studied.

Comparison of Three Serologic Tests for the Detection of Anti-Coxiella burnetii Antibodies in Patients with Q Fever

The performance of a commercial immunofluorescence assay (IFA commercial), an in-house immunofluorescence assay (IFA in-house) and an indirect enzyme-linked immunosorbent assay (ELISA) were evaluated in the detection of antibodies anti-C. burnetii in the serum of Q fever patients and persons without the disease. For the study, seropositive and seronegative samples for Q fever (n = 200) from a serum bank of the Instituto Adolfo Lutz in Brazil were used. Commercial IFA was considered in this study as the gold standard for diagnosing Q fever. The in-house IFA demonstrated good agreement with the commercial test, showing high sensitivity (91%) and specificity (97%) compared to the gold standard, with a Kappa coefficient of 0.8954. The indirect ELISA test showed lower agreement with the gold standard, showing low sensitivity (67%), although the specificity of the technique was high (97%) and the Kappa coefficient was moderate (0.6631). In-house IFA is an excellent alternative for diagnosing Q fever.

Coxiella burnetii Seroprevalence and Associated Risk Factors in Cattle, Sheep, and Goats in Estonia

Q fever, a disease caused by Coxiella burnetii (CB), is an emerging zoonotic health problem. The prevalence data from potential sources are valuable for assessing the risk to human and animal health. To estimate the prevalence of CB antibodies in Estonian ruminants, pooled milk and serum samples from cattle (Bos taurus) and pooled serum samples from sheep (Ovis aries) and goats (Capra hircus) were analyzed. Additionally, bulk tank milk samples (BTM; n = 72) were analyzed for the presence of CB DNA. Questionnaires and herd-level datasets were used to identify the risk factors for exposure using binary logistic regression analysis. The prevalence of CB-positive dairy cattle herds (27.16%) was significantly higher than that in beef cattle herds (6.67%) and sheep flocks (2.35%). No CB antibodies were detected in the goat flocks. CB DNA was found in 11.36% of the BTM samples. The odds of seropositivity were higher in dairy cattle herds, with an increasing number of cattle in the herd, and with location in southwestern, northeastern and northwestern Estonia. Dairy cattle herds had higher odds of testing positive for CB in BTM if the dairy cows were kept loose and lower odds if the herd was located in northwestern Estonia.

Characterization of recombinant Ybgf protein for the detection of Coxiella antibodies in ruminants

Q fever remains a One Health problem, posing a zoonotic threat and causing significant economic losses to the livestock industry. The advancement of detection tools is critical to the effective control of infection. In humans, laboratory investigations depend largely on the immunofluorescence assay, considered the gold standard. In contrast, serologic tools routinely used for veterinary screening have several gaps, resulting in interpretations that are frequently misleading. We investigated the potential application of recombinant Ybgf antigen (r-Ybgf), a periplasmic protein described as one of the most immunodominant antigens in humans, in an indirect ELISA. Following successful expression in the prokaryotic system and the preliminary evaluation of immunoreactivity in western blot, we used r-Ybgf to develop an in-house ELISA using serum samples from sheep, goats, and cattle, which were tested in parallel with an Idexx ELISA kit. The results obtained with the 2 tests were compared, and r-Ybgf performed favorably, with 81.8% sensitivity and 90.1% specificity and substantial agreement, as revealed by receiver operating characteristic analysis. Moreover, we evaluated the serologic response against phase I (PhI) and phase II (PhII) antigens, and r-Ybgf antigen induced by vaccination, using phase-specific ELISAs. The dynamics of antibody response showed a significant increase in reactivity against PhI and PhII, but not against r-Ybgf, antigens. This property may be very useful given the absence of a protocol for the differentiation of infected from vaccinated animals.

Sero-epidemiological survey of Coxiella burnetii in livestock and humans in Tana River and Garissa counties in Kenya

Background

Coxiella burnetii is a widely distributed pathogen, but data on its epidemiology in livestock, and human populations remain scanty, especially in developing countries such as Kenya. We used the One Health approach to estimate the seroprevalance of C. burnetii in cattle, sheep, goats and human populations in Tana River county, and in humans in Garissa county, Kenya. We also identified potential determinants of exposure among these hosts.

Methods

Data were collected through a cross-sectional study. Serum samples were taken from 2,727 animals (466 cattle, 1,333 goats, and 928 sheep) and 974 humans and screened for Phase I/II IgG antibodies against C. burnetii using enzyme-linked immunosorbent assay (ELISA). Data on potential factors associated with animal and human exposure were collected using a structured questionnaire. Multivariable analyses were performed with households as a random effect to adjust for the within-household correlation of C. burnetii exposure among animals and humans, respectively.

Results

The overall apparent seroprevalence estimates of C. burnetii in livestock and humans were 12.80% (95% confidence interval [CI]: 11.57–14.11) and 24.44% (95% CI: 21.77–27.26), respectively. In livestock, the seroprevalence differed significantly by species (p < 0.01). The highest seroprevalence estimates were observed in goats (15.22%, 95% CI: 13.34-17.27) and sheep (14.22%, 95% CI: 12.04–16.64) while cattle (3.00%, 95% CI: 1.65–4.99) had the lowest seroprevalence. Herd-level seropositivity of C. burnetii in livestock was not positively associated with human exposure. Multivariable results showed that female animals had higher odds of seropositivity for C. burnetii than males, while for animal age groups, adult animals had higher odds of seropositivity than calves, kids or lambs. For livestock species, both sheep and goats had significantly higher odds of seropositivity than cattle. In human populations, men had a significantly higher odds of testing positive for C. burnetii than women.

Conclusions

This study provides evidence of livestock and human exposure to C. burnetii which could have serious economic implications on livestock production and impact on human health. These results also highlight the need to establish active surveillance in the study area to reduce the disease burden associated with this pathogen.

