1
|
Espí A, del Cerro A, Oleaga Á, Rodríguez-Pérez M, López CM, Hurtado A, Rodríguez-Martínez LD, Barandika JF, García-Pérez AL. One Health Approach: An Overview of Q Fever in Livestock, Wildlife and Humans in Asturias (Northwestern Spain). ANIMALS : AN OPEN ACCESS JOURNAL FROM MDPI 2021; 11:ani11051395. [PMID: 34068431 PMCID: PMC8153578 DOI: 10.3390/ani11051395] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/10/2021] [Accepted: 05/10/2021] [Indexed: 11/16/2022]
Abstract
This study aimed to investigate the seroprevalence of C. burnetii in domestic ruminants, wild ungulates, as well as the current situation of Q fever in humans in a small region in northwestern Spain where a close contact at the wildlife-livestock-human interface exists, and information on C. burnetii infection is scarce. Seroprevalence of C. burnetii was 8.4% in sheep, 18.4% in cattle, and 24.4% in goats. Real-time PCR analysis of environmental samples collected in 25 livestock farms detected Coxiella DNA in dust and/or aerosols collected in 20 of them. Analysis of sera from 327 wild ungulates revealed lower seroprevalence than that found in domestic ruminants, with 8.4% of Iberian red deer, 7.3% chamois, 6.9% fallow deer, 5.5% European wild boar and 3.5% of roe deer harboring antibodies to C. burnetii. Exposure to the pathogen in humans was determined by IFAT analysis of 1312 blood samples collected from patients admitted at healthcare centers with Q fever compatible symptoms, such as fever and/or pneumonia. Results showed that 15.9% of the patients had IFAT titers ≥ 1/128 suggestive of probable acute infection. This study is an example of a One Health approach with medical and veterinary institutions involved in investigating zoonotic diseases.
Collapse
Affiliation(s)
- Alberto Espí
- Department of Animal Health, Regional Service for Agrofood Research and Development (SERIDA), 33394 Gijón, Spain;
- Translational Microbiology Consolidated Group, Instituto de Investigación Sanitaria del Principado de Asturias (Health Research Institute of Asturias, ISPA), Av. del Hospital Universitario, s/n, 33011 Oviedo, Spain; (Á.O.); (M.R.-P.)
- Correspondence: ; Tel.: +34-653372118
| | - Ana del Cerro
- Department of Animal Health, Regional Service for Agrofood Research and Development (SERIDA), 33394 Gijón, Spain;
- Translational Microbiology Consolidated Group, Instituto de Investigación Sanitaria del Principado de Asturias (Health Research Institute of Asturias, ISPA), Av. del Hospital Universitario, s/n, 33011 Oviedo, Spain; (Á.O.); (M.R.-P.)
| | - Álvaro Oleaga
- Translational Microbiology Consolidated Group, Instituto de Investigación Sanitaria del Principado de Asturias (Health Research Institute of Asturias, ISPA), Av. del Hospital Universitario, s/n, 33011 Oviedo, Spain; (Á.O.); (M.R.-P.)
- SERPA—Sociedad de Servicios del Principado de Asturias S.A., 33202 Gijón, Spain
| | - Mercedes Rodríguez-Pérez
- Translational Microbiology Consolidated Group, Instituto de Investigación Sanitaria del Principado de Asturias (Health Research Institute of Asturias, ISPA), Av. del Hospital Universitario, s/n, 33011 Oviedo, Spain; (Á.O.); (M.R.-P.)
- Department of Microbiology, Central Hospital of Asturias (HUCA), 33011 Oviedo, Spain
| | - Ceferino M. López
- Department of Animal Pathology, Animal Health, Veterinary Faculty, University of Santiago de Compostela, 27071 Lugo, Spain;
| | - Ana Hurtado
- Department of Animal Health, NEIKER-Basque Institute for Agricultural Research and Development, Basque Research and Technology Alliance (BRTA), 48160 Derio, Spain; (A.H.); (J.F.B.); (A.L.G.-P.)
| | | | - Jesús F. Barandika
- Department of Animal Health, NEIKER-Basque Institute for Agricultural Research and Development, Basque Research and Technology Alliance (BRTA), 48160 Derio, Spain; (A.H.); (J.F.B.); (A.L.G.-P.)
| | - Ana L. García-Pérez
- Department of Animal Health, NEIKER-Basque Institute for Agricultural Research and Development, Basque Research and Technology Alliance (BRTA), 48160 Derio, Spain; (A.H.); (J.F.B.); (A.L.G.-P.)
