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Devaux CA, Osman IO, Million M, Raoult D. Coxiella burnetii in Dromedary Camels ( Camelus dromedarius): A Possible Threat for Humans and Livestock in North Africa and the Near and Middle East? Front Vet Sci 2020; 7:558481. [PMID: 33251255 PMCID: PMC7674558 DOI: 10.3389/fvets.2020.558481] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 09/28/2020] [Indexed: 01/09/2023] Open
Abstract
The "One Health" concept recognizes that human health is connected to animal health and to the ecosystems. Coxiella burnetii-induced human Q fever is one of the most widespread neglected zoonosis. The main animal reservoirs responsible for C. burnetii transmission to humans are domesticated ruminants, primarily goats, sheep, and cattle. Although studies are still too sparse to draw definitive conclusions, the most recent C. burnetii serosurvey studies conducted in herds and farms in Africa, North Africa, Arabian Peninsula, and Asia highlighted that seroprevalence was strikingly higher in dromedary camels (Camelus dromedarius) than in other ruminants. The C. burnetii seroprevalence in camel herds can reach more than 60% in Egypt, Saudi Arabia, and Sudan, and 70 to 80% in Algeria and Chad, respectively. The highest seroprevalence was in female camels with a previous history of abortion. Moreover, C. burnetii infection was reported in ticks of the Hyalomma dromedarii and Hyalomma impeltatum species collected on camels. Even if dromedary camels represent <3% of the domesticated ruminants in the countries of the Mediterranean basin Southern coast, these animals play a major socioeconomic role for millions of people who live in the arid zones of Africa, Middle East, and Asia. In Chad and Somalia, camels account for about 7 and 21% of domesticated ruminants, respectively. To meet the growing consumers demand of camel meat and milk (>5 million tons/year of both raw and pasteurized milk according to the Food and Agriculture Organization) sustained by a rapid increase of population (growth rate: 2.26-3.76 per year in North Africa), dromedary camel breeding tends to increase from the Maghreb to the Arabic countries. Because of possible long-term persistence of C. burnetii in camel hump adipocytes, this pathogen could represent a threat for herds and breeding farms and ultimately for public health. Because this review highlights a hyperendemia of C. burnetii in dromedary camels, a proper screening of herds and breeding farms for C. burnetii is urgently needed in countries where camel breeding is on the rise. Moreover, the risk of C. burnetii transmission from camel to human should be further evaluated.
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Affiliation(s)
- Christian A. Devaux
- Aix-Marseille Univ, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille, France
- CNRS, Marseille, France
| | - Ikram Omar Osman
- Aix-Marseille Univ, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille, France
- Faculty of Sciences Ben-Ben-M'Sik, University Hassan II, Casablanca, Morocco
| | - Matthieu Million
- Aix-Marseille Univ, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille, France
| | - Didier Raoult
- Aix-Marseille Univ, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille, France
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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.
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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:
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Schneeberger PM, Wintenberger C, van der Hoek W, Stahl JP. Q fever in the Netherlands - 2007-2010: what we learned from the largest outbreak ever. Med Mal Infect 2014; 44:339-53. [PMID: 25108615 DOI: 10.1016/j.medmal.2014.02.006] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2013] [Revised: 02/17/2014] [Accepted: 02/17/2014] [Indexed: 10/24/2022]
Abstract
Q fever is a zoonosis caused by Coxiella burnetii with a presentation ranging from asymptomatic seroconversion to possibly fatal chronic Q fever. The Netherlands faced an exceptionally large outbreak of Q fever from 2007 to 2010: 4026 human cases were notified, which makes it the largest Q fever outbreak ever reported. This outbreak, because of its size, allowed collecting a wide range of information on the natural history of Q fever, as well as on its transmission and clinical presentation. It also posed unprecedented public healthcare problems, especially for the concomitant management of the epizootic by veterinarian authorities and public health authorities, but also for the management of transmission risk related to blood donation. The need for cost efficient measures emerged rapidly because of the great number of infected individuals or at risk of infection, with a need for guidance on follow-up of acute Q fever patients, screening of pregnant women, or implementation of diagnostic algorithms. The acute outbreak was controlled by drastic veterinarian measures but chronic Q fever will remain a problem for the coming years.
