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Amin F, Ali S, Imran M, Cleary NG, von Fricken ME, Khan I. Molecular detection of Coxiella burnetii in ticks infesting wild and domestic animals in the Eastern region of Punjab, Pakistan. Trop Anim Health Prod 2024; 56:252. [PMID: 39225870 DOI: 10.1007/s11250-024-04087-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 07/18/2024] [Indexed: 09/04/2024]
Abstract
Tick-borne pathogens are significant for human, veterinary, and wildlife health. Coxiella burnetii is an example that is widely distributed across various hosts and can cross species boundaries. In Pakistan, there is a scarcity of data regarding C. burnetii at the intersection of wildlife and livestock. Ticks were collected from ruminants and wildlife from the districts of Kasur, Pakpattan, and Okara in Pakistan. Five tick species totaling 571 ticks were collected, with the following distribution: 56.4% Hyalomma anatolicum, 22.4% Rhipicephalus microplus, 10.5% Hyalomma marginatum, 7.9% Rhipicephalus sanguineus, and 2.8% Rhipicephalus turanicus. Fifty tick pools were screened for C. burnetii to amplify a segment of the IS1111 using real-time PCR assays. Ticks collected from sheep and goats had a greater rate of positivity for C. burnetii (40% and 38%, respectively) compared to Indian long-eared hedgehogs with a prevalence of 2%. Coxiella burnetii was prominent in Rhipicephalus microplus (92.3%) and Hyalomma anatolicum (88.9%), followed by Rhipicephalus turanicus (66.6%), Rhipicephalus sanguineus (33.3%), and Hyalomma marginatum (25.0%). Ticks from Pakpattan district displayed the highest prevalence of C. burnetii (88.9%), whereas the lowest was observed in ticks from Kasur district (77.3%). There was no significant association between tick gender and C. burnetii infection. Female host animals were more likely to harbor ticks containing C. burnetii, with a prevalence rate of 81.8%. The research underscores the urgent need for comprehensive studies on C. burnetii in Pakistan, especially at the interface of wildlife and livestock. The high prevalence rates observed in certain tick species and geographic regions emphasize the importance of targeted public health interventions. Future research should focus on elucidating the transmission dynamics and implementing effective control measures to mitigate the impact of these pathogens on human, veterinary, and wildlife health in the region.
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Affiliation(s)
- Freeha Amin
- Department of Wildlife & Ecology, Discipline of Zoology, Wildlife Epidemiology and Molecular Microbiology Laboratory (One Health Group), University of Veterinary and Animal Sciences, Lahore, Ravi Campus, Pattoki, 55300, Pakistan
| | - Shahzad Ali
- Department of Wildlife & Ecology, Discipline of Zoology, Wildlife Epidemiology and Molecular Microbiology Laboratory (One Health Group), University of Veterinary and Animal Sciences, Lahore, Ravi Campus, Pattoki, 55300, Pakistan.
| | - Muhammad Imran
- Institute of Biochemistry and Biotechnology, University of Veterinary and Animal Sciences (UVAS), Lahore, Pakistan
| | - Nora G Cleary
- Department of Environmental and Global Health, University of Florida, Gainesville, FL, USA
| | - Michael E von Fricken
- Department of Environmental and Global Health, University of Florida, Gainesville, FL, USA
| | - Iahtasham Khan
- Department of Epidemiology and Public Health, University of Veterinary and Animal Sciences, Lahore, Pakistan
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Rodrigo C, Walker G, Sevendal ATK, Nguyen C, Stelzer-Braid S, Rawlinson W, Graves S, Gidding HF, Stenos J, Lloyd AR. Acute Q fever in patients with an influenza-like illness in regional New South Wales, Australia. PLoS Negl Trop Dis 2024; 18:e0012385. [PMID: 39102433 PMCID: PMC11326637 DOI: 10.1371/journal.pntd.0012385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 08/15/2024] [Accepted: 07/18/2024] [Indexed: 08/07/2024] Open
Abstract
INTRODUCTION Query (Q) fever is a zoonosis caused by the bacterium Coxiella burnetii typically presenting as an influenza-like illness (ILI) with or without hepatitis. The infection may be missed by clinicians in settings of low endemicity, as the presentation is clinically not specific, and there are many more common differential diagnoses for ILI including SARS-CoV-2 infection. METHODS Residual serum samples were retrospectively tested for Phase 1 and 2 Q fever-specific IgM, IgG, IgA antibodies by indirect immunofluorescence and C. burnetii DNA by polymerase chain reaction. They had not been previously tested for Q fever, originating from undiagnosed patients with probable ILI, aged 10-70 years and living in regional New South Wales, Australia. The results were compared with contemperaneous data on acute Q fever diagnostic tests which had been performed based on clinicians requests from a geographically similar population. RESULTS Only one (0.2%) instance of missed acute Q fever was identified after testing samples from 542 eligible patients who had probable ILI between 2016-2023. Laboratory data showed that during the same period, 731 samples were tested for acute Q fever for clinician-initiated requests and of those 70 (9.6%) were positive. Probability of being diagnosed with Q fever after a clinician initiated request was similar regardless of the patients sex, age and the calendar year of sampling. CONCLUSION In this sample, Q fever was most likely to be diagnosed via clinician requested testing rather than by testing of undiagnosed patients with an influenza like illness.
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Affiliation(s)
- Chaturaka Rodrigo
- School of Biomedical Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Gregory Walker
- School of Biomedical Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
- NSW Health Pathology, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Andrea T K Sevendal
- NSW Health Pathology, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Chelsea Nguyen
- Australian Rickettsial Reference Laboratory, Geelong, Victoria, Australia
| | - Sacha Stelzer-Braid
- School of Biomedical Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
- NSW Health Pathology, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - William Rawlinson
- School of Biomedical Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
- NSW Health Pathology, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Stephen Graves
- Australian Rickettsial Reference Laboratory, Geelong, Victoria, Australia
| | - Heather F Gidding
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - John Stenos
- Australian Rickettsial Reference Laboratory, Geelong, Victoria, Australia
| | - Andrew R Lloyd
- Kirby Institute, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
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Wainaina M, Lindahl JF, Mayer-Scholl A, Ufermann CM, Domelevo Entfellner JB, Roesler U, Roesel K, Grace D, Bett B, Al Dahouk S. Molecular and serological diagnosis of multiple bacterial zoonoses in febrile outpatients in Garissa County, north-eastern Kenya. Sci Rep 2024; 14:12263. [PMID: 38806576 PMCID: PMC11133362 DOI: 10.1038/s41598-024-62714-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 05/21/2024] [Indexed: 05/30/2024] Open
Abstract
Bacterial zoonoses are diseases caused by bacterial pathogens that can be naturally transmitted between humans and vertebrate animals. They are important causes of non-malarial fevers in Kenya, yet their epidemiology remains unclear. We investigated brucellosis, Q-fever and leptospirosis in the venous blood of 216 malaria-negative febrile patients recruited in two health centres (98 from Ijara and 118 from Sangailu health centres) in Garissa County in north-eastern Kenya. We determined exposure to the three zoonoses using serological (Rose Bengal test for Brucella spp., ELISA for C. burnetti and microscopic agglutination test for Leptospira spp.) and real-time PCR testing and identified risk factors for exposure. We also used non-targeted metagenomic sequencing on nine selected patients to assess the presence of other possible bacterial causes of non-malarial fevers. Considerable PCR positivity was found for Brucella (19.4%, 95% confidence intervals [CI] 14.2-25.5) and Leptospira spp. (1.7%, 95% CI 0.4-4.9), and high endpoint titres were observed against leptospiral serovar Grippotyphosa from the serological testing. Patients aged 5-17 years old had 4.02 (95% CI 1.18-13.70, p-value = 0.03) and 2.42 (95% CI 1.09-5.34, p-value = 0.03) times higher odds of infection with Brucella spp. and Coxiella burnetii than those of ages 35-80. Additionally, patients who sourced water from dams/springs, and other sources (protected wells, boreholes, bottled water, and water pans) had 2.39 (95% CI 1.22-4.68, p-value = 0.01) and 2.24 (1.15-4.35, p-value = 0.02) times higher odds of exposure to C. burnetii than those who used unprotected wells. Streptococcus and Moraxella spp. were determined using metagenomic sequencing. Brucellosis, leptospirosis, Streptococcus and Moraxella infections are potentially important causes of non-malarial fevers in Garissa. This knowledge can guide routine diagnosis, thus helping lower the disease burden and ensure better health outcomes, especially in younger populations.