| |
Collapse
|
2
|
Epidemiological scenario of Q fever hospitalized patients in the Spanish Health System: What's new. Int J Infect Dis 2019; 90:226-233. [PMID: 31698135 DOI: 10.1016/j.ijid.2019.10.043] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 10/28/2019] [Accepted: 10/30/2019] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVES The objective of this study was to assess the epidemiology and burden of Q fever (QF) in Spain. METHODS We designed a retrospective descriptive study using the minimum basic data set in patients admitted to hospitals of the National Health System between 1998 and 2015 with a diagnosis of Q fever (ICD-9: 083.0.). RESULTS We found 4214 hospitalized patients with a mean age (±SD) of 50.9±19.3 years. The male/female ratio was 3:1. The incidence rate was between 0.41 and 0.65 cases per 100,000 person-years over the 18-year period. The highest incidence of cases was from March to August (p=0.024). 21.1% patients had pneumonia, 17.5% had liver disease, and only 3.2% had endocarditis. The average hospital stay was 13.8 days (±12.8). A total of 117 (2.8%) patients died. The total mean cost of QF is approximately €154,232,779 (€36,600±139,422 per patient). CONCLUSIONS QF is an important zoonosis in Spain with a stable incidence rate and high cost for hospitalization. Older patients have a more severe clinical picture and higher mortality, which can be decreased with early clinical suspicion.
Collapse
|
3
|
Alonso E, Lopez-Etxaniz I, Hurtado A, Liendo P, Urbaneja F, Aspiritxaga I, Olaizola JI, Piñero A, Arrazola I, Barandika JF, Hernáez S, Muniozguren N, García- Pérez AL. Q Fever Outbreak among Workers at a Waste-Sorting Plant. PLoS One 2015; 10:e0138817. [PMID: 26398249 PMCID: PMC4580639 DOI: 10.1371/journal.pone.0138817] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 09/03/2015] [Indexed: 01/26/2023] Open
Abstract
An outbreak of Q fever occurred in February-April 2014 among workers at a waste-sorting plant in Bilbao (Spain). The outbreak affected 58.5% of investigated employees, 47.2% as confirmed cases (PCR and/or serology) and 11.3% as probable cases (symptoms without laboratory confirmation). Only employees who had no-access to the waste processing areas of the plant were not affected and incidence of infection was significantly higher among workers not using respiratory protection masks. Detection by qPCR of Coxiella burnetii in dust collected from surfaces of the plant facilities confirmed exposure of workers inside the plant. Animal remains sporadically detected among the residues received for waste-sorting were the most probable source of infection. After cleaning and disinfection, all environmental samples tested negative. Personal protection measures were reinforced and made compulsory for the staff and actions were taken to raise farmers' awareness of the biological risk of discharging animal carcasses as urban waste.
Collapse
Affiliation(s)
- Eva Alonso
- Department of Epidemiology, Subdirección de Salud Pública de Bizkaia, Gobierno Vasco, Bilbao, Bizkaia, Spain
| | - Idoia Lopez-Etxaniz
- Department of Epidemiology, OSALAN- Instituto Vasco de Seguridad y Salud Laborales, Barakaldo, Bizkaia, Spain
| | - Ana Hurtado
- Department of Animal Health, NEIKER- Instituto Vasco de Investigación y Desarrollo Agrario, Derio, Bizkaia, Spain
| | - Paloma Liendo
- Department of Microbiology, Hospital Universitario de Basurto, Bilbao, Bizkaia, Spain
| | - Felix Urbaneja
- Department of Epidemiology, OSALAN- Instituto Vasco de Seguridad y Salud Laborales, Barakaldo, Bizkaia, Spain
| | - Inmaculada Aspiritxaga
- Department of Epidemiology, Subdirección de Salud Pública de Bizkaia, Gobierno Vasco, Bilbao, Bizkaia, Spain
| | - Jose Ignacio Olaizola
- Department of Epidemiology, OSALAN- Instituto Vasco de Seguridad y Salud Laborales, Barakaldo, Bizkaia, Spain
| | - Alvaro Piñero
- Department of Animal Health, NEIKER- Instituto Vasco de Investigación y Desarrollo Agrario, Derio, Bizkaia, Spain
| | - Iñaki Arrazola
- Department of Agriculture, Diputación Foral de Bizkaia, Bilbao, Bizkaia, Spain
| | - Jesús F. Barandika
- Department of Animal Health, NEIKER- Instituto Vasco de Investigación y Desarrollo Agrario, Derio, Bizkaia, Spain
| | - Silvia Hernáez
- Department of Microbiology, Hospital Universitario de Basurto, Bilbao, Bizkaia, Spain
| | - Nerea Muniozguren
- Department of Epidemiology, Subdirección de Salud Pública de Bizkaia, Gobierno Vasco, Bilbao, Bizkaia, Spain
| | - Ana L. García- Pérez
- Department of Animal Health, NEIKER- Instituto Vasco de Investigación y Desarrollo Agrario, Derio, Bizkaia, Spain
- * E-mail:
| |
Collapse
|
4
|
Piñero A, Ruiz-Fons F, Hurtado A, Barandika J, Atxaerandio R, García-Pérez A. Changes in the dynamics of Coxiella burnetii infection in dairy cattle: An approach to match field data with the epidemiological cycle of C. burnetii in endemic herds. J Dairy Sci 2014; 97:2718-30. [DOI: 10.3168/jds.2013-7229] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Accepted: 01/22/2014] [Indexed: 11/19/2022]