Q fever caused by Coxiella burnetii is a significant zoonotic disease that affects wildlife, domestic animals and humans. This study determined the prevalence of antibodies to C. burnetii in livestock (cattle, sheep, and goats) and human populations in arid and semi-arid areas of Kenya between December 2013 and February 2014. We also identified potential factors that were associated with exposure among the above-targeted hosts. Results from this study showed considerable exposure in both livestock and human populations. However, human exposure to this pathogen at the household level was not correlated with herd-level seropositivity. Further studies are needed to elucidate the transmission routes of this pathogen among humans.

Seropositivity to Coxiella burnetii in primiparous and multiparous ewes from southern Australia: A cross-sectional study

The role of infectious diseases including coxiellosis in causing poorer reproductive performance of primiparous ewes are not well studied. The aims of this study were to determine if natural exposure to Coxiella burnetii is widespread in breeding ewes and whether seropositivity is associated with poor reproductive performance of primiparous ewes. Seropositivity to Coxiella burnetii was 0.08% (CI95% 0.01, 0.36) in primiparous ewes and 0.36% (CI95% 0.07, 1.14) in mature ewes. Coxiella burnetii was not detected in aborted or stillborn lambs using qPCR. These findings suggest C. burnetii infection was unlikely to be an important contributor to abortion and perinatal mortalities observed for primiparous ewe flocks, and exposure to C. burnetii was not widespread in ewes on farms located over wide geographical region of southern Australia. Whilst ewes on these farms were not an important reservoir for C. burnetii, sporadic zoonotic transmission from sheep is reported and has public health implications.

Seroprevalence of brucellosis and Q fever infections amongst pastoralists and their cattle herds in Sokoto State, Nigeria

Brucellosis and Q fever are neglected zoonoses of global health importance, with unknown true prevalence in occupationally vulnerable settings, partly due to misdiagnosis for other febrile conditions and poor access to primary health care. We examined the seroprevalence of these diseases and associated factors amongst pastoralists and their cattle in Sokoto State, a hub of cattle and pastoral populations in Nigeria. Serum samples randomly collected from 137 pastoralists and 366 cattle from 27 herds in three selected Local Government Areas (LGAs) in the state were analysed for antibodies to Brucella abortus using Rose Bengal Plate Test (RBT) and competitive Enzyme-Linked Immunosorbent Assay (cELISA) as well as antibodies to Coxiella burnetti using indirect ELISA. Consenting pastoralists' knowledge, perception and practices about the diseases were assessed using a semi-structured questionnaire. Data were analysed using descriptive statistics and bivariate analysis at p ≤ 0.05 level of significance. Brucellosis adjusted individual seroprevalence were 0.83% (95%CI: 0.04-4.59%) and 0% among pastoralists; 2.28% (95%CI: 1.16-4.43%) and 5.70% (95%CI: 3.68-8.74%) in cattle by RBT and cELISA, respectively. Adjusted herd-level seroprevalence for brucellosis were 23.20% (95%CI: 11.07-42.54%) and 42.00% (95%CI: 25.27-61.11%) by RBT and cELISA, respectively. For Q fever, higher seroprevalence of 62.57% (95%CI: 54.04-70.46%) and 2.98% (95%CI: 1.57-5.58%) were recorded amongst the pastoralists and their cattle, respectively. with adjusted herd-level seroprevalence of 40.36% (95%CI: 22.57-63.17%). The LGAs of sampling were significantly (OR: 0.2; 95%CI: 0.02-1.00) associated with Q fever infection, though marginal. The majority of the pastoralists had poor knowledge, perception and practices towards the diseases. This is the first study establishing the presence of brucellosis and Q fever at the human-animal interface in Sokoto State, Nigeria. The pastoralists' poor knowledge, perception and practices about these diseases are worrisome and are important factors for consideration in disease control.

Evaluation using latent class models of the diagnostic performances of three ELISA tests commercialized for the serological diagnosis of Coxiella burnetii infection in domestic ruminants

ELISA methods are the diagnostic tools recommended for the serological diagnosis of Coxiella burnetii infection in ruminants but their respective diagnostic performances are difficult to assess because of the absence of a gold standard. This study focused on three commercial ELISA tests with the following objectives (1) assess their sensitivity and specificity in sheep, goats and cattle, (2) assess the between- and within-herd seroprevalence distribution in these species, accounting for diagnostic errors, and (3) estimate optimal sample sizes considering sensitivity and specificity at herd level. We comparatively tested 1413 cattle, 1474 goat and 1432 sheep serum samples collected in France. We analyzed the cross-classified test results with a hierarchical zero-inflated beta-binomial latent class model considering each herd as a population and conditional dependence as a fixed effect. Potential biases and coverage probabilities of the model were assessed by simulation. Conditional dependence for truly seropositive animals was high in all species for two of the three ELISA methods. Specificity estimates were high, ranging from 94.8% [92.1; 97.8] to 99.2% [98.5; 99.7], whereas sensitivity estimates were generally low, ranging from 39.3 [30.7; 47.0] to 90.5% [83.3; 93.8]. Between- and within-herd seroprevalence estimates varied greatly among geographic areas and herds. Overall, goats showed higher within-herd seroprevalence levels than sheep and cattle. The optimal sample size maximizing both herd sensitivity and herd specificity varied from 3 to at least 20 animals depending on the test and ruminant species. This study provides better interpretation of three widely used commercial ELISA tests and will make it possible to optimize their implementation in future studies. The methodology developed may likewise be applied to other human or animal diseases.

