Progression of Coxiella burnetii infection after implementing a two-year vaccination program in a naturally infected dairy cattle herd

Efficacy and Safety of an Inactivated Phase I Coxiella burnetii Vaccine to Control Q Fever in Ruminants: A Systematic Review

Q fever is a disease caused by Coxiella burnetii that affects many animal species and humans. In ruminants, the disease is responsible for several reproductive disorders (such as abortions, stillbirths, premature births, weak offspring, retained foetal membranes and infertility). An inactivated vaccine based on a phase I antigen of C. burnetii is available for cattle, goats and sheep. This review aims to summarise the scientific literature regarding the efficacy and safety of this vaccine to control the infection in these three domestic ruminant species. Forty-five publications and one experimental veterinary thesis reporting on experimental studies, case reports, mathematical modelling and intervention studies were selected according to the PRISMA guidelines. Although some studies lack control groups or statistical analyses, for all three species, published data show that vaccination often results in a reduction in abortions and an improvement in reproductive performance in comparison with absence of vaccination. There is also evidence, including in infected herds and animals, that vaccination is associated with a reduction in bacterial shedding, both in intensity and duration in comparison with absence of vaccination. For these reasons, in case of human outbreaks, vaccination is one of the pillars of control measures. Vaccination is generally well tolerated, despite the rare occurrence of mild, transient side-effects, such as hyperthermia and reduction in milk yield.

Controlling Coxiella burnetii in naturally infected sheep, goats and cows, and public health implications: a scoping review

Q fever is a worldwide zoonotic disease which domestic ruminants are the main source of infection for humans. This scoping review summarizes the control measures currently available to reduce Coxiella burnetii (Cb) infection in naturally infected sheep, goat and cattle herds. A total of 28 articles were included in the review. A lack of methodological standardization was noted in the articles analyzed. The results indicated that long-term vaccination in cows reduces bacterial excretion in milk and environmental contamination. In small ruminants, the results of vaccination in terms of efficacy are variable. In goats, there is a reduction in bacterial excretion, unlike in sheep, where a long-term vaccination program is necessary to reduce bacterial excretion. Moreover, the high persistence of viable Cb in the environment means that control measures for sheep are needed for several years. The use of antibiotics as a control measure in cows and sheep was not found to reduce excretion. However, the combination of vaccination with antibiotic therapy appears to have positive effects in small ruminants in terms of controlling outbreaks of Q fever. Hygiene and biosecurity measures are the basic means for controlling Cb infection on ruminant farms and ensuring public health.

QTest: A new way to easily sample, store, and ship samples to perform Q fever PCR analysis on bulk tank milk

Bulk tank milk (BTM) is an easy, inexpensive, and representative sample for detection of Coxiella burnetii infections (Q fever) in dairy herds using real-time PCR. Bulk tank milk PCR can be performed either for initial herd screening or for monitoring the effectiveness of preventive measures. However, one major limitation under field conditions is the need to deliver BTM samples in adequate condition (quickly, safely, and under refrigeration) to a qualified laboratory. In addition, sending non-inactivated biological samples via normal mail may be prohibited. We developed an innovative, easy, and accurate diagnostic tool (QTest) for Q fever to support veterinarians and farmers in overcoming these constraints. The farmer or veterinarian simply places some drops of BTM on a Whatman FTA Elute Micro Card (FTA card) and lets the card dry before mailing it to the laboratory. In a 2-step study, we tested the hypotheses that (1) BTM samples stored on FTA cards are stable over time and at different temperatures, and (2) PCR results obtained via FTA cards are consistent with those obtained from raw BTM samples. The stability of C. burnetii DNA in milk preserved on an FTA card was maintained for at least 29 d at room temperature or 37°C to mimic field conditions. In our field study, of the original 70 positive BTM samples (when tested on raw BTM just after sampling), 58 samples were positive (on either raw BTM or FTA card) by the time of the direct comparison study (10 to 14 d later). Of these 58 samples, 45 raw BTM samples still tested positive after aging, and 53 FTA card BTM samples tested positive, indicating that detection was higher using FTA cards (91.4%) than raw milk (77.6%). Therefore, with inactivation and shipping advantages, this technique facilitates an easier and more practical approach to diagnosis of Q fever at the herd level and would support Q fever control strategies, especially in countries lacking adequate and close laboratory facilities.