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Affiliation(s)
- Martin Wainaina
- Animal and Human Health Program, International Livestock Research Institute, Nairobi, 00100, Kenya.
- Department of Veterinary Medicine, Freie Universität Berlin, 14163, Berlin, Germany.
- Department of Biological Safety, German Federal Institute for Risk Assessment, 12277, Berlin, Germany.
| | - Johanna F Lindahl
- Animal and Human Health Program, International Livestock Research Institute, Nairobi, 00100, Kenya
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, 75007, Uppsala, Sweden
- Department of Medical Biochemistry and Microbiology, Uppsala University, 75123, Uppsala, Sweden
| | - Anne Mayer-Scholl
- Department of Biological Safety, German Federal Institute for Risk Assessment, 12277, Berlin, Germany
| | - Christoph-Martin Ufermann
- Department of Biological Safety, German Federal Institute for Risk Assessment, 12277, Berlin, Germany
| | | | - Uwe Roesler
- Institute for Animal Hygiene and Environmental Health, Freie Universität Berlin, 14163, Berlin, Germany
| | - Kristina Roesel
- Animal and Human Health Program, International Livestock Research Institute, Nairobi, 00100, Kenya
- Department of Veterinary Medicine, Freie Universität Berlin, 14163, Berlin, Germany
| | - Delia Grace
- Animal and Human Health Program, International Livestock Research Institute, Nairobi, 00100, Kenya
- Food and Markets Department, Natural Resources Institute, University of Greenwich, London, ME130NQ, UK
| | - Bernard Bett
- Animal and Human Health Program, International Livestock Research Institute, Nairobi, 00100, Kenya
| | - Sascha Al Dahouk
- Department of Biological Safety, German Federal Institute for Risk Assessment, 12277, Berlin, Germany
- Department of Internal Medicine III, RWTH Aachen University Hospital, 52074, Aachen, Germany
- Department 1 - Infectious Diseases, Robert Koch Institute, 13353, Berlin, Germany
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Moorthy GS, Rubach MP, Maze MJ, Refuerzo RP, Shirima GM, Lukambagire AS, Bodenham RF, Cash-Goldwasser S, Thomas KM, Sakasaka P, Mkenda N, Bowhay TR, Perniciaro JL, Nicholson WL, Kersh GJ, Kazwala RR, Mmbaga BT, Buza JJ, Maro VP, Haydon DT, Crump JA, Halliday JE. Prevalence and risk factors for Q fever, spotted fever group rickettsioses, and typhus group rickettsioses in a pastoralist community of northern Tanzania, 2016-2017. Trop Med Int Health 2024; 29:365-376. [PMID: 38480005 PMCID: PMC11073910 DOI: 10.1111/tmi.13980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
BACKGROUND In northern Tanzania, Q fever, spotted fever group (SFG) rickettsioses, and typhus group (TG) rickettsioses are common causes of febrile illness. We sought to describe the prevalence and risk factors for these zoonoses in a pastoralist community. METHODS Febrile patients ≥2 years old presenting to Endulen Hospital in the Ngorongoro Conservation Area were enrolled from August 2016 through October 2017. Acute and convalescent blood samples were collected, and a questionnaire was administered. Sera were tested by immunofluorescent antibody (IFA) IgG assays using Coxiella burnetii (Phase II), Rickettsia africae, and Rickettsia typhi antigens. Serologic evidence of exposure was defined by an IFA titre ≥1:64; probable cases by an acute IFA titre ≥1:128; and confirmed cases by a ≥4-fold rise in titre between samples. Risk factors for exposure and acute case status were evaluated. RESULTS Of 228 participants, 99 (43.4%) were male and the median (interquartile range) age was 27 (16-41) years. Among these, 117 (51.3%) had C. burnetii exposure, 74 (32.5%) had probable Q fever, 176 (77.2%) had SFG Rickettsia exposure, 134 (58.8%) had probable SFG rickettsioses, 11 (4.8%) had TG Rickettsia exposure, and 4 (1.8%) had probable TG rickettsioses. Of 146 participants with paired sera, 1 (0.5%) had confirmed Q fever, 8 (5.5%) had confirmed SFG rickettsioses, and none had confirmed TG rickettsioses. Livestock slaughter was associated with acute Q fever (adjusted odds ratio [OR] 2.54, 95% confidence interval [CI] 1.38-4.76) and sheep slaughter with SFG rickettsioses case (OR 4.63, 95% CI 1.08-23.50). DISCUSSION Acute Q fever and SFG rickettsioses were detected in participants with febrile illness. Exposures to C. burnetii and to SFG Rickettsia were highly prevalent, and interactions with livestock were associated with increased odds of illness with both pathogens. Further characterisation of the burden and risks for these diseases is warranted.
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Affiliation(s)
- Ganga S. Moorthy
- Division of Pediatric Infectious Diseases, Duke University Medical Center, Durham, United States of America
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | - Matthew P. Rubach
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
- Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, United States of America
- Kilimanjaro Christian Medical University College, Tumaini University, Moshi, Tanzania
- Programme in Emerging Infectious Diseases, Duke-National University of Singapore Medical School, Singapore, Singapore
| | - Michael J. Maze
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Regina P. Refuerzo
- School of Biodiversity, One Health and Veterinary Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Gabriel M. Shirima
- Nelson Mandela African Institution of Science and Technology, School of Life Sciences and Bioengineering, Arusha, Tanzania
| | - AbdulHamid S. Lukambagire
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
- EcoHealth Alliance, New York, United States of America
| | | | - Shama Cash-Goldwasser
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | - Kate M. Thomas
- Centre for International Health, University of Otago, Dunedin, New Zealand
| | | | - Nestory Mkenda
- Endulen Hospital, Endulen, Ngorongoro Conservation Area, Tanzania
| | - Thomas R. Bowhay
- Centre for International Health, University of Otago, Dunedin, New Zealand
| | - Jamie L. Perniciaro
- Rickettsial Zoonoses Branch, US Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - William L. Nicholson
- Rickettsial Zoonoses Branch, US Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Gilbert J. Kersh
- Rickettsial Zoonoses Branch, US Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Rudovick R. Kazwala
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Blandina T. Mmbaga
- Kilimanjaro Christian Medical University College, Tumaini University, Moshi, Tanzania
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Joram J. Buza
- Nelson Mandela African Institution of Science and Technology, School of Life Sciences and Bioengineering, Arusha, Tanzania
| | - Venance P. Maro
- Kilimanjaro Christian Medical University College, Tumaini University, Moshi, Tanzania
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Daniel T. Haydon
- School of Biodiversity, One Health and Veterinary Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - John A. Crump
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
- Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, United States of America
- Kilimanjaro Christian Medical University College, Tumaini University, Moshi, Tanzania
- Centre for International Health, University of Otago, Dunedin, New Zealand
| | - Jo E.B. Halliday
- School of Biodiversity, One Health and Veterinary Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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Diseko LJ, Tsotetsi-Khambule AM, Onyiche TE, Ramatla T, Thekisoe O, Gcebe N. Coxiella burnetii infections from animals and ticks in South Africa: a systematic review. Vet Res Commun 2024; 48:19-28. [PMID: 37642820 PMCID: PMC10811037 DOI: 10.1007/s11259-023-10204-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 08/17/2023] [Indexed: 08/31/2023]
Abstract
Coxiella burnetii is a zoonotic intracellular bacterium that is widely distributed and affects domestic animals, wildlife, humans and non-mammalian species. This systematic review was aimed at synthesizing research findings on C. burnetii in both domestic and wild animals of South Africa. The systematic review protocol was registered with Open Society Foundations of systematic reviews ( https://doi.org/10.17605/OSF.IO/8WS ). PRISMA guidelines were followed to collect and evaluate relevant scientific articles published on C. burnetii infecting domestic and wild animals in South Africa. Published articles were sourced from five electronic databases, namely, Google Scholar, PubMed and ScienceDirect, EBSCO and Scopus. Results showed 11 eligible studies involving four domestic animals, three wild animals and one ectoparasite species from seven provinces across South Africa. The occurrence of C. burnetii infection was high in Ceratotherium simum (white rhinoceros) (53.9%), medium in sheep (29.0%) and low in pigs (0.9%). Limpopo province (26%) had the most recorded infections followed by KwaZulu-Natal (19%) and Free State (3%) had the least reported occurrence of C. burnetii. The current study discovered that there is scarcity of published research on prevalence and distribution of C. burnetii infecting domestic and wild animals in South Africa, and this is of concern as this bacterium is an important zoonotic pathogen of "One Health" importance.