Evaluation of three immunological assays to mitigate the risk of transboundary spread of Coxiella burnetii by alpacas

Coxiella burnetii causes coxiellosis in animals and Q fever in humans, a potentially debilitating zoonotic disease commonly transmitted through domestic ruminants. To prevent transboundary spread of C. burnetii, animals may be tested prior to export. In alpacas, this process is complicated by the lack of scientific evidence for C. burnetii infection in the species, and the unique composition of camelid antibodies, which may cause false-positive results in assays developed for ruminants. We evaluated a complement fixation test (CFT; currently recommended for alpacas in New Zealand), an enzyme-linked immunosorbent assay (ELISA) and an immunofluorescence assay (IFA). Positive analytical control samples were generated through vaccination of alpacas with a human Q fever vaccine, whereas negative analytical control samples were sourced from New Zealand (deemed free of C. burnetii). Immunological assays were conducted on 131 alpaca sera submitted for export testing. Test characteristics (sensitivity, specificity, positive and negative predictive values) for CFT, ELISA and IFA were determined using Bayesian latent class analysis. Due to anticomplementary activity, 37 (28.2%) of the CFT results were inconclusive, making CFT unsuitable for routine use. Of the remaining 94 samples, 10.6%, 0% and 7.4% were positive for C. burnetii antibodies based on CFT, ELISA and IFA, respectively, yielding estimated sensitivities of 58%, 26% and 78%, and estimated specificities of 95%, 98% and 95%, with the estimates for sensitivity being imprecise, as evidenced by wide 95% credible intervals. Positive predictive values were similar across assays, albeit very low at the estimated seroprevalence of 5%. Our results indicate that, of the tests available, IFA appears to be the most appropriate for use in alpacas. Higher sensitivity of antibody detection, use of antigen detection assays and availability of samples from individuals with evidence of infection could provide additional insight into the risk of transboundary spread of C. burnetii by alpacas.

A Freedom of Coxiella burnetii Infection Survey in European Bison (Bison bonasus) in Poland

Simple Summary

Q fever is one of the important diseases transmissible from animals to humans. The source of infection can be numerous species of animals including mammals, birds, reptiles, amphibians as well as ticks. The role of wildlife in its epidemiology is poorly understood. Therefore, we examined 523 sera samples obtained from European bison for the presence of specific antibodies to assess whether infection occurs in this species and whether European bison may be an important source of infection in the natural environment as suggested by historical reports. The antibodies were found only in one free-living bull, while two other samples were doubtful. The results suggest the transmission of infection to the European bison was rather accidental and its role as an important source of infection nowadays is unlikely.

Abstract

Q fever is an important zoonosis caused by the intracellular Gram-negative bacteria Coxiella burnetii. The source of infection are numerous species of mammals, birds, reptiles and amphibians, as well as ticks. The disease is widespread throughout Europe, but the role of wildlife in its epidemiology is poorly understood. The European bison (Bison bonasus) population has been growing European-wide quite dynamically over the last few years. The aim of this study was to determine whether C. burnetii infection occurs in European bison and whether it can be considered an important bacterial reservoir in the natural environment. Five hundred and twenty three samples of European bison sera originating from 14 (out of the 26 existing) Polish populations were examined for the presence of specific antibodies using an ID Screen Q Fever Indirect Multi-species ELISA test. Only one (0.19%) serum sample was positive in ELISA, and two other samples were doubtful. The only seropositive animal found in this study was a free-living bull. It suggests possible transmission from domestic cattle by sharing pastures. The transmission of C. burnetii into the European bison was rather accidental in the country and its role as an important wild reservoir is unlikely. Since no tests are available for wildlife ruminants there is a need for the adaptation of the available tests.

Humoral immune response to Q fever vaccination of three sheep flocks naturally pre-infected with Coxiella burnetii

Qfever is a zoonotic disease caused by the bacterium Coxiella burnetii; Coxiella-infected ruminants are the main reservoir shedding the pathogen during abortion or parturition through birth products. Germany has a long history of small-scale Q fever epidemics in the human population mostly associated with lambing sheep. Therefore, fast and efficient control measures are essentially required to prevent transmission from infected sheep flocks to humans. In our present study, three sheep flocks were vaccinated with an inactivated C.burnetii phase I vaccine after a field infection with C.burnetii was diagnosed. Serum samples and vaginal swabs were collected at different time points to evaluate the extent of the outbreak and the consequences of the vaccination. The serum samples were examined by phase-specific IgG phase I and phase II ELISAs and a commercial ELISA, simultaneously detecting both phase variations. Moreover, vaginal swabs were analysed by qPCR. The fourth flock with no Q fever history and non-vaccinated animals were used as a control group to evaluate the phase-specific ELISAs. The inactivated C.burnetii phase I vaccine induced an IgG phase II response and boosted the humoral immune reaction against natural pre-infections. Furthermore, the longevity of vaccine-induced antibodies seems to depend on previous infections. Around 16 months after primary vaccination, mainly IgG phase I antibodies were detectable. Vaccination did not prevent shedding at the next lambing season. Most interestingly, the phase-specific ELISAs revealed more C.burnetii positive animals than the blended ELISA-Assay. Taken together, phase-specific ELISAs are suitable tools to provide insights into natural- or vaccine-induced humoral immune responses to C.burnetii in sheep.

Infectious bovine abortions: observations from an organized dairy herd

Abortions in dairy animals can be caused by several infectious agents. Identification of the actual causal agent(s) is important for formulating suitable control strategies. A 3-year (2016-2018) longitudinal study was conducted in a dairy farm following an abortion storm in the mid- to late gestations. The investigation focused on the seven major infectious abortifacient in cattle, viz. bovine alphaherpesvirus-1 (BoHV-1), bovine viral diarrhoea virus (BVDV), Neospora caninum, Brucella abortus, Coxiella burnetii, Leptospira Hardjo, and Listeria monocytogenes. High seroprevalence was observed for BVDV (79.4%), Leptospira (70.5%), BoHV-1 (53.5%), and Brucella (45.0%) at the beginning of the investigation (August 2016). The incidence proportion increased for BVDV, Leptospira, and Brucella in the following years of the investigation. A strong association of Brucella seropositivity with history of abortion (OR = 3.27) was recorded. Incidence of BoHV-1 reduced during the period of study coincident with systematic IBR inactivated marker vaccination of the herd. Sixty-four abortion cases were investigated for the identification of causative agent(s) by microbial culture, serological (ELISA), and molecular detection (PCR/ real-time PCR). Antibodies to BVDV, Brucella, BoHV-1, Leptospira, Neospora, and Coxiella were detected in 63, 61, 56, 35, 5, and 6 aborting cattle, respectively. Real-time PCR/PCR of clinical specimens detected DNA of Brucella, BoHV-1, Coxiella, Leptospira, and Listeria in 34, 13, 12, 9, and 4 abortion cases, respectively. BVDV and Neospora were not detected in any specimen samples. Brucella abortus isolated from the farm was determined as ST1 by multi-locus sequence typing (MLST). DNA of multiple agents were detected in 21 of the 64 cases (43.75%). Overall, the data suggests, Brucella was the major causative agent, although multiple causative agents circulated in the farm.

