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Raboisson D, Lhermie G, Guatteo R. A New Tool to Assess the Economic Impact of Q Fever on Dairy Cattle Farms. Animals (Basel) 2024; 14:1166. [PMID: 38672314 PMCID: PMC11047405 DOI: 10.3390/ani14081166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 04/09/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
To support farmers in their decisions related to Q fever, a dedicated economic assessment tool is developed. The present work describes the calculator, its economic rationale, and the supporting assumptions. The calculator integrates a yearly compartmental model to represent population dynamism and the main interactions between disorders linked to Q fever, especially reproductive disorders (abortion, retained foetal membranes, purulent vaginal discharge and endometritis, extra services, and calving-conception delays). The effects of the nontangible cost of the disease on human health, the welfare of the animals, and the workload of farmers were not integrated into the model. The model shows high-level sensitivity to the prevalence of Q fever in the herd prevaccination and to the costs of abortion and extra days of calving-conception intervals. Breakeven points, i.e., cost values that allow us to achieve positive vaccination benefits, are also reported. For herds with moderate or high prevalence rates of Q fever prevaccination (>30%), a vaccination benefit is observed. The vaccine should be considered a type of insurance in herds with low prevalence rates of Q fever prevaccination (≤20%). The calculator was developed to aid decision-making at the farm level, and no conclusion can be extrapolated as a generic trend based on the present work.
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Affiliation(s)
- Didier Raboisson
- CIRAD, UMR ASTRE, 34398 Montpellier, France
- ASTRE, CIRAD, INRAE, Univ Montpellier, 34090 Montpellier, France
- ENVT, Université de Toulouse, 31400 Toulouse, France
| | - Guillaume Lhermie
- CIRAD, UMR ASTRE, 34398 Montpellier, France
- ASTRE, CIRAD, INRAE, Univ Montpellier, 34090 Montpellier, France
- ENVT, Université de Toulouse, 31400 Toulouse, France
- Department of Production Animal Health, University of Calgary, Calgary, AB T2N 4Z6, Canada
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Reukers DFM, de Boer PT, Loohuis AO, Wever PC, Bleeker-Rovers CP, van Gageldonk-Lafeber AB, van der Hoek W, Timen A. Targeted Screening for Chronic Q Fever, the Netherlands. Emerg Infect Dis 2022; 28:1403-1409. [PMID: 35731163 PMCID: PMC9239892 DOI: 10.3201/eid2807.212273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Early detection of and treatment for chronic Q fever might prevent potentially life-threatening complications. We performed a chronic Q fever screening program in general practitioner practices in the Netherlands 10 years after a large Q fever outbreak. Thirteen general practitioner practices located in outbreak areas selected 3,419 patients who had specific underlying medical conditions, of whom 1,642 (48%) participated. Immunofluorescence assay of serum showed that 289 (18%) of 1,642 participants had a previous Coxiella burnetii infection (IgG II titer >1:64), and 9 patients were suspected of having chronic Q fever (IgG I y titer >1:512). After medical evaluation, 4 of those patients received a chronic Q fever diagnosis. The cost of screening was higher than estimated earlier, but the program was still cost-effective in certain high risk groups. Years after a large Q fever outbreak, targeted screening still detected patients with chronic Q fever and is estimated to be cost-effective.
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Jeske R, Dangel L, Sauerbrey L, Frangoulidis D, Teras LR, Fischer SF, Waterboer T. Development of High-Throughput Multiplex Serology to Detect Serum Antibodies against Coxiella burnetii. Microorganisms 2021; 9:microorganisms9112373. [PMID: 34835498 PMCID: PMC8623512 DOI: 10.3390/microorganisms9112373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/10/2021] [Accepted: 11/11/2021] [Indexed: 11/16/2022] Open
Abstract
The causative agent of Q fever, the bacterium Coxiella burnetii (C. burnetii), has gained increasing interest due to outbreak events and reports about it being a potential risk factor for the development of lymphomas. In order to conduct large-scale studies for population monitoring and to investigate possible associations more closely, accurate and cost-effective high-throughput assays are highly desired. To address this need, nine C. burnetii proteins were expressed as recombinant antigens for multiplex serology. This technique enables the quantitative high-throughput detection of antibodies to multiple antigens simultaneously in a single reaction. Based on a reference group of 76 seropositive and 91 seronegative sera, three antigens were able to detect C. burnetii infections. Com1, GroEL, and DnaK achieved specificities of 93%, 69%, and 77% and sensitivities of 64%, 72%, and 47%, respectively. Double positivity to Com1 and GroEL led to a combined specificity of 90% and a sensitivity of 71%. In a subgroup of seropositives with an increased risk for chronic Q fever, the double positivity to these markers reached a specificity of 90% and a sensitivity of 86%. Multiplex serology enables the detection of antibodies against C. burnetii and appears well-suited to investigate associations between C. burnetii infections and the clinical manifestations in large-scale studies.
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Affiliation(s)
- Rima Jeske
- Division of Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (L.S.); (T.W.)
- Faculty of Biosciences, Heidelberg University, 69120 Heidelberg, Germany
- Correspondence:
| | - Larissa Dangel
- German National Consiliary Laboratory of Coxiella burnetii, 70191 Stuttgart, Germany; (L.D.); (S.F.F.)