A randomised controlled trial of the immunogenicity and safety of a formaldehyde-inactivated Coxiella burnetii vaccine in 8-week-old goats

Coxiella burnetii causes Q fever in individuals exposed to infected ruminants. Vaccination in 3-4-month-old goats, has been reported to result in significantly greater reduction in C. burnetii shedding compared to goats vaccinated one month before breeding, the most commonly used strategy of controlling Q fever on infected intensively-managed herds. It is possible that an even greater reduction in the number of animals shedding C. burnetii could be achieved if vaccination were administered shortly after protection from colostrum antibodies wanes and animals become susceptible to infection with C. burnetii. This study aimed to evaluate the immunogenicity and safety of a formaldehyde-inactivated phase 1 C. burnetii vaccine in 8-week-old goats. Two injections, four weeks apart, elicited specific IgM and IgG responses in all vaccinated goats (n = 6), while no antibodies were detected in two control groups (n = 12). Swelling at the site of inoculation was observed in all the vaccinated and in 10/11 of the placebo-treated goats but receded after 3 weeks. Weight change and rectal temperatures were also comparable between vaccinated and control goats. The data indicated that this vaccine could be suitable for immunising 8-week-old goats, although further trials to determine level of protection against challenge are required.

[Effects of vaccination against Q-fever in Lower Saxony dairy cattle farms]

OBJECTIVE

Being a notifiable and zoonotic disease, Q-fever is coming under increasing focus of epizootic disease control. Current studies indicate that the disease is more widespread in Germany than the number of notifications suggest. Therefore, since 2013, under certain conditions a hardship allowance is granted by the Animal Diseases Fund of Lower Saxony for the vaccine costs of the basic immunization to support affected farms. Material und methods: All farmers, on whose farms clinical signs of Q-fever and the pathogen Coxiella burnetii had been detected prior to vaccination and who had taken advantage of the hardship allowance during the previous 2 years were surveyed to assess the effectiveness of the measure. The survey was conducted by telephone using a previously compiled questionnaire. The topics included the observed clinical signs in cattle before and after the vaccination and the evaluation of the vaccination.

RESULTS

Clinical manifestations indicating a Q-fever infection may differ widely and include aborts and fertility disorders and/or frequently occurring inflammations (pneumonia, mastitis, metritis) and/or unspecific symptoms presenting as higher susceptibility to disease, weakness, and fever attacks. Following vaccination, the vast majority of the farmers (84 %) observed a marked health improvement in their cattle and two thirds of the respondents intend to continue with the vaccination even without financial support from the Animal Diseases Fund. Adverse effects beyond general vaccination reactions, including transiently elevated body temperature, physical weakness and fluctuations in milk performance, were rarely observed.

CONCLUSIONS AND CLINICAL RELEVANCE

The clinical signs for Q-fever were diverse and often unspecific. According to the assessments by the farmers, clinical problems in most cases were considerably reduced following Q-fever vaccination. Vaccination appears to be a valuable tool in the control of this zoonosis.

Genetic diversity and variation over time of Coxiella burnetii genotypes in dairy cattle and the farm environment

The genetic diversity of Coxiella burnetii from 36 dairy cattle herds was determined by Multiple-Locus Variable number tandem repeats Analysis (MLVA), and genotypes from different sources (bulk-tank milk - BTM and surface dust) and sampling time (2009/10 and 2011/12) were compared. A total of 15 different genotypes were identified from 60 BTM and seven dust samples, including seven genotypes reported here for the first time (BN, BO, BP, BQ, BR, BS, BT). The two most prevalent genotypes (J and I), detected both in BTM and dust, accounted for 44.5% of the C. burnetii typed and have been reported infecting cattle worldwide. In 52% of herds more than one genotype was found, and mixed infection with two genotypes was observed in seven BTM samples. Comparison of C. burnetii genotypes at different samplings within each herd detected a change in genotype in 32% of herds, while a persistent genotype was identified in the remaining 68%. In addition, the genotype obtained from dust samples was always identical to that present in the BTM sample. Often persistent genotypes were among the most prevalent types. Clustering of the MLVA genotypes from this and other studies using the minimum spanning tree method separated our C. burnetii strains into two clusters, 10 genotypes clustered within genomic group (GG) III, and the remaining five types (AE, BQ, BR, BS and BT) grouped with GG II, which includes strains implicated in human outbreaks. Although presence in cattle of genotypes closely related to those identified in humans does not seem to be common event, it cannot be neglected and surveillance of genotype distribution is needed to fully understand the epidemiology of Q fever.