Coxiella burnetii in slaughterhouses in Brazil: A public health concern

Q fever is an important zoonosis, yet it is often neglected and can present large outbreaks, as observed in the Netherlands. In the past few years, cases of Q fever have been described in Brazil; however, the epidemiological situation of Q fever in ruminants, the main reservoir of the pathogen, is unknown in this country. Our study aimed to estimate the prevalence of C. burnetii in cattle sent to slaughterhouses using an immunofluorescence assay (IFA) and quantitative real-time PCR (qPCR). From 1515 cattle serum samples collected from nine slaughterhouses, 23.8% (360/1515) were serologically positive by IFA (cutoff titer>1:64), indicating past or recent exposure to C. burnetii infection. Among the 54 cities sampled during the study, 83.3% (45/54) had at least one seropositive animal. Subsequently, all seropositive samples were submitted to qPCR for C. burnetii DNA, and 12.2% (44/360) of the sera were qPCR positive, which indicates bacteremia and suggests active or recent infection. The results highlight the risk for abattoir workers that results from exposure to contaminated aerosols produced during slaughter procedures. Moreover, the heat maps that were construction from the positive samples demonstrate the widespread distribution of C. burnetii in the State of São Paulo, Brazil and denotes the need for surveillance and preventive measures to reduce the prevalence in cattle.

Detection of Coxiella burnetii antibodies in sheep and cattle on a veterinary campus in St. Kitts: Implications for one health in the Caribbean region

Coxiella burnetii is a ubiquitous zoonotic bacterium reported worldwide that causes Q-fever. Infections result in profound economic losses to livestock producers by causing abortions and low birth weights. Current information about the disease in the Caribbean region is scarce. With multiple small islands and territories, it is often considered that the bacterium is absent or circulates at a low prevalence. Our study aimed to determine whether sheep and cattle housed at a veterinary campus in St Kitts had previous exposure to C. burnetii. Blood samples were taken from cattle (n = 63; 72% of the herd) and sheep (n = 133; 71% of the flock). Antibodies to C. burnetii were detected by a commercial indirect enzyme-linked immunosorbent assay (IDvet® ELISA) test. The seroprevalence was estimated at 26.3% (95% CI: 19.1–34.7%) in sheep and 0% (95% CI: 0–5.7%) in cattle. Sheep importation to St. Kitts is very rare, thus, these results suggest that C. burnetii is present on the island. The seronegativity of all the cattle highlights the absence of the bacterium on the veterinary campus. The high seroprevalence in sheep, however, has potentially important implications for animal health and public health as well as for wildlife conservation. Further investigation about animal seroprevalence and human exposure are warranted in St. Kitts and in the Caribbean region.

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Seroprevalence in sheep from a veterinary university was 26.3%

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No cattle from the university were seropositive

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Risk for human and animal health is likely to be important in St. Kitts

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There is a need to investigate the prevalence of Coxiella burnetii in Caribbean region

Evaluation of the Diagnostic Potential of Recombinant Coxiella burnetii Com1 in an ELISA for the Diagnosis of Q Fever in Sheep, Goats and Cattle

Coxiella burnetii is the causative agent of Q fever, a zoonosis infecting domestic ruminants and humans. Currently used routine diagnostic tools offer limited sensitivity and specificity and symptomless infected animals may be missed. Therefore, diagnostic tools of higher sensitivity and specificity must be developed. For this purpose, the C. burnetii outer membrane protein Com1 was cloned and expressed in Escherichia coli. The His-tagged recombinant protein was purified and used in an indirect enzyme-linked immunosorbent assay (ELISA). Assay performance was tested with more than 400 positive and negative sera from sheep, goats and cattle from 36 locations. Calculation of sensitivity and specificity was undertaken using receiver operating characteristic (ROC) curves. The sensitivities and specificities for sheep were 85% and 68% (optical density at 450nm, OD₄₅₀ cut-off value 0.32), for goats 94% and 77% (OD₄₅₀ cut-off value 0.23) and for cattle 71% and 70% (OD₄₅₀ cut-off value 0.18), respectively. These results correspond to excellent, outstanding and acceptable discrimination of positive and negative sera. In summary, recombinant Com1 can provide a basis for more sensitive and specific diagnostic tools in veterinary medicine.

Prevalence of Coxiella burnetii in German sheep flocks and evaluation of a novel approach to detect an infection via preputial swabs at herd-level

A prevalence study was conducted on German sheep flocks including goats if they cohabitated with sheep. In addition, a novel approach was applied to identify an infection at the herd-level before lambing season with preputial swabs, suspecting venereal transmission and ensuing colonisation of preputial mucosa with Coxiella (C.) burnetii. Blood samples and genital swabs were collected from breeding males and females after the mating season and were analysed by enzyme-linked immunosorbent assay (ELISA) and quantitative polymerase chain reaction (qPCR) respectively. In total, 3367 animals were sampled across 71 flocks. The true herd-level prevalence adjusted for misclassification probabilities of the applied diagnostic tests using the Rogan-Gladen estimator for the prevalence estimate and a formula by Lang and Reiczigel (2014) for the confidence limits, ranged between 31.3% and 33% (95% confidence interval [95% CI] 17.3–45.5) detected by the ELISA and/or qPCR. Overall 26–36.6% (95% CI 13–56.8) were detected by ELISA, 13.9% (95% CI 4.5–23.2) by the qPCR and 7.9–11.2% (95% CI 0.08–22.3) by both tests simultaneously. The range of results is due to data obtained from literature with different specifications for test quality for ELISA. Among eight farms with females shedding C. burnetii, three farms (37.5%) could also be identified by preputial swabs from breeding sires. This indicates less reliability of preputial swabs if used as a single diagnostic tool to detect C. burnetii infection at the herd-level.