- State Health Office Baden-Württemberg, 70565 Stuttgart, Germany
| | - Leander Sauerbrey
- Division of Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (L.S.); (T.W.)
- Faculty of Biosciences, Heidelberg University, 69120 Heidelberg, Germany
| | - Dimitrios Frangoulidis
- Bundeswehr Institute of Microbiology, 80937 Munich, Germany;
- Bundeswehr Medical Service Headquarters VI-2, Medical Intelligence & Information (MI2), 80637 Munich, Germany
| | - Lauren R. Teras
- Department of Population Science, American Cancer Society, Atlanta, GA 30303-1002, USA;
| | - Silke F. Fischer
- German National Consiliary Laboratory of Coxiella burnetii, 70191 Stuttgart, Germany; (L.D.); (S.F.F.)
- State Health Office Baden-Württemberg, 70565 Stuttgart, Germany
| | - Tim Waterboer
- Division of Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (L.S.); (T.W.)
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Buijs SB, Bleeker-Rovers CP, van Roeden SE, Kampschreur LM, Hoepelman AIM, Wever PC, Oosterheert JJ. Still new chronic Q fever cases diagnosed eight years after a large Q fever outbreak. Clin Infect Dis 2021; 73:1476-1483. [PMID: 34028546 DOI: 10.1093/cid/ciab476] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Chronic Q fever usually develops within two years after primary infection with Coxiella burnetii. We determined the interval between acute Q fever and diagnosis of chronic infection, assessed what factors contribute to a longer interval, and evaluated the long-term follow-up. METHODS From 2007-2018, patients with chronic Q fever were included from 45 participating hospitals. The interval between acute and chronic infection was calculated in patients with a known day of first symptoms and/or serological confirmation of acute Q fever. Chronic Q fever-related complications and mortality were assessed by two investigators based on predefined criteria. RESULTS In total, 313 (60.3%) proven, 81 (15.6%) probable and 125 (24.1%) possible chronic Q fever patients were identified. The date of acute Q fever was known in 200 patients: in 45 (22.5%) the interval was longer than two years with the longest observed interval being 9.2 years. Patients in whom serological follow-up was performed after acute Q fever were diagnosed less often after this two-year interval (OR 0.26, 95% CI 0.12-0.54). Chronic Q fever-related complications occurred in 216 patients (41.6%). Chronic Q fever-related mortality occurred in 83 (26.5%) of proven and 3 (3.7%) of probable chronic Q fever patients. CONCLUSIONS Chronic Q fever is still being diagnosed and mortality keeps occurring eight years after a large outbreak. Intervals between acute Q fever and diagnosis of chronic infection can reach over 9 years. We urge physicians to perform microbiological testing for chronic Q fever even many years after an outbreak or acute Q fever disease.
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Affiliation(s)
- Sheila B Buijs
- Department of Internal Medicine and Infectious Diseases, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Chantal P Bleeker-Rovers
- Department of Internal Medicine and Infectious Diseases, Radboud Expertise Centre for Q Fever, Radboud university medical center, Nijmegen, the Netherlands
| | - Sonja E van Roeden
- Department of Internal Medicine and Infectious Diseases, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Linda M Kampschreur
- Department of Internal Medicine, Medical Center Leeuwarden, Leeuwarden, the Netherlands
| | - Andy I M Hoepelman
- Department of Internal Medicine and Infectious Diseases, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Peter C Wever
- Department of Medical Microbiology and Infection Control, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands
| | - Jan Jelrik Oosterheert
- Department of Internal Medicine and Infectious Diseases, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands
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Buijs SB, Stuart SK, Oosterheert JJ, Karhof S, Hoepelman AIM, Renders NHM, van Petersen AS, Bleeker-Rovers CP, Wever PC, Koning OHJ. Long-term serological follow-up after primary Coxiella burnetii infection in patients with vascular risk factors for chronic Q fever. Eur J Clin Microbiol Infect Dis 2021; 40:1569-1572. [PMID: 33566203 PMCID: PMC8205920 DOI: 10.1007/s10096-021-04179-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 01/26/2021] [Indexed: 12/25/2022]
Abstract
We evaluated the long-term serological follow-up of patients with vascular risk factors for chronic Q fever that were previously Coxiella burnetii seropositive. C. burnetii phase I IgG titers were reevaluated in patients that gave informed consent or retrospectively collected in patients already deceased or lost to follow-up. Of 107 patients, 25 (23.4%) became seronegative, 77 (72.0%) retained a profile of past resolved Q fever infection, and five (4.7%) developed chronic Q fever. We urge clinicians to stay vigilant for chronic Q fever beyond two years after primary infection and perform serological testing based on clinical presentation.
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Affiliation(s)
- Sheila B Buijs
- Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
| | - Sanne K Stuart
- Department of Surgery, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
| | - Jan Jelrik Oosterheert
- Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Steffi Karhof
- Department of Surgery, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
| | - Andy I M Hoepelman
- Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Nicole H M Renders
- Department of Medical Microbiology and Infection Control, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
| | | | - Chantal P Bleeker-Rovers
- Department of Internal Medicine and Infectious Diseases, Radboud Expert Centre for Q Fever, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Peter C Wever
- Department of Medical Microbiology and Infection Control, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
| | - Olivier H J Koning
- Department of Surgery, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
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