|
5
|
Palmela C, Badura R, Valadas E. Acute Q fever in Portugal. Epidemiological and clinical features of 32 hospitalized patients. Germs 2012; 2:43-59. [PMID: 24432263 DOI: 10.11599/germs.2012.1013] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Accepted: 05/22/2012] [Indexed: 01/17/2023]
Abstract
INTRODUCTION Q fever is a worldwide zoonosis caused by Coxiella burnetii. The main characteristic of acute Q fever is its clinical polymorphism, usually presenting as a febrile illness with varying degrees of hepatitis and/or pneumonia. Q fever is endemic in Portugal, and it is an obligatory notifiable disease since 1999. However, its epidemiological and clinical characteristics are still incompletely described. METHODS We performed a retrospective study of 32 cases admitted in the Infectious Diseases Department, Santa Maria's University Hospital, from January 2001 to December 2010, in whom acute Q fever was diagnosed by the presence of antibodies to phase II Coxiella burnetii antigens associated with a compatible clinical syndrome. RESULTS Out of the 32 cases recorded, 29 (91%) were male, with a male:female ratio of 9.7:1. Individuals at productive age were mainly affected (88%, n=28, with ages between 25 and 64 years). Clinically, the most common manifestation of acute Q fever was hepatic involvement (84%, n=27), which occurred isolated in 53% (n=17) of the cases. Hepatitis was more severe, presenting with higher values of liver function tests, in patients presenting both pulmonary and hepatic involvement. Additionally, we report one case of myocarditis and another one with neurological involvement. Empiric but appropriate antibiotic therapy was given in 66% (n=21) of the cases. There was a complete recovery in 94% (n=30) of the patients, and one death. We confirmed the sub-notification of this disease in Portugal, with only 47% (n=15) of the cases notified. CONCLUSION In Portugal further studies are needed to confirm our results. From the 32 cases studied, acute Q fever presented more frequently as a febrile disease with hepatic involvement affecting mainly young male individuals. Furthermore, acute Q fever is clearly underdiagnosed and underreported in Portugal, which suggests that an increased awareness of the disease is needed, together with a broader use of serological testing.
Collapse
Affiliation(s)
| | - Robert Badura
- MD, Infectious and Parasitic Diseases University Clinic, Faculty of Medicine, Santa Maria's University Hospital, Lisbon, Portugal
| | - Emília Valadas
- PhD, Infectious and Parasitic Diseases University Clinic, Faculty of Medicine, Santa Maria's University Hospital, Lisbon, Portugal
| |
Collapse
|
6
|
Hogema BM, Slot E, Molier M, Schneeberger PM, Hermans MH, van Hannen EJ, van der Hoek W, Cuijpers HT, Zaaijer HL. Coxiella burnetii infection among blood donors during the 2009 Q-fever outbreak in The Netherlands. Transfusion 2011; 52:144-50. [PMID: 21756265 DOI: 10.1111/j.1537-2995.2011.03250.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND In 2007, 2008, and 2009 outbreaks of Q-fever occurred in The Netherlands with increasing magnitude. The 2009 outbreak with 2354 reported cases is the largest human Q-fever outbreak ever recorded. To assess the extent of infection and the safety of donated blood, we tested local blood donations for presence of Coxiella burnetii antibodies and DNA. STUDY DESIGN AND METHODS Starting May 2009, more than 40,000 serum samples were collected from all consenting blood donors in the areas with high Q-fever incidence. The 1004 samples from the areas with the highest number of reported cases were tested for C. burnetii DNA by polymerase chain reaction; seroprevalence and incidence were determined using enzyme-linked immunosorbent assay and immunofluorescence assays (IFAs) in the subset of 543 donors of whom a follow-up sample was available. RESULTS A total of 6 of 1004 donor samples tested reactive for C. burnetii DNA. Confirmatory testing (IFA) on the index and follow-up samples demonstrated seroconversion in two donors, high-level preexisting antibodies in one donor, and no seroconversion in three donors. Immunoglobulin (Ig)G testing of the 543 serum pairs showed that 66 were reactive in the latest sample, of which 10 represented seroconversions. CONCLUSION In the area with highest incidence during a large Q-fever outbreak, 3 of 1004 blood donations contained C. burnetii DNA (0.3%; 95% confidence interval, 0.1%-1.0%). A total of 66 of 543 (12.2%) donors tested positive for anti-Coxiella IgG. Ten seroconversions were detected, resulting in an incidence of 5.7% per year, which is more than 10-fold higher than the local number of reported clinical cases (0.47% per year).
Collapse
Affiliation(s)
- Boris M Hogema
- Department of Blood-borne Infections, Sanquin Blood Supply Foundation, Amsterdam, The Netherlands.
| | | | | | | | | | | | | | | | | |
Collapse
|