Seroprevalence of Q Fever in Sheep and Goats from the Marmara Region, Turkey

Introduction

The aim of this study was to investigate Q fever seroprevalence in sheep and goats in the Marmara region. Q fever is a zoonotic disease caused by Coxiella burnetii. In ruminants, the disease causes reproductive disorders, premature births and stillbirths.

Material and Methods

Blood samples of sheep and goats were collected from the Marmara region of Turkey and a commercial ELISA was used for detection of specific antibodies to C. burnetii. A total of 832 samples (627 from sheep and 205 from goats) obtained from 126 herds located in 110 villages in 63 municipalities across all 11 provinces were utilised.

Results

Total seroprevalence was found to be 13.22%, while the proportion of seropositive herds was determined to be over threefold higher at 42.85%. The seroprevalence for sheep was found to be 14.19%, and for goats 10.24%. The herd seropositivity rate for sheep of 46.31% and for goats of 32.25% were also over threefold higher than the species-level seroprevalences. The provincial seroprevalence varied between 1.38% and 21.79%.

Conclusion

This study confirms the presence of C. burnetii in sheep and goat herds in the Marmara region and provides original seroprevalence data in hitherto uninvestigated provinces. The data gathered are beneficial for evaluation and elaboration of the seroprevalence of Q fever in sheep and goats in the Marmara region. Surveillance studies should be maintained, particularly in provinces with high seropositivity rates.

Occurrence of Coxiella burnetii in Polish dairy cattle herds based on serological and PCR tests

The aim of the research was to assess the prevalence of antibodies to Coxiella burnetii in dairy cattle herds in Poland and to compare the results of real-time PCR and ELISA tests performed on bulk tank milk (BTM) samples. In total, 2635 serum samples collected from 969 dairy cattle herds from all provinces were tested using ELISA. Additionally, BTM specimens from 101 herds were analysed by ELISA and real-time PCR targeting IS1111 element. Presence of anti-C. burnetii antibodies was confirmed in 25.39% of serum samples in 237 herds (24.46%) and the herd-level seroprevalence in Voivodeships varied from 2.5% to 61.4%. Moreover, 46 (45.5%) of analysed bulk tank milk samples gave postive result in ELISA and microbial DNA was detected in 40 (39.6%) of tested herds. The comparative analysis of ELISA and real-time PCR results obtained for BTM samples using the chi-square test showed statistically significant relationship between results of both methods.

Validation of an indirect immunofluorescence assay (IFA) for the detection of IgG antibodies against Coxiella burnetii in bovine serum

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.

Cross-sectional study of brucellosis and Q fever in Thailand among livestock in two districts at the Thai-Cambodian border, Sa Kaeo province

Brucellosis and Q fever impart high morbidity in humans and economic losses among livestock worldwide. However their prevalence is still not fully known in Thailand. We conducted a sero-survey of brucellosis and Q fever in beef, dairy cattle, goat, and sheep herds from Thai communities at the border with Cambodia, a cross-border trading center. Serum samples were tested for brucellosis and Q fever by antibody-based tests at the National Institute of Animal Health, Thailand. We surveyed a total of 520 individuals from 143 herds. Brucellosis herd-level seroprevalence for beef cattle and small ruminants (goats and sheep) was 2.6% (3/117) and 13.3% (2/15) respectively. Q fever herd-level seroprevalence for beef cattle, dairy cattle, and small ruminants was 4.3% (5/117), 27.3% (3/11) and 33.3% (5/15) respectively. This study identified a significant burden of brucellosis and Q fever among small ruminants and dairy cattle at the Thai-Cambodian border.

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Brucellosis and Q fever are present in livestock at the Thai-Cambodian border.

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Brucellosis is highly prevalent in small ruminant flocks.

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Q fever is highly prevalent in small ruminants and dairy cattle herds.

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There is a need to strengthen the surveillance system in rural communities at border areas.

Bayesian Validation of the Indirect Immunofluorescence Assay and Its Superiority to the Enzyme-Linked Immunosorbent Assay and the Complement Fixation Test for Detecting Antibodies against Coxiella burnetii in Goat Serum

Although many studies have reported the indirect immunofluorescence assay (IFA) to be more sensitive in detection of antibodies to Coxiella burnetii than the complement fixation test (CFT), the diagnostic sensitivity (DSe) and diagnostic specificity (DSp) of the assay have not been previously established for use in ruminants. This study aimed to validate the IFA by describing the optimization, selection of cutoff titers, repeatability, and reliability as well as the DSe and DSp of the assay. Bayesian latent class analysis was used to estimate diagnostic specifications in comparison with the CFT and the enzyme-linked immunosorbent assay (ELISA). The optimal cutoff dilution for screening for IgG and IgM antibodies in goat serum using the IFA was estimated to be 1:160. The IFA had good repeatability (>96.9% for IgG, >78.0% for IgM), and there was almost perfect agreement (Cohen's kappa > 0.80 for IgG) between the readings reported by two technicians for samples tested for IgG antibodies. The IFA had a higher DSe (94.8%; 95% confidence interval [CI], 80.3, 99.6) for the detection of IgG antibodies against C. burnetii than the ELISA (70.1%; 95% CI, 52.7, 91.0) and the CFT (29.8%; 95% CI, 17.0, 44.8). All three tests were highly specific for goat IgG antibodies. The IFA also had a higher DSe (88.8%; 95% CI, 58.2, 99.5) for detection of IgM antibodies than the ELISA (71.7%; 95% CI, 46.3, 92.8). These results underscore the better suitability of the IFA than of the CFT and ELISA for detection of IgG and IgM antibodies in goat serum and possibly in serum from other ruminants.