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Affiliation(s)
- Letlhogonolo J Diseko
- Unit for Environmental Sciences and Management, North-West University, Potchefstroom, 2520, South Africa
| | - Ana M Tsotetsi-Khambule
- Department of Life and Consumer Sciences, College of Agriculture and Environmental Sciences, University of South Africa, Florida, 1709, South Africa
| | - ThankGod E Onyiche
- Unit for Environmental Sciences and Management, North-West University, Potchefstroom, 2520, South Africa
- Department of Veterinary Parasitology and Entomology, University of Maiduguri, P.M.B. 1069, Maiduguri, Nigeria
| | - Tsepo Ramatla
- Unit for Environmental Sciences and Management, North-West University, Potchefstroom, 2520, South Africa.
| | - Oriel Thekisoe
- Unit for Environmental Sciences and Management, North-West University, Potchefstroom, 2520, South Africa
| | - Nomakorinte Gcebe
- Agricultural Research Council-Bacteriology and Zoonotic Diseases Diagnostic Laboratory, Onderstepoort Veterinary Research, Onderstepoort, Pretoria, 0110, South Africa
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Tagoe JNA, Yeboah C, Behene E, Kumordjie S, Nimo-Paintsil S, Attram N, Nyarko EO, Carroll JA, Fox AT, Watters C, Koram K, Anang AK, Sanders T, Letizia AG. Coinfection of Malaria and Bacterial Pathogens among Acute Febrile Patients in Selected Clinics in Ghana. Am J Trop Med Hyg 2023; 109:1036-1046. [PMID: 37748764 PMCID: PMC10622490 DOI: 10.4269/ajtmh.23-0099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 07/05/2023] [Indexed: 09/27/2023] Open
Abstract
Malaria remains the leading cause of acute febrile illness (AFI) in Africa despite successful control measures and programs. Acute febrile illnesses can be misdiagnosed as malaria as a result of the overlapping spectrum of nonspecific symptoms or may not be pursued because of limited diagnostic capabilities. This study investigated potential etiologies of AFIs in Ghana and determined the relationship between coinfection between malaria and Q fever, leptospirosis, and culturable bacteria in febrile patients. Participants were enrolled between July 2015 and December 2019 from four Ghanaian military treatment facilities. Of the 399 febrile participants, 222 (55.6%) males and 177 (44.6%) females were enrolled. Malaria was diagnosed in 275 (68.9%) participants. Malaria coinfection occurred with leptospirosis, Q fever, and blood-cultured bacteria in 11/206 (5.3%), 24/206 (11.7%), and 6/164 (3.7%) participants, respectively. Among the 124 malaria-negative samples, the positivity rates were 4.1% (3/74), 8.1% (6/74), and 3.6% (2/56) for leptospirosis, Q fever, and bacterial pathogens isolated from blood culture, respectively. The majority of documented clinical signs and symptoms were not significantly associated with specific diseases. Approximately 10% of malaria-positive participants also had evidence suggesting the presence of a bacterial coinfection. Therefore, even in the case of a positive malaria test, other pathogens contributing to febrile illness should be considered. Understanding the frequency of malaria coinfection and other etiological agents responsible for AFIs will improve diagnosis and treatment and better inform public health knowledge gaps in Ghana.
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Affiliation(s)
- Janice N. A. Tagoe
- Noguchi Memorial Institute for Medical Research, Accra, Ghana
- U.S. Naval Medical Research Unit-No.3, Ghana Detachment, Accra, Ghana
| | - Clara Yeboah
- Noguchi Memorial Institute for Medical Research, Accra, Ghana
- U.S. Naval Medical Research Unit-No.3, Ghana Detachment, Accra, Ghana
| | - Eric Behene
- Noguchi Memorial Institute for Medical Research, Accra, Ghana
- U.S. Naval Medical Research Unit-No.3, Ghana Detachment, Accra, Ghana
| | - Selassie Kumordjie
- Noguchi Memorial Institute for Medical Research, Accra, Ghana
- U.S. Naval Medical Research Unit-No.3, Ghana Detachment, Accra, Ghana
| | | | - Naiki Attram
- U.S. Naval Medical Research Unit-No.3, Ghana Detachment, Accra, Ghana
| | | | | | - Anne T. Fox
- U.S. Naval Medical Research Unit-No.3, Ghana Detachment, Accra, Ghana
| | - Chaselynn Watters
- U.S. Naval Medical Research Unit-No.3, Ghana Detachment, Accra, Ghana
| | - Kwadwo Koram
- Noguchi Memorial Institute for Medical Research, Accra, Ghana
| | | | - Terrel Sanders
- U.S. Naval Medical Research Unit-No.3, Ghana Detachment, Accra, Ghana
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Bento JT, Dahmane A, Santos-Silva S, Reghaissia N, Almeida D, Mesquita JR. Antibody-Based Assessment of Coxiella burnetii Circulation in Algerian Goat Herds. Animals (Basel) 2023; 13:2926. [PMID: 37760325 PMCID: PMC10525101 DOI: 10.3390/ani13182926] [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: 08/16/2023] [Revised: 09/09/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
Q fever is a zoonotic disease caused by Coxiella burnetii (C. burnetii), a pathogen with a high capability for infection. The disease primarily affects ruminants, leading to reproductive disorders, but can also be transmitted to humans through contact with infected animals or their products. In Algeria, Q fever is endemic, but little is known about the presence and circulation of C. burnetii in domestic goats. This study aimed to perform a multicentric serological analysis of C. burnetii antibodies in domestic goats from four provinces in the North East Region of Algeria. A total of 504 goat serum samples were collected from 77 herds, and serological analysis was performed using an indirect ELISA. The overall seroprevalence at the herd level was 35.06%, and 8.73% at the individual level. Herds with a history of abortions showed a high seropositivity rate of 88.9%. This research indicates the wide distribution of C. burnetii in goats in this region, suggesting the potential for zoonotic transmission to humans. Further studies and monitoring programs are essential to gain a comprehensive understanding of C. burnetii epidemiology in Algeria and to prevent or mitigate potential outbreaks. Awareness among practitioners and farmers is crucial to address this public health concern effectively.