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Affiliation(s)
- P M Schneeberger
- Jeroen Bosch Hospital, Department of Medical Microbiology and Infection Control, P.O.BOX 90153, 5200 ME's-Hertogenbosch, The Netherlands
| | - C Wintenberger
- Maladies Infectieuses et Tropicales, CHU de Grenoble, 38043 Grenoble, France.
| | - W van der Hoek
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu [RIVM]), Bilthoven, The Netherlands
| | - J P Stahl
- Maladies Infectieuses et Tropicales, CHU de Grenoble, 38043 Grenoble, France
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Dean AS, Bonfoh B, Kulo AE, Boukaya GA, Amidou M, Hattendorf J, Pilo P, Schelling E. Epidemiology of brucellosis and q Fever in linked human and animal populations in northern togo. PLoS One 2013; 8:e71501. [PMID: 23951177 PMCID: PMC3741174 DOI: 10.1371/journal.pone.0071501] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2013] [Accepted: 06/30/2013] [Indexed: 12/26/2022] Open
Abstract
Background Although brucellosis (Brucella spp.) and Q Fever (Coxiella burnetii) are zoonoses of global importance, very little high quality data are available from West Africa. Methods/Principal Findings A serosurvey was conducted in Togo’s main livestock-raising zone in 2011 in 25 randomly selected villages, including 683 people, 596 cattle, 465 sheep and 221 goats. Additionally, 464 transhumant cattle from Burkina Faso were sampled in 2012. The serological analyses performed were the Rose Bengal Test and ELISA for brucellosis and ELISA and the immunofluorescence assay (IFA) for Q Fever Brucellosis did not appear to pose a major human health problem in the study zone, with only 7 seropositive participants. B. abortus was isolated from 3 bovine hygroma samples, and is likely to be the predominant circulating strain. This may explain the observed seropositivity amongst village cattle (9.2%, 95%CI:4.3–18.6%) and transhumant cattle (7.3%, 95%CI:3.5–14.7%), with an absence of seropositive small ruminants. Exposure of livestock and people to C. burnetii was common, potentially influenced by cultural factors. People of Fulani ethnicity had greater livestock contact and a significantly higher seroprevalence than other ethnic groups (Fulani: 45.5%, 95%CI:37.7–53.6%; non-Fulani: 27.1%, 95%CI:20.6–34.7%). Appropriate diagnostic test cut-off values in endemic settings requires further investigation. Both brucellosis and Q Fever appeared to impact on livestock production. Seropositive cows were more likely to have aborted a foetus during the previous year than seronegative cows, when adjusted for age. This odds was 3.8 times higher (95%CI: 1.2–12.1) for brucellosis and 6.7 times higher (95%CI: 1.3–34.8) for Q Fever. Conclusions This is the first epidemiological study of zoonoses in Togo in linked human and animal populations, providing much needed data for West Africa. Exposure to Brucella and C. burnetii is common but further research is needed into the clinical and economic impact.