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Q fever is a zoonosis of worldwide distribution with the exception of New Zealand. It is caused by an intracellular bacterium, Coxiella burnetii. The disease often goes underdiagnosed because the main manifestation of its acute form is a general self-limiting flu-like syndrome. The Dutch epidemics renewed attention to this disease, which was less considered before. This review summarizes the description of C. burnetii (taxonomy, intracellular cycle, and genome) and Q fever disease (description, diagnosis, epidemiology, and pathogenesis). Finally, vaccination in humans and animals is also considered.

Coxiella burnetii seropositivity and associated risk factors in sheep in Ontario, Canada

Coxiella burnetii is a zoonotic bacterium that can cause abortion in sheep in late gestation, as well as the delivery of stillborn, and non-viable lambs (Rodolakis, 2006). A cross-sectional study was conducted in Ontario, Canada, to investigate C. burnetii exposure in sheep. Between August 2010 and January 2012, sera from 2363 reproductively active ewes from 72 farms were tested for C. burnetii specific antibodies using the CHEKIT Q fever ELISA Test kit (IDEXX Laboratories). Overall, exposure was common; sheep-level seroprevalence was 14.7% (347/2363, 95% CI: 13.3-16.2), and was higher in dairy sheep (24.3%, 181/744) than meat sheep (10.2%, 166/1619) (p<0.0001). At the farm-level, 48.6% (35/72, 95% CI: 37.2-60.1) of farms had at least one seropositive sheep. A mixed multivariable logistic model that controlled for farm-level clustering, identified risk factors associated (p<0.05) with sheep seropositivity. Increasing female flock size (logarithmic scale) was associated with increased odds of seropositivity. By way of illustration, increasing the female flock size from 100 to 200 increased the odds of seropositivity by 2.26 times (95% CI: 1.5-3.5). Sheep that lambed in an airspace separate from the flock had 11.3 times (95% CI: 2.9-43.6) the odds of seropositivity relative to other sheep. The practice of loaning sheep that returned to the farm increased odds of seropositivity by 8.1 times (95% CI: 1.8-33.6). Lambing pen hygiene practices also influenced odds of seropositivity. Relative to sheep from farms where all lambing pen hygiene measures were practiced after lambing (i.e., adding bedding, removing birth materials and disinfection), sheep from farms that only added bedding, or those that just added bedding and removed birthing materials had 5.9 times (95% CI: 1.1-32.1) and 9.0 times (95% CI: 2.2-36.9) the odds of seropositivity, respectively. These results can be used to inform prevention and control strategies with the aim of reducing C. burnetii exposure in sheep.

Coxiella burnetii infections in sheep or goats: an opinionated review

Q fever is an almost ubiquitous zoonosis caused by Coxiella burnetii, which is able to infect several animal species, as well as humans. Cattle, sheep and goats are the primary animal reservoirs. In small ruminants, infections are mostly without clinical symptoms, however, abortions and stillbirths can occur, mainly during late pregnancy. Shedding of C. burnetii occurs in feces, milk and, mostly, in placental membranes and birth fluids. During parturition of infected small ruminants, bacteria from birth products become aerosolized. Transmission to humans mainly happens through inhalation of contaminated aerosols. In the last decade, there have been several, sometimes large, human Q fever outbreaks related to sheep and goats. In this review, we describe C. burnetii infections in sheep and goats, including both advantages and disadvantages of available laboratory techniques, as pathology, different serological tests, PCR and culture to detect C. burnetii. Moreover, worldwide prevalences of C. burnetii in small ruminants are described, as well as possibilities for treatment and prevention. Prevention of shedding and subsequent environmental contamination by vaccination of sheep and goats with a phase I vaccine are possible. In addition, compulsory surveillance of C. burnetii in small ruminant farms raises awareness and hygiene measures in farms help to decrease exposure of people to the organism. Finally, this review challenges how to contain an infection of C. burnetii in small ruminants, bearing in mind possible consequences for the human population and probable interference of veterinary strategies, human risk perception and political considerations.

Serological survey using ELISA to determine the prevalence of Coxiella burnetii infection (Q fever) in sheep and goats in Great Britain

A survey of Coxiella burnetii infection (Q fever) in sheep flocks and goat herds in Great Britain was undertaken. A total of 5791 sheep (384 flocks) and 522 goats (145 herds) were examined for C. burnetii antibodies using an ELISA. Overall, 53 sheep (37 flocks), and four goats (four herds), tested positive. Estimates of individual animal, between-flock/-herd and within-flock/-herd crude prevalences were 0·9%, 10·2% and 9·0%, respectively, for sheep, and 0·8%, 3% and 26·3%, respectively, for goats. With sheep, the likelihood of an animal testing positive increased with total flock size (P = 0·002) and number of breeding ewes in the flock (P = 0·021). It also increased with number of goats within a 10 km radius (P = 0·038). There was no evidence for spatial clustering of positive herds above that expected by chance alone. No analysis of risk factors was attempted for goats because of the paucity of positives.