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Affiliation(s)
- Jaqueline T. Bento
- Department of Biology, Campus de Santiago, University of Aveiro (UA), 3810-193 Aveiro, Portugal;
| | - Abdeldjalil Dahmane
- Higher National Veterinary School, Rue Issad Abbes, El Alia, Algiers 16000, Algeria;
| | - Sérgio Santos-Silva
- School of Medicine and Biomedical Sciences (ICBAS), University of Porto, 4200-319 Porto, Portugal; (S.S.-S.); (D.A.)
| | - Nassiba Reghaissia
- Laboratory of Sciences and Living Techniques, Institute of Agronomic and Veterinary Sciences, University of Souk Ahras, Souk Ahras 41000, Algeria;
| | - Daniela Almeida
- School of Medicine and Biomedical Sciences (ICBAS), University of Porto, 4200-319 Porto, Portugal; (S.S.-S.); (D.A.)
| | - João R. Mesquita
- School of Medicine and Biomedical Sciences (ICBAS), University of Porto, 4200-319 Porto, Portugal; (S.S.-S.); (D.A.)
- Epidemiology Research Unit (EPIUnit), Instituto de Saúde Pública da Universidade do Porto, 4050-600 Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600 Porto, Portugal
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8
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Anastácio S, de Sousa SR, Saavedra MJ, da Silva GJ. Role of Goats in the Epidemiology of Coxiella burnetii. BIOLOGY 2022; 11:biology11121703. [PMID: 36552213 PMCID: PMC9774940 DOI: 10.3390/biology11121703] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/17/2022] [Accepted: 11/21/2022] [Indexed: 11/27/2022]
Abstract
Since its first description in the late 1930s, Q fever has raised many questions. Coxiella burnetii, the causative agent, is a zoonotic pathogen affecting a wide range of hosts. This airborne organism leads to an obligate, intracellular lifecycle, during which it multiplies in the mononuclear cells of the immune system and in the trophoblasts of the placenta in pregnant females. Although some issues about C. burnetii and its pathogenesis in animals remain unclear, over the years, some experimental studies on Q fever have been conducted in goats given their excretion pattern. Goats play an important role in the epidemiology and economics of C. burnetii infections, also being the focus of several epidemiological studies. Additionally, variants of the agent implicated in human long-term disease have been found circulating in goats. The purpose of this review is to summarize the latest research on C. burnetii infection and the role played by goats in the transmission of the infection to humans.
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Affiliation(s)
- Sofia Anastácio
- Vasco da Gama Research Centre (CIVG), Department of Veterinary Sciences, Vasco da Gama University School, Avenida José R. Sousa Fernandes 197 Lordemão, 3020-210 Coimbra, Portugal
- Center of Neurosciences and Cell Biology, Health Science Campus, 3000-548 Coimbra, Portugal
- Correspondence:
| | - Sérgio Ramalho de Sousa
- Vasco da Gama Research Centre (CIVG), Department of Veterinary Sciences, Vasco da Gama University School, Avenida José R. Sousa Fernandes 197 Lordemão, 3020-210 Coimbra, Portugal
| | - Maria José Saavedra
- Laboratory Medical Microbiology—Antimicrobials, Biocides and Biofilms Unit, Department of Veterinary Sciences, School of Agrarian and Veterinary Sciences, University of Trás-os-Montes e Alto Douro, Quinta de Prados, 5000-801 Vila Real, Portugal
- Centre for the Research and Technology Agro-Environmental and Biological Sciences and Inov4Agro—Institute for Innovation, Capacity Building and Sustainability of Agri-Food Production, 5000-801 Vila Real, Portugal
| | - Gabriela Jorge da Silva
- Center of Neurosciences and Cell Biology, Health Science Campus, 3000-548 Coimbra, Portugal
- Faculty of Pharmacy, University of Coimbra, 3000-548 Coimbra, Portugal
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Muema J, Nyamai M, Wheelhouse N, Njuguna J, Jost C, Oyugi J, Bukania Z, Oboge H, Ogoti B, Makori A, Fernandez MDP, Omulo S, Thumbi S. Endemicity of Coxiella burnetii infection among people and their livestock in pastoral communities in northern Kenya. Heliyon 2022; 8:e11133. [PMID: 36303929 PMCID: PMC9593183 DOI: 10.1016/j.heliyon.2022.e11133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 07/26/2022] [Accepted: 10/13/2022] [Indexed: 11/06/2022] Open
Abstract
Background Coxiella burnetti can be transmitted to humans primarily through inhaling contaminated droplets released from infected animals or consumption of contaminated dairy products. Despite its zoonotic nature and the close association pastoralist communities have with their livestock, studies reporting simultaneous assessment of C. burnetti exposure and risk-factors among people and their livestock are scarce. Objective This study therefore estimated the seroprevalence of Q-fever and associated risk factors of exposure in people and their livestock. Materials and methods We conducted a cross-sectional study in pastoralist communities in Marsabit County in northern Kenya. A total of 1,074 women and 225 children were enrolled and provided blood samples for Q-fever testing. Additionally, 1,876 goats, 322 sheep and 189 camels from the same households were sampled. A structured questionnaire was administered to collect individual- and household/herd-level data. Indirect IgG ELISA kits were used to test the samples. Results Household-level seropositivity was 13.2% [95% CI: 11.2–15.3]; differences in seropositivity levels among women and children were statistically insignificant (p = 0.8531). Lactating women had higher odds of exposure, odds ratio (OR) = 2.4 [1.3–5.3], while the odds of exposure among children increased with age OR = 1.1 [1.0–1.1]. Herd-level seroprevalence was 83.7% [81.7–85.6]. Seropositivity among goats was 74.7% [72.7–76.7], while that among sheep and camels was 56.8% [51.2–62.3] and 38.6% [31.6–45.9], respectively. Goats and sheep had a higher risk of exposure OR = 5.4 [3.7–7.3] and 2.6 [1.8–3.4], respectively relative to camels. There was no statistically significant association between Q-fever seropositivity and nutrition status in women, p = 0.900 and children, p = 1.000. We found no significant association between exposure in people and their livestock at household level (p = 0.724) despite high animal exposure levels, suggesting that Q-fever exposure in humans may be occurring at a scale larger than households. Conclusion The one health approach used in this study revealed that Q-fever is endemic in this setting. Longitudinal studies of Q-fever burden and risk factors simultaneously assessed in human and animal populations as well as the socioeconomic impacts of the disease and further explore the role of environmental factors in Q-fever epidemiology are required. Such evidence may form the basis for designing Q-fever prevention and control strategies.
