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Pustahija T, Medić S, Vuković V, Lozanov-Crvenković Z, Patić A, Štrbac M, Jovanović V, Dimitrijević D, Milinković M, Kosanović ML, Maltezou HC, Mellou K, Musa S, Bakić M, Medenica S, Sokolovska N, Rodić NV, Devrnja M, Ristić M, Petrović V. Epidemiology of Q Fever in Southeast Europe for a 20-Year Period (2002-2021). J Epidemiol Glob Health 2024; 14:1305-1318. [PMID: 39230863 DOI: 10.1007/s44197-024-00288-4] [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: 07/11/2024] [Accepted: 08/14/2024] [Indexed: 09/05/2024] Open
Abstract
This study aimed to assess epidemiological trends of Q fever in six countries of Southeast Europe by analysing surveillance data for 2002-2021 period. In this descriptive analysis, we collected and analysed data on confirmed human Q fever cases, obtained from the national Public Health Institutes of Bosnia and Herzegovina, Croatia, Greece, Montenegro, North Macedonia and Serbia. Overall, 2714 Q fever cases were registered during the 20-year period. The crude average annual notification rate was 0.82 (± 2.06) (95% CI: 0.47-1.16) per 100,000 inhabitants, ranged from 0.06 (± 0.04) (95% CI: 0.04-0.08) /100,000 in Greece to 2.78 (± 4.80) (95% CI: 0.53-5.02) /100,000 in the Republic of Srpska (entity of Bosnia and Herzegovina). Significant declining trends of Q fever age standardized rates were registered in Croatia, the Federation of Bosnia and Herzegovina, North Macedonia and Serbia, with an average annual change of -30.15%; -17.13%; -28.33% and - 24.77%, respectively. An unequal spatial distribution was observed. The highest average age-specific notification rate was reported in the 20-59 age group (0.84 (± 0.40) (95% CI: 0.65-1.02) /100,000). Most cases (53.69%) were reported during the spring. Q fever remains a significant public health threat in this part of Europe. The findings of this study revealed the endemic maintenance of this disease in the including countries, with large regional and subnational disparities in notification rates. A downward trend was found in Q fever notification rates across the study countries with the average notification rate higher than in the EU/EEA, during the same period.
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Affiliation(s)
- Tatjana Pustahija
- Department of Epidemiology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
- Institute of Public Health of Vojvodina, Novi Sad, Serbia.
| | - Snežana Medić
- Department of Epidemiology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- Institute of Public Health of Vojvodina, Novi Sad, Serbia
| | - Vladimir Vuković
- Department of Epidemiology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- Institute of Public Health of Vojvodina, Novi Sad, Serbia
| | | | - Aleksandra Patić
- Institute of Public Health of Vojvodina, Novi Sad, Serbia
- Department of Microbiology with Parasitology and Immunology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Mirjana Štrbac
- Institute of Public Health of Vojvodina, Novi Sad, Serbia
| | | | | | | | | | - Helena C Maltezou
- Directorate for Research, Studies and Documentation, National Public Health Organization, Athens, Greece
| | - Kassiani Mellou
- Department of Epidemiological Surveillance and Interventions, Hellenic Centre for Diseases Control and Prevention, Athens, Greece
| | - Sanjin Musa
- Department of Epidemiology, Institute for Public Health of the Federation of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina
- Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina
| | - Marijan Bakić
- Institute of Public Health of Montenegro, Podgorica, Montenegro
| | - Sanja Medenica
- Institute of Public Health of Montenegro, Podgorica, Montenegro
| | - Nikolina Sokolovska
- Epidemiology with Unit for Pest Control and Laboratory of Entomology, Center for Public Health, Skopje, North, Macedonia
| | - Nina Vukmir Rodić
- Public Health Institute of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina
- Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina
| | - Milica Devrnja
- Institute of Public Health of Vojvodina, Novi Sad, Serbia
| | - Mioljub Ristić
- Department of Epidemiology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- Institute of Public Health of Vojvodina, Novi Sad, Serbia
| | - Vladimir Petrović
- Department of Epidemiology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- Institute of Public Health of Vojvodina, Novi Sad, Serbia
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El Zein S, Challener DW, Ranganath N, Khodadadi RB, Theel ES, Abu Saleh OM. Acute Coxiella burnetii Infection: A 10-Year Clinical Experience at a Tertiary Care Center in the United States. Open Forum Infect Dis 2024; 11:ofae277. [PMID: 38868311 PMCID: PMC11167673 DOI: 10.1093/ofid/ofae277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 05/08/2024] [Indexed: 06/14/2024] Open
Abstract
Background Identifying and treating patients with acute Q fever who are at an increased risk of progressing to persistent disease is crucial for preventing future complications. In this study, we share our decade-long clinical experience with acute Q fever, highlighting the challenges that clinicians encounter from making an initial diagnosis and performing risk stratification to determining the appropriate prophylaxis regimen and duration. Methods We retrieved records of adult Mayo Clinic patients (≥18 years) with positive Coxiella burnetii serology results between 1 January 2012 and 31 March 2022. Patients with Q fever anti-phase II immunoglobulin G ≥1:256 by indirect immunofluorescence were further analyzed. Results Thirty-one patients were included. Their median age was 58 years (IQR, 50-64), and the majority were men (84%). Acute hepatitis (29%), flu-like illness (25.8%), and pneumonia (16%) were the most common presentations. Thirteen patients (42%) received antibiotic prophylaxis to prevent disease progression, with significant variation in the indications and duration across physicians. The combination of doxycycline and hydroxychloroquine was the preferred regimen. Prophylaxis was administered for a median 333 days (IQR, 168-414). Four patients (13%) progressed to Q fever native valve infective endocarditis, with elevated anticardiolipin immunoglobulin G levels being the sole risk factor in 2 cases. The small sample size precluded drawing conclusions on the impact of prophylaxis in preventing disease progression. Conclusions Management of acute Q fever is complicated by the lack of comprehensive clinical guidelines leading to varied clinical practices. There is a critical need for randomized trials to establish robust evidence-based protocols for management.