Q fever infection in dairy cattle herds: increased risk with high wind speed and low precipitation

Ruminants are considered the main reservoir for transmission of Coxiella burnetii (Cb) to humans. The implementation of effective control measures against Cb in ruminants requires knowledge about potential risk factors. The objectives of this study were (i) to describe the spatial distribution of Q fever-infected dairy cattle herds in Sweden, (ii) to quantify the respective contributions of wind and animal movements on the risk of infection, while accounting for other sources of variation, and (iii) to investigate the possible protective effect of precipitation. A total of 1537 bulk milk samples were collected and tested for presence of Cb antibodies. The prevalence of test-positive herds was higher in the south of Sweden. For herds located in areas with high wind speed, open landscape, high animal densities and high temperature, the risk of being infected reached very high values. Because these factors are difficult to control, vaccination could be an appropriate control measure in these areas. Finally, the cumulated precipitation over 1 year was identified as a protective factor.

Surveys on Coxiella burnetii infections in Swedish cattle, sheep, goats and moose

Background

Q fever is a zoonotic disease caused by the bacterium Coxiella burnetii. Prevalence data in ruminant species are important to support risk assessments regarding public and animal health. The aim was to investigate the presence of or exposure to C. burnetii in cattle, sheep, goats and moose, and to compare two enzyme-linked immunosorbent assays (ELISAs). National surveys of antibodies against C. burnetii were performed for dairy cattle (n=1537), dairy goats (n=58) and sheep (n=518). Bovine samples consisted of bulk milk, caprine of pooled milk, and ovine of pooled serum. Antibodies were investigated in moose samples (n=99) from three regions. A one-year regional cattle bulk milk survey was performed on the Isle of Gotland (n=119, four occasions). Cattle, sheep and goat samples were analysed with indirect ELISA and moose samples with complement fixation test. For the sheep, goat, and parts of the cattle survey, samples were run in parallel by ELISAs based on antigens from infected ruminants and ticks. Bulk milk samples from the regional cattle survey and vaginal swabs from a subset of the sheep herds (n=80) were analysed for the agent by polymerase chain reaction. Spatial clustering was investigated in the national cattle survey.

Results

The prevalence of antibodies in dairy herds was 8.2% with large regional differences. High risk clusters were identified in the southern regions. The prevalence among dairy herds on the Isle of Gotland varied from 55.9% to 64.6% and 46.4% to 58.9.0% for antibodies and agent, respectively, overall agreement between agent and antibodies was 85.2%. The prevalence of antibodies in sheep was 0.6%, the agent was not detected the vaginal swabs. Antibodies were not detected in goats or moose, although parts of the moose samples were collected in an area with high prevalence in cattle. The overall agreement between the two ELISAs was 90.4%.

Conclusions

The prevalence of antibodies against C. burnetii in dairy cattle in Sweden shows large regional differences. The results suggest that C. burnetii is a rare pathogen among Swedish moose, dairy goat and sheep. ELISAs based on ruminant and tick antigen performed in a similar manner under Swedish conditions.

Epidemiology of reproductive pathogens in semi-intensive lamb-producing flocks in North-West Spain: a comparative serological study

The aim of this study was to better understand the epidemiology of five major reproductive pathogens in semi-intensive lamb-producing flocks in North-West Spain. Two thousand four hundred serum samples were collected from 44 flocks, and several factors were studied to assess their influence on seropositivity. Farms that tested seropositive for more than one pathogen were common (84.1%), but seroprevalence was high only for Toxoplasma gondii (38.1%), and low for the other four pathogens, namely, Neospora caninum (5.5%), Coxiella burnetii (4.0%), Chlamydia abortus (3.9%) and Pestivirus (2.3%). Farm level exposure was highest for T. gondii and N. caninum (100% and 72.7%, respectively). For both of these pathogens, and for C. burnetii, seropositivity was associated with age and area. Farm level exposure was lowest for Pestivirus and C. abortus (13.6% and 18.2%, respectively), and, for the latter, seropositivity was principally related to flock size.

Coxiella burnetii serology assays in goat abortion storm

Many commercial antibody detection enzyme-linked immunosorbent assay (ELISA) kits for Q fever utilize the Nine Mile (Montana tick) strain of Coxiella burnetii as antigen. An ELISA kit manufactured in France employs ovine placenta-sourced antigen and has been used in Europe. Sera from goats experiencing a Q fever abortion storm in the United States were used to compare the sensitivity and specificity of these 2 ELISA formats and the Q fever complement fixation test (CFT). Latent class estimates of sensitivity ranged from 97% to 100% with a specificity of 95–100% for the 2 ELISA kits. Estimates for sensitivity and specificity of the CFT were 89% and 82%, respectively. There was not a significant increase in ELISA sensitivity observed with the ovine-sourced antigen kit in this study. Real-time polymerase chain reactions performed on a portion of the sera found that 15 out of 20 sera were congruent across 4 tests for positive and negative sera.

Coxiella burnetii seroprevalence in small ruminants in The Gambia

Background

Q fever is a zoonosis caused by Coxiella burnetii, a Gram negative bacterium present worldwide. Small ruminants are considered the main reservoirs for infection of humans. This study aimed to estimate the extent of C. burnetii infection among sheep and goats in part of The Gambia.

Methodology/Principal Findings

This survey was carried out from March to May 2012 at two areas in The Gambia. The first area comprised a cluster of seven rural villages situated 5–15 km west of Farafenni as well as the local abattoir. A second sampling was done at the central abattoir in Abuko (30 km from the capital, Banjul) in the Western Region. Serum samples were obtained from 490 goats and 398 sheep. In addition, 67 milk samples were obtained from lactating dams. Sera were tested with a Q fever ELISA kit. C. burnetii DNA was extracted from milk samples and then detected using a specific quantitative multiplex PCR assay, targeting the IS1111a element. A multivariable mixed logistic regression model was used to examine the relationship between seropositivity and explanatory variables. An overall seroprevalence of 21.6% was found. Goats had a significantly higher seroprevalence than sheep, respectively 24.2% and 18.5%. Seropositive animals were significantly older than seronegative animals. Animals from the villages had a significantly lower seroprevalence than animals from the central abattoir (15.1% versus 29.1%). C. burnetii DNA was detected in 2 out of 67 milk samples, whereas 8 samples gave a doubtful result.

Conclusion/Significance

A substantial C. burnetii seroprevalence in sheep and goats in The Gambia was demonstrated. People living in close proximity to small ruminants are exposed to C. burnetii. Q fever should be considered as a possible cause of acute febrile illness in humans in The Gambia. Future studies should include a simultaneous assessment of veterinary and human serology, and include aetiology of febrile illness in local clinics.

Seroprevalence of Coxiella burnetii in Washington State domestic goat herds

A caprine herd seroprevalence of Coxiella burnetii infection was determined by passive surveillance of domestic goat herds in Washington State. Serum samples (n=1794) from 105 herds in 31 counties were analyzed for C. burnetii antibodies using a commercially available Q fever antibody enzyme-linked immunosorbent assay (ELISA) test kit. The sera were submitted to the Washington Animal Disease Diagnostic Laboratory for routine serologic screening over an approximate 1-year period from November, 2010, through November, 2011. To avoid bias introduced by testing samples from ill animals, only accessions for routine screening of nonclinical animals were included in the study. A standard cluster sampling approach to investigate seroprevalence at the herd level was used to determine optimal study sample size. The results identified C. burnetii antibodies in 8.0% of samples tested (144/1794), 8.6% of goat herds tested (9/105), and 25.8% of counties tested (8/31). Within-herd seroprevalence in positive counties ranged from 2.9% to 75.8%. Counties with seropositive goats were represented in the western, eastern, southeastern, and Columbia basin agricultural districts of the state. To our knowledge this is the first county-specific, statewide study of C. burnetii seroprevalence in Washington State goat herds. The findings provide baseline information for future epidemiologic, herd management and public health investigations of Q fever.

Clinical microbiology of Coxiella burnetii and relevant aspects for the diagnosis and control of the zoonotic disease Q fever

Coxiella burnetii is the causative agent of the zoonotic disease Q fever. Since its first recognition as a disease in the 1930s, the knowledge about the agent and the disease itself has increased. This review summarizes the current knowledge on C. burnetii and Q fever, its pathogenesis, diagnosis and control. C. burnetii is a bacterium which naturally replicates inside human or animal host cells. The clinical presentation of Q fever varies per host species. C. burnetii infection in animals is mainly asymptomatic except for pregnant ruminants in which abortions and stillbirth can occur. In humans, the disease is also mainly asymptomatic, but clinical presentations include acute and chronic Q fever and the post-Q fever fatigue syndrome. Knowledge of the pathogenesis of Q fever in animals and excretion of C. burnetii in infected animals is crucial in understanding the transmission routes and risks of human infection. Our studies indicated that infected pregnant animals only excrete C. burnetii during and after parturition, independent of abortion, and that C. burnetii phase specific serology can be a useful tool in the early detection of infection. Domestic ruminants are the main reservoir for human Q fever, which has a major public health impact when outbreaks occur. In outbreaks, epidemiological source identification can only be refined by genotypic analysis of the strains involved. To control outbreaks and Q fever in domestic ruminants, vaccination with a phase 1 vaccine is effective. Future challenges are to identify factors for virulence, host susceptibility and protection.

Vaccination using phase I vaccine is effective to control Coxiella burnetii shedding in infected dairy cattle herds

The effectiveness of the vaccination of dairy cows combined or not with antibiotics (i.e. oxytetracycline) to control Coxiella burnetii (Cb) shedding at herd level was investigated in 77 Q fever clinically affected herds. In addition to nulliparous heifers' vaccination, one out of the four following medical strategies was randomly assigned to dairy cows in each herd: vaccination (using a phase I vaccine) alone, vaccination combined with oxytetracycline, oxytetracycline alone or nothing. Their effectiveness to reduce Cb load in quarterly samples of bulk tank milk (BTM) and of pooled milk of primiparous (MP) was assessed through logistic hierarchical models. A significant reduction in Cb load was observed in herds where the vaccination of ≥80% of dairy cows was implemented; whereas the use of antibiotics was uneffective. Our findings support the interest of a whole vaccination strategy and provide evidence for decreasing the use of antibiotics in dairy cattle herds.

Factors associated with Coxiella burnetii antibody positivity in Danish dairy cows

The aim of the study was to identify associations between the level of Coxiella burnetii (C. burnetii) antibodies in individual milk samples and cow and herd level factors in Danish dairy cows. The study, designed as a prospective cross sectional study with follow up, included 24 herds identified by a stratified random sampling procedure according to the level of C. burnetii antibodies in one bulk tank milk (BTM) sample at the beginning of the study. Ten herds were BTM positive, ten herds were BTM negative and four herds had an intermediate level. The samples were tested with an ELISA and results determined as S/P (sample to positive control) values. Three cross sectional studies of all lactating cows within each herd were then conducted during an 11 months follow up period with collection of a total of 5829 milk samples from 3116 cows. Each sample was tested with the same ELISA as used for BTM testing, and cows were considered test positive for S/P values ≥ 40, and otherwise negative. Individual cow information was extracted from the Danish Cattle Database and herd information was obtained from a telephone interview with each farmer. From multivariable logistic regression analysis accounting for hierarchical structures in the data it was concluded that odds for seropositivity increased with Danish Holstein breed, increasing number of parity and high milk protein contents, but decreased with increasing milk yield and high milk fat contents. Cows were at a higher risk during summer than other seasons. Among the herd level factors, herd size, tie stall housing system, quarantine of newly purchased animals and good hygienic precautions taken by the veterinarian before entering into the stable were also significantly associated with reduced odds of C. burnetii antibody positivity. The prevalence of test positive cows was almost constant during the study period in herds which were initially BTM positive and BTM intermediate, whilst the prevalence of positive cows in a few of the initial BTM negative herds changed from almost zero to higher than 60%. This indicates that herd infections last quite long and that test negative herds may convert to positive due to a few latently infected cows or due to transmissions from other herds.