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Affiliation(s)
- Josphat Muema
- Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya,Washington State University Global Health Program – Kenya, Nairobi, Kenya,Feed the Future Innovation Lab for Animal Health, Washington State University, USA,Corresponding author.
| | - Mutono Nyamai
- Washington State University Global Health Program – Kenya, Nairobi, Kenya,Feed the Future Innovation Lab for Animal Health, Washington State University, USA,Center for Epidemiological Modelling and Analysis, University of Nairobi, Nairobi, Kenya
| | | | - Joseph Njuguna
- Food and Agriculture Organization of the United Nations, Nairobi, Kenya
| | - Christine Jost
- United States Agency for International Development's Bureau for Humanitarian Assistance (USAID/BHA), Washington, DC, USA,Global Health Support Initiative III, Social Solutions International, Washington DC, USA
| | - Julius Oyugi
- Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya
| | - Zipporah Bukania
- Center for Public Health Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Harriet Oboge
- Washington State University Global Health Program – Kenya, Nairobi, Kenya,Feed the Future Innovation Lab for Animal Health, Washington State University, USA
| | - Brian Ogoti
- Washington State University Global Health Program – Kenya, Nairobi, Kenya,Center for Epidemiological Modelling and Analysis, University of Nairobi, Nairobi, Kenya
| | - Anita Makori
- Washington State University Global Health Program – Kenya, Nairobi, Kenya,Center for Epidemiological Modelling and Analysis, University of Nairobi, Nairobi, Kenya
| | | | - Sylvia Omulo
- Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya,Feed the Future Innovation Lab for Animal Health, Washington State University, USA,Paul G. Allen School for Global Health, Washington State University, Pullman, USA
| | - S.M. Thumbi
- Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya,Feed the Future Innovation Lab for Animal Health, Washington State University, USA,Center for Epidemiological Modelling and Analysis, University of Nairobi, Nairobi, Kenya,Paul G. Allen School for Global Health, Washington State University, Pullman, USA,South African Center for Epidemiological Modelling Analysis, South Africa,Institute of Immunology and Infection Research, University of Edinburgh, UK
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Serological Prevalence of and Risk Factors for Coxiella burnetti Infection in Women of Punjab Province, Pakistan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084576. [PMID: 35457443 PMCID: PMC9027314 DOI: 10.3390/ijerph19084576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 04/01/2022] [Accepted: 04/07/2022] [Indexed: 01/09/2023]
Abstract
Background: Coxiella burnetii, the etiological agent of Q (query) fever, provokes abortions in ruminants and is suspected to cause adverse pregnancy outcomes in women. Infection of pregnant women is linked with high mortality and morbidity of the fetus and the mother is at high risk to acquire chronic Q fever. This research was conducted to evaluate the prevalence of Q fever in women and to detect associated risk factors in four districts of Punjab Province, Pakistan. Methods: A total of 297 blood samples were obtained from 147 pregnant and 150 non-pregnant women of the districts Okara, Jhang, Chiniot and Faisalabad of Punjab, Pakistan. Data related to risk factors and demographic parameters were collected using a questionnaire. Serum samples were screened for phase I and phase II specific IgG antibodies for antigens of phase I and phase II using ELISA tests. Univariate and binary regression were used to analyze important risk factors of Q fever. Results: Twenty-five serum samples (8.4%) were found seropositive for Q fever. Seventeen women were positive for Phase-I and twenty-one were positive for phase-II antibodies. Highest and statistically significant (p < 0.05) seroprevalence of 17.1% was observed in Faisalabad. Age, urbanicity, living status, pregnancy status, abortion history, occupation, and consumption of tap water were positively correlated (p < 0.05) with Q fever, while being aged, urbanity, low income, contact with animals and consumption of tap water was identified as potential risk factors. Conclusions: Q fever is prevalent in women of Pakistan. There is a need for an awareness program about the importance of C. burnetii infections and prevention strategies in women during pregnancy to minimize adverse pregnancy outcomes.
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Mwololo D, Nthiwa D, Kitala P, Abuom T, Wainaina M, Kairu-Wanyoike S, Lindahl JF, Ontiri E, Bukachi S, Njeru I, Karanja J, Sang R, Grace D, Bett B. Sero-epidemiological survey of Coxiella burnetii in livestock and humans in Tana River and Garissa counties in Kenya. PLoS Negl Trop Dis 2022; 16:e0010214. [PMID: 35239658 PMCID: PMC8923444 DOI: 10.1371/journal.pntd.0010214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 03/15/2022] [Accepted: 01/28/2022] [Indexed: 01/17/2023] Open
Abstract
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.
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Affiliation(s)
- Damaris Mwololo
- Directorate of Veterinary Services, Ministry of Agriculture, Livestock, Fisheries and Cooperatives, Nairobi, Kenya
| | - Daniel Nthiwa
- Department of Biological Sciences, University of Embu, Embu, Kenya
- International Livestock Research Institute, Nairobi, Kenya
- * E-mail:
| | - Philip Kitala
- Department of Public Health, Pharmacology and Toxicology, Faculty of Veterinary Medicine, University of Nairobi, Nairobi, Kenya
| | - Tequiero Abuom
- Department of Clinical Medicine, Faculty of Veterinary Medicine, University of Nairobi, Nairobi, Kenya
| | | | - Salome Kairu-Wanyoike
- Department of Veterinary Services, Ministry of Agriculture, Livestock and Fisheries, Nairobi, Kenya
| | - Johanna F. Lindahl
- International Livestock Research Institute, Nairobi, Kenya
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
- Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Enoch Ontiri
- International Livestock Research Institute, Nairobi, Kenya
| | - Salome Bukachi
- Institute of Anthropology, University of Nairobi, Nairobi, Kenya
| | - Ian Njeru
- Division of Disease Surveillance and Response, Ministry of Public Health and Sanitation, Kenyatta National Hospital, Nairobi, Kenya
| | - Joan Karanja
- Division of Disease Surveillance and Response, Ministry of Public Health and Sanitation, Kenyatta National Hospital, Nairobi, Kenya
| | | | - Delia Grace
- International Livestock Research Institute, Nairobi, Kenya
- Natural Resources Institute, University of Greenwich, Kent, United Kingdom
| | - Bernard Bett
- International Livestock Research Institute, Nairobi, Kenya
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12
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Lemtudo AP, Mutai BK, Mwamburi L, Waitumbi JN. Seroprevalence of Coxiella burnetii in patients presenting with acute febrile illness at Marigat District Hospital, Baringo County, Kenya. Vet Med Sci 2021; 7:2093-2099. [PMID: 33955713 PMCID: PMC8464244 DOI: 10.1002/vms3.493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 03/25/2021] [Accepted: 04/01/2021] [Indexed: 11/07/2022] Open
Abstract
Q fever is not routinely diagnosed in Kenyan hospitals. This study reports on Q fever in patients presenting at Marigat District Hospital, Kenya, with febrile illness. ELISA was used to detect Coxiella burnetii phase antigens. Of 406 patients, 45 (11.1%) were judged to have acute disease (phase II IgM or IgG > phase I IgG), 2 (0.5%) were chronic (phase I IgG titer >800 or phase I IgG > phase II IgG), while 26 (6.4%) had previous exposure (phase I IgG titer <800). Age (6–10 years, p = 0.002) and contact with goats (p = 0.014) were significant risk factors. Compared to immunofluorescence antibody test, the sensitivity and specificity for phase I IgG were 84% and 98%, respectfully, 46% and 100% for phase II IgG and 35% and 89% for phase II IgM. It is concluded that the low sensitivity of phase II ELISA underestimated the true burden of acute Q fever in the study population.