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Affiliation(s)
- Anna S. Dean
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Bassirou Bonfoh
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | - Abalo E. Kulo
- Ecole Supérieur d’Agronomie, Université de Lomé, Lomé, Togo
| | - G. Aboudou Boukaya
- Direction de l’Elevage, Ministère de l’Agriculture, de l’Elevage et de la Pêche, Lomé, Togo
| | - Moussa Amidou
- Directional Régional de la Santé - Savanes, Dapaong, Lomé, Togo
| | - Jan Hattendorf
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Paola Pilo
- Institute for Veterinary Bacteriology, University of Bern, Bern, Switzerland
| | - Esther Schelling
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- * E-mail:
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Graham JG, MacDonald LJ, Hussain SK, Sharma UM, Kurten RC, Voth DE. Virulent Coxiella burnetii pathotypes productively infect primary human alveolar macrophages. Cell Microbiol 2013; 15:1012-25. [PMID: 23279051 DOI: 10.1111/cmi.12096] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Revised: 11/27/2012] [Accepted: 12/16/2012] [Indexed: 11/29/2022]
Abstract
The intracellular bacterial pathogen Coxiella burnetii is a category B select agent that causes human Q fever. In vivo, C. burnetii targets alveolar macrophages wherein the pathogen replicates in a lysosome-like parasitophorous vacuole (PV). In vitro, C. burnetii infects a variety of cultured cell lines that have collectively been used to model the pathogen's infectious cycle. However, differences in the cellular response to infection have been observed, and virulent C. burnetii isolate infection of host cells has not been well defined. Because alveolar macrophages are routinely implicated in disease, we established primary human alveolar macrophages (hAMs) as an in vitro model of C. burnetii-host cell interactions. C. burnetii pathotypes, including acute disease and endocarditis isolates, replicated in hAMs, albeit with unique PV properties. Each isolate replicated in large, typical PV and small, non-fused vacuoles, and lipid droplets were present in avirulent C. burnetii PV. Interestingly, a subset of small vacuoles harboured single organisms undergoing degradation. Prototypical PV formation and bacterial growth in hAMs required a functional type IV secretion system, indicating C. burnetii secretes effector proteins that control macrophage functions. Avirulent C. burnetii promoted sustained activation of Akt and Erk1/2 pro-survival kinases and short-termphosphorylation of stress-related p38. Avirulent organisms also triggered a robust, early pro-inflammatory response characterized by increased secretion of TNF-α and IL-6, while virulent isolates elicited substantially reduced secretion of these cytokines. A corresponding increase in pro- and mature IL-1β occurred in hAMs infected with avirulent C. burnetii, while little accumulation was observed following infection with virulent isolates. Finally, treatment of hAMs with IFN-γ controlled intracellular replication, supporting a role for this antibacterial insult in the host response to C. burnetii. Collectively, the current results demonstrate the hAM model is a human disease-relevant platform for defining novel innate immune responses to C. burnetii.
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Affiliation(s)
- Joseph G Graham
- Department of Microbiology and Immunology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
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van Loenhout JA, Paget WJ, Vercoulen JH, Wijkmans CJ, Hautvast JLA, van der Velden K. Assessing the long-term health impact of Q-fever in the Netherlands: a prospective cohort study started in 2007 on the largest documented Q-fever outbreak to date. BMC Infect Dis 2012; 12:280. [PMID: 23110336 PMCID: PMC3511285 DOI: 10.1186/1471-2334-12-280] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Accepted: 10/25/2012] [Indexed: 11/17/2022] Open
Abstract
Background Between 2007 and 2011, the Netherlands experienced the largest documented Q-fever outbreak to date with a total of 4108 notified acute Q-fever patients. Previous studies have indicated that Q-fever patients may suffer from long-lasting health effects, such as fatigue and reduced quality of life. Our study aims to determine the long-term health impact of Q-fever. It will also compare the health status of Q-fever patients with three reference groups: 1) healthy controls, 2) patients with Legionnaires’ disease and 3) persons with a Q-fever infection but a-specific symptoms. Methods/design Two groups of Q-fever patients were included in a prospective cohort study. In the first group the onset of illness was in 2007–2008 and participation was at 12 and 48 months. In the second group the onset of illness was in 2010–2011 and participation was at 6 time intervals, from 3 to 24 months. The reference groups were included at only one time interval. The subjective health status, fatigue status and quality of life of patients will be assessed using two validated quality of life questionnaires. Discussion This study is the largest prospective cohort study to date that focuses on the effects of acute Q-fever. It will determine the long-term (up to 4 years) health impact of Q-fever on patients and compare this to three different reference groups so that we can present a comprehensive assessment of disease progression over time.
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Affiliation(s)
- Joris Af van Loenhout
- Academic Collaborative Centre AMPHI, Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
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