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Affiliation(s)
- Said El Zein
- Division of Public Health, Infectious Diseases and Occupational Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Doug W Challener
- Division of Public Health, Infectious Diseases and Occupational Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Nischal Ranganath
- Division of Public Health, Infectious Diseases and Occupational Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Ryan B Khodadadi
- Division of Public Health, Infectious Diseases and Occupational Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Elitza S Theel
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Omar M Abu Saleh
- Division of Public Health, Infectious Diseases and Occupational Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
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Kraft DC, Naeem M, Mansour J, Beal MA, Bailey TC, Bhalla S. Body Imaging of Bacterial and Parasitic Zoonoses: Keys to Diagnosis. Radiographics 2023; 43:e220092. [PMID: 36729948 DOI: 10.1148/rg.220092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Zoonotic infections, which are transmitted from animals to humans, have been a substantial source of human disease since antiquity. As the human population continues to grow and human influence on the planet expands, humans frequently encounter both domestic and wild animals. This has only increased as deforestation, urbanization, agriculture, habitat fragmentation, outdoor recreation, and international travel evolve in modern society, all of which have resulted in the emergence and reemergence of zoonotic infections. Zoonotic infections pose a diagnostic challenge because of their nonspecific clinical manifestations and the need for specialized testing procedures to confirm these diagnoses. Affected patients often undergo imaging during their evaluation, and a radiologist familiar with the specific and often subtle imaging patterns of these infections can add important clinical value. The authors review the multimodality thoracic, abdominal, and musculoskeletal imaging findings of zoonotic bacterial (eg, Bartonella henselae, Pasteurella multocida, Francisella tularensis, Coxiella burnetii, and Brucella species), spirochetal (eg, Leptospira species), and parasitic (eg, Echinococcus, Paragonimus, Toxocara, and Dirofilaria species) infections that are among the more commonly encountered zoonoses in the United States. Relevant clinical, epidemiologic, and pathophysiologic clues such as exposure history, occupational risk factors, and organism life cycles are also reviewed. Although many of the imaging findings of zoonotic infections overlap with those of nonzoonotic infections, granulomatous diseases, and malignancies, radiologists' familiarity with the imaging patterns can aid in the differential diagnosis in a patient with a suspected or unsuspected zoonotic infection. © RSNA, 2023 Quiz questions for this article are available through the Online Learning Center.
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Affiliation(s)
- David C Kraft
- From the Department of Radiology, Baylor University Medical Center, 3500 Gaston Ave, Dallas, Texas 75246-2017 (D.C.K.); Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Ga (M.N.); Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Ind (J.M.); and Mallinckrodt Institute of Radiology (M.A.B., S.B.) and Department of Infectious Diseases (T.C.B.), Washington University School of Medicine, St Louis, Mo
| | - Muhammad Naeem
- From the Department of Radiology, Baylor University Medical Center, 3500 Gaston Ave, Dallas, Texas 75246-2017 (D.C.K.); Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Ga (M.N.); Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Ind (J.M.); and Mallinckrodt Institute of Radiology (M.A.B., S.B.) and Department of Infectious Diseases (T.C.B.), Washington University School of Medicine, St Louis, Mo
| | - Joseph Mansour
- From the Department of Radiology, Baylor University Medical Center, 3500 Gaston Ave, Dallas, Texas 75246-2017 (D.C.K.); Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Ga (M.N.); Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Ind (J.M.); and Mallinckrodt Institute of Radiology (M.A.B., S.B.) and Department of Infectious Diseases (T.C.B.), Washington University School of Medicine, St Louis, Mo
| | - Michael A Beal
- From the Department of Radiology, Baylor University Medical Center, 3500 Gaston Ave, Dallas, Texas 75246-