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Affiliation(s)
- Allan P. Lemtudo
- United States Army Medical Research Directorate‐Africa/KenyaWalter Reed Army Institute of Research/Kenya Medical Research InstituteKisumuKenya
- Department of Biological SciencesSchool of ScienceUniversity of EldoretEldoretKenya
| | - Beth K. Mutai
- United States Army Medical Research Directorate‐Africa/KenyaWalter Reed Army Institute of Research/Kenya Medical Research InstituteKisumuKenya
| | - Lizzy Mwamburi
- Department of Biological SciencesSchool of ScienceUniversity of EldoretEldoretKenya
| | - John N. Waitumbi
- United States Army Medical Research Directorate‐Africa/KenyaWalter Reed Army Institute of Research/Kenya Medical Research InstituteKisumuKenya
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Sahu R, Rawool DB, Dhaka P, Yadav JP, Mishra SP, Kumar M, Vergis J, Malik SS, Barbuddhe SB. Current perspectives on the occurrence of Q fever: highlighting the need for systematic surveillance for a neglected zoonotic disease in Indian subcontinent. ENVIRONMENTAL MICROBIOLOGY REPORTS 2021; 13:138-158. [PMID: 33314653 DOI: 10.1111/1758-2229.12918] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 12/08/2020] [Accepted: 12/09/2020] [Indexed: 06/12/2023]
Abstract
Coxiellosis or Q fever is an important global occupational zoonotic disease caused by one of the most contagious bacterial pathogens - Coxiella burnetii, which ranks one among the 13 global priority zoonoses. The detection of C. burnetii infection is exhibiting an increasing trend in high-risk personnel around the globe. It has increasingly been detected from foods of animal origin (including bulk milk, eggs, and meat) as well as tick vectors in many parts of the world. Coxiellosis is reported to be an important public health threat causing spontaneous abortions in humans and potential reproductive failure, which would result in production losses among livestock. Further, comprehensive coverage of the reports and trends of Q fever in developing countries, where this infection is supposed to be widely prevalent appears scarce. Also, the pathogen remains grossly neglected and underreported. Moreover, policymakers and funding agencies do not view it as a priority problem, especially in the Indian subcontinent, including Sri Lanka, Bhutan, Pakistan, Nepal, Bangladesh and Maldives. Here, we review the occurrence and epidemiology of the disease in a global context with special emphasis on its status in the Indian subcontinent.
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Affiliation(s)
- Radhakrishna Sahu
- Division of Veterinary Public Health, ICAR- Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, 243 122, India
| | - Deepak Bhiwa Rawool
- ICAR- National Research Centre on Meat, Hyderabad, Telangana, 500 092, India
| | - Pankaj Dhaka
- School of Public Health and Zoonoses, College of Veterinary Science, GADVASU, Ludhiana, Punjab, 141004, India
| | - Jay Prakash Yadav
- Division of Veterinary Public Health, ICAR- Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, 243 122, India
| | - Sidharth Prasad Mishra
- Department of Animal Genetics and Breeding, West Bengal University of Animal and Fishery Sciences, Kolkata, West Bengal, 700037, India
| | - Manesh Kumar
- Division of Veterinary Public Health, ICAR- Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, 243 122, India
| | - Jess Vergis
- Division of Veterinary Public Health, ICAR- Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, 243 122, India
| | - Satyaveer Singh Malik
- Division of Veterinary Public Health, ICAR- Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, 243 122, India
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Sahu R, Rawool DB, Vinod VK, Malik SVS, Barbuddhe SB. Current approaches for the detection of Coxiella burnetii infection in humans and animals. J Microbiol Methods 2020; 179:106087. [PMID: 33086105 DOI: 10.1016/j.mimet.2020.106087] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 10/14/2020] [Accepted: 10/14/2020] [Indexed: 02/09/2023]
Abstract
Q fever (coxiellosis), caused by Coxiella burnetii, is an emerging or re-emerging zoonotic disease of public health significance and with worldwide distribution. As a causal agent of the one among the 13 global priority zoonoses, having the infectious dose as low as one bacterium, C. burnetii has been regarded as an obligate intracellular bacterial pathogen. The agent has been classified as a Group B bioterrorism agent by the Centre for Disease Control and Prevention (CDC), and the disease is included in the World Organisation for Animal Health (OIE) list of notifiable diseases. It is mainly transmitted through airborne route in humans and animals. Isolation of C. burnetii, using standard routine laboratory culture techniques was impossible until formulation of axenic-based medium. However, it is still to be included among routinely isolated laboratory pathogen, accounting prolonged incubation period (~7 days) and requirement of specific oxygen concentration (2.5% O2). Therefore, indirect diagnostic tools have been mainly used for its diagnosis. So far serology has been mostly used for testing for C. burnetii infection. The detection of C. burnetii DNA by PCR in various clinical samples have also been widely used. The disease has remained largely under-reported, underdiagnosed and as a masked zoonosis; and therefore, needs to be explored through well-planned scientific studies for knowing its true status and likely it impact in humans and animals by employing state-of-the-art diagnostics, identifying its diverse and new host range, as well as risk factors involved in different geo-climatic, behavioural and social settings as well as risk groups. Here, we reviewed the current approaches used for the detection of C. burnetii infection in humans and animals at the population and individual level.
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Affiliation(s)
- Radhakrishna Sahu
- Division of Veterinary Public Health, ICAR- Indian Veterinary Research Institute, Izatnagar 243 122, India
| | - Deepak B Rawool
- ICAR- National Research Centre on Meat, Hyderabad 500 092, India
| | - Valil Kunjukunju Vinod
- Division of Veterinary Public Health, ICAR- Indian Veterinary Research Institute, Izatnagar 243 122, India
| | - S V S Malik
- Division of Veterinary Public Health, ICAR- Indian Veterinary Research Institute, Izatnagar 243 122, India
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Hackert VH, Dukers-Muijrers NHTM, Hoebe CJPA. Signs and symptoms do not predict, but may help rule out acute Q fever in favour of other respiratory tract infections, and reduce antibiotics overuse in primary care. BMC Infect Dis 2020; 20:690. [PMID: 32957938 PMCID: PMC7503428 DOI: 10.1186/s12879-020-05400-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 09/06/2020] [Indexed: 11/10/2022] Open
Abstract
Background From early 2009, the Dutch region of South Limburg experienced a massive outbreak of Q fever, overlapping with the influenza A(H1N1)pdm09 pandemic during the second half of the year and affecting approximately 2.9% of a 300,000 population. Acute Q fever shares clinical features with other respiratory conditions. Most symptomatic acute infections are characterized by mild symptoms, or an isolated febrile syndrome. Pneumonia was present in a majority of hospitalized patients during the Dutch 2007–2010 Q fever epidemic. Early empiric doxycycline, guided by signs and symptoms and patient history, should not be delayed awaiting laboratory confirmation, as it may shorten disease and prevent progression to focalized persistent Q fever. We assessed signs’ and symptoms’ association with acute Q fever to guide early empiric treatment in primary care patients. Methods In response to the outbreak, regional primary care physicians and hospital-based medical specialists tested a total of 1218 subjects for Q fever. Testing activity was bimodal, a first “wave” lasting from March to December 2009, followed by a second “wave” which lasted into 2010 and coincided with peak pandemic influenza activity. We approached all 253 notified acute Q fever cases and a random sample of 457 Q fever negative individuals for signs and symptoms of disease. Using data from 140/229(61.1%) Q fever positive and 194/391(49.6%) Q fever negative respondents from wave 1, we built symptom-based models predictive of Q-fever outcome, validated against subsets of data from wave 1 and wave 2. Results Our models had poor to moderate AUC scores (0.68 to 0.72%), with low positive (4.6–8.3%), but high negative predictive values (91.7–99.5%). Male sex, fever, and pneumonia were strong positive predictors, while cough was a strong negative predictor of acute Q fever in these models. Conclusion Whereas signs and symptoms of disease do not appear to predict acute Q fever, they may help rule it out in favour of other respiratory conditions, prompting a delayed or non-prescribing approach instead of early empiric doxycycline in primary care patients with non-severe presentations. Signs and symptoms thus may help reduce the overuse of antibiotics in primary care during and following outbreaks of Q fever.
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Affiliation(s)
- Volker H Hackert
- Department of Sexual Health, Infectious Diseases, and Environmental Health, South Limburg Public Health Service, Heerlen, 6411, TE, The Netherlands. .,Department of Social Medicine and Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University / MUMC+, Maastricht, 6229, HX, The Netherlands.
| | - Nicole H T M Dukers-Muijrers
- Department of Sexual Health, Infectious Diseases, and Environmental Health, South Limburg Public Health Service, Heerlen, 6411, TE, The Netherlands.,Department of Social Medicine and Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University / MUMC+, Maastricht, 6229, HX, The Netherlands
| | - Christian J P A Hoebe
- Department of Sexual Health, Infectious Diseases, and Environmental Health, South Limburg Public Health Service, Heerlen, 6411, TE, The Netherlands.,Department of Social Medicine and Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University / MUMC+, Maastricht, 6229, HX, The Netherlands
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Abstract
Purpose of Review The non-specific presentation of acute Q fever makes it difficult to diagnose in children, but untreated Q fever can result in chronic infections that have severe complications. Recent Findings Pediatric Q fever cases continue to be infrequently reported in the literature, and primarily document cases of persistent infections with Coxiella burnetii. Standardized treatment protocols for chronic Q fever in children still do not exist. Doxycycline and hydroxychloroquine are the treatment combination most utilized by healthcare providers to treat Q fever endocarditis or osteomyelitis in children, but a variety of other antibiotic combinations have been reported with varying results. The use of adjunctive therapies, such as such as interferon gamma, has produced mixed outcomes. Summary The true impact of Coxiella burnetii on the health of children remains unknown; long-term longitudinal follow-up of children with acute or chronic Q fever has not been reported. Both the acute and chronic forms of Q fever are underreported and underdiagnosed. Healthcare providers should consider Q fever in pediatric patients with culture-negative endocarditis or osteomyelitis.
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Coxiella burnetii Antibody Prevalence and Risk Factors of Infection in the Human Population of Estonia. Microorganisms 2019; 7:microorganisms7120629. [PMID: 31795442 PMCID: PMC6956122 DOI: 10.3390/microorganisms7120629] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 11/24/2019] [Accepted: 11/27/2019] [Indexed: 01/16/2023] Open
Abstract
Q fever is an emerging health problem in both humans and animals. To estimate the prevalence of Coxiella burnetii (C. burnetii) antibodies in the Estonian population, we analyzed plasma samples from 1000 individuals representing the general population and 556 individual serum samples from five population groups potentially at a higher risk (veterinary professionals, dairy cattle, beef cattle, and small ruminant stockbreeders and hunters). Additionally, 118 dairy cow bulk tank milk samples were analyzed to establish the infection status of the dairy cattle herds and the participating dairy cattle keepers. Questionnaires were used to find the potential risk factors of exposure. The effects of different variables were evaluated using binary logistic regression analysis and mixed-effects logistic analysis. The prevalence in veterinary professionals (9.62%; p = 0.003) and dairy cattle farmers (7.73%; p = 0.047) was significantly higher than in the general population (3.9%). Contact with production animals in veterinary practice and being a dairy stockbreeder in C. burnetii positive farms were risk factors for testing C. burnetii seropositive (p = 0.038 and p = 0.019, respectively). Results suggest that C. burnetii is present in Estonia and the increased risk of infection in humans is associated with farm animal contact.
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Pradeep J, Kumar S, Stephen S, Kamboj DV, Gunasekaran D, Hanifah M. Detection of acute Q fever human cases by indirect immunofluorescence & real-time polymerase chain reaction in a tertiary care hospital in Puducherry. Indian J Med Res 2019; 148:449-452. [PMID: 30666008 PMCID: PMC6362714 DOI: 10.4103/ijmr.ijmr_692_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Affiliation(s)
- Jothimani Pradeep
- Department of Microbiology, Mahatma Gandhi Medical College & Research Institute, Sri Balaji Vidyapeeth (Deemed University), Puducherry 607 402, India
| | - Sanjay Kumar
- Department of Biotechnology, Defence Research & Development Establishment, Gwalior 474 002, Madhya Pradesh, India
| | - Selvaraj Stephen
- Department of Microbiology, Mahatma Gandhi Medical College & Research Institute, Sri Balaji Vidyapeeth (Deemed University), Puducherry 607 402, India
| | - Dev Vrat Kamboj
- Department of Biotechnology, Defence Research & Development Establishment, Gwalior 474 002, Madhya Pradesh, India
| | - Dhandapany Gunasekaran
- Department of Paediatrics, Mahatma Gandhi Medical College & Research Institute, Sri Balaji Vidyapeeth (Deemed University), Puducherry 607 402, India
| | - Mohammed Hanifah
- Department of General Medicine, Mahatma Gandhi Medical College & Research Institute, Sri Balaji Vidyapeeth (Deemed University), Puducherry 607 402, India
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Salifu SP, Bukari ARA, Frangoulidis D, Wheelhouse N. Current perspectives on the transmission of Q fever: Highlighting the need for a systematic molecular approach for a neglected disease in Africa. Acta Trop 2019; 193:99-105. [PMID: 30831112 DOI: 10.1016/j.actatropica.2019.02.032] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 02/28/2019] [Accepted: 02/28/2019] [Indexed: 01/08/2023]
Abstract
Q fever is a bacterial worldwide zoonosis (except New Zealand) caused by the Gram-negative obligate intracellular bacterium Coxiella burnetii (C. burnetii). The bacterium has a large host range including arthropods, wildlife and companion animals and is frequently identified in human and livestock populations. In humans, the disease can occur as either a clinically acute or chronic aetiology, affecting mainly the lungs and liver in the acute disease, and heart valves when chronic. In livestock, Q fever is mainly asymptomatic; however, the infection can cause abortion, and the organism is shed in large quantities, where it can infect other livestock and humans. The presence of Q fever in Africa has been known for over 60 years, however while our knowledge of the transmission routes and risk of disease have been well established in many parts of the world, there is a significant paucity of knowledge across the African continent, where it remains a neglected zoonosis. Our limited knowledge of the disease across the African sub-continent have relied largely upon observational (sero) prevalence studies with limited focus on the molecular epidemiology of the disease. This review highlights the need for systematic studies to understand the routes of C. burnetii infection, and understand the disease burden and risk factors for clinical Q fever in both humans and livestock. With such knowledge gaps filled, the African continent could stand a better chance of eradicating Q fever through formulation and implementation of effective public health interventions.
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Systematic Review of Important Bacterial Zoonoses in Africa in the Last Decade in Light of the 'One Health' Concept. Pathogens 2019; 8:pathogens8020050. [PMID: 30995815 PMCID: PMC6631375 DOI: 10.3390/pathogens8020050] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 04/10/2019] [Accepted: 04/11/2019] [Indexed: 02/07/2023] Open
Abstract
Zoonoses present a major public health threat and are estimated to account for a substantial part of the infectious disease burden in low-income countries. The severity of zoonotic diseases is compounded by factors such as poverty, living in close contact with livestock and wildlife, immunosuppression as well as coinfection with other diseases. The interconnections between humans, animals and the environment are essential to understand the spread and subsequent containment of zoonoses. We searched three scientific databases for articles relevant to the epidemiology of bacterial zoonoses/zoonotic bacterial pathogens, including disease prevalence and control measures in humans and multiple animal species, in various African countries within the period from 2008 to 2018. The review identified 1966 articles, of which 58 studies in 29 countries met the quality criteria for data extraction. The prevalence of brucellosis, leptospirosis, Q fever ranged from 0–40%, 1.1–24% and 0.9–28.2%, respectively, depending on geographical location and even higher in suspected outbreak cases. Risk factors for human zoonotic infection included exposure to livestock and animal slaughters. Dietary factors linked with seropositivity were found to include consumption of raw milk and locally fermented milk products. It was found that zoonoses such as leptospirosis, brucellosis, Q fever and rickettsiosis among others are frequently under/misdiagnosed in febrile patients seeking treatment at healthcare centres, leading to overdiagnoses of more familiar febrile conditions such as malaria and typhoid fever. The interactions at the human–animal interface contribute substantially to zoonotic infections. Seroprevalence of the various zoonoses varies by geographic location and species. There is a need to build laboratory capacity and effective surveillance processes for timely and effective detection and control of zoonoses in Africa. A multifaceted ‘One Health’ approach to tackle zoonoses is critical in the fight against zoonotic diseases. The impacts of zoonoses include: (1) Humans are always in contact with animals including livestock and zoonoses are causing serious life-threatening infections in humans. Almost 75% of the recent major global disease outbreaks have a zoonotic origin. (2) Zoonoses are a global health challenge represented either by well-known or newly emerging zoonotic diseases. (3) Zoonoses are caused by all-known cellular (bacteria, fungi and parasites) and noncellular (viruses or prions) pathogens. (4) There are limited data on zoonotic diseases from Africa. The fact that human health and animal health are inextricably linked, global coordinated and well-established interdisciplinary research efforts are essential to successfully fight and reduce the health burden due to zoonoses. This critically requires integrated data from both humans and animals on zoonotic diseases.
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Evaluating Camel Health in Kenya—An Example of Conservation Medicine in Action. FOWLER'S ZOO AND WILD ANIMAL MEDICINE CURRENT THERAPY, VOLUME 9 2019. [PMCID: PMC7152025 DOI: 10.1016/b978-0-323-55228-8.00016-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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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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Sahu R, Kale SB, Vergis J, Dhaka P, Kumar M, Choudhary M, Jain L, Choudhary BK, Rawool DB, Chaudhari SP, Kurkure NV, Malik S, Barbuddhe SB. Apparent prevalence and risk factors associated with occurrence of Coxiella burnetii infection in goats and humans in Chhattisgarh and Odisha, India. Comp Immunol Microbiol Infect Dis 2018; 60:46-51. [DOI: 10.1016/j.cimid.2018.08.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Revised: 05/22/2018] [Accepted: 08/29/2018] [Indexed: 02/08/2023]
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24
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Browne AS, Fèvre EM, Kinnaird M, Muloi DM, Wang CA, Larsen PS, O'Brien T, Deem SL. Serosurvey of Coxiella burnetii (Q fever) in Dromedary Camels (Camelus dromedarius) in Laikipia County, Kenya. Zoonoses Public Health 2017; 64:543-549. [PMID: 28176495 PMCID: PMC5655913 DOI: 10.1111/zph.12337] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Indexed: 12/19/2022]
Abstract
Dromedary camels (Camelus dromedarius) are an important protein source for people in semi-arid and arid regions of Africa. In Kenya, camel populations have grown dramatically in the past few decades resulting in the potential for increased disease transmission between humans and camels. An estimated four million Kenyans drink unpasteurized camel milk, which poses a disease risk. We evaluated the seroprevalence of a significant zoonotic pathogen, Coxiella burnetii (Q fever), among 334 camels from nine herds in Laikipia County, Kenya. Serum testing revealed 18.6% positive seroprevalence of Coxiella burnetii (n = 344). Increasing camel age was positively associated with C. burnetii seroprevalence (OR = 5.36). Our study confirmed that camels living in Laikipia County, Kenya, have been exposed to the zoonotic pathogen, C. burnetii. Further research to evaluate the role of camels in disease transmission to other livestock, wildlife and humans in Kenya should be conducted.
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Affiliation(s)
- A. S. Browne
- Molecular Epidemiology and Public Health LaboratoryHopkirk Research InstituteMassey UniversityPalmerston NorthNZ
| | - E. M. Fèvre
- Institute of Infection and Global HealthUniversity of LiverpoolNestonUK
- International Livestock Research InstituteNairobiKE
| | | | - D. M. Muloi
- Centre for Immunity, Infection and EvolutionUniversity of EdinburghEdinburghUK
| | - C. A. Wang
- College of Veterinary MedicineNorth Carolina State UniversityRaleighNCUSA
| | - P. S. Larsen
- Department of EpidemiologySchool of Public HealthUniversity of MichiganAnn ArborMIUSA
| | - T. O'Brien
- Mpala Research CentreNanyukiKE
- Wildlife Conservation SocietyGlobal Conservation ProgramsBronx, New YorkNYUSA
| | - S. L. Deem
- Saint Louis Zoo Institute for Conservation MedicineSaint LouisMOUSA
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Njeru J, Tomaso H, Mertens K, Henning K, Wareth G, Heller R, Kariuki S, Fèvre EM, Neubauer H, Pletz MW. Serological evidence of Francisella tularensis in febrile patients seeking treatment at remote hospitals, northeastern Kenya, 2014-2015. New Microbes New Infect 2017; 19:62-66. [PMID: 28721222 PMCID: PMC5498284 DOI: 10.1016/j.nmni.2017.05.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 05/16/2017] [Accepted: 05/29/2017] [Indexed: 11/02/2022] Open
Abstract
Tularaemia is a highly contagious infectious zoonosis caused by the bacterial agent Francisella tularensis. The aim of this study was to investigate the presence of antibodies to F. tularensis in febrile patients in northeastern Kenya. During 2014-2015, 730 patients were screened for anti-F. tularensis antibodies using a combination of ELISA and Western blot. Twenty-seven (3.7%) individuals were positive for F. tularensis. Tularaemia was not suspected by the treating clinicians in any of them. Our results suggest that tularaemia may be present in Kenya but remain unreported, and emphasizes the need for local clinicians to broaden their diagnostic repertoire when evaluating patients with undifferentiated febrile illness.
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Affiliation(s)
- J Njeru
- Institute of Bacterial Infections and Zoonoses, Friedrich-Loeffler-Institute, Jena, Germany.,Centre for Infectious Diseases and Infection Control, Jena University Hospital, Jena, Germany.,Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - H Tomaso
- Institute of Bacterial Infections and Zoonoses, Friedrich-Loeffler-Institute, Jena, Germany
| | - K Mertens
- Institute of Bacterial Infections and Zoonoses, Friedrich-Loeffler-Institute, Jena, Germany
| | - K Henning
- Institute of Bacterial Infections and Zoonoses, Friedrich-Loeffler-Institute, Jena, Germany
| | - G Wareth
- Institute of Bacterial Infections and Zoonoses, Friedrich-Loeffler-Institute, Jena, Germany.,Faculty of Veterinary Medicine, Benha University, Moshtohor, Egypt
| | - R Heller
- Institute for Molecular Cell Biology, Center for Molecular Biomedicine, Friedrich Schiller University of Jena, Jena, Germany
| | - S Kariuki
- Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - E M Fèvre
- Institute of Infection and Global Health, University of Liverpool, Liverpool, UK.,International Livestock Research Institute, Nairobi, Kenya
| | - H Neubauer
- Institute of Bacterial Infections and Zoonoses, Friedrich-Loeffler-Institute, Jena, Germany
| | - M W Pletz
- Centre for Infectious Diseases and Infection Control, Jena University Hospital, Jena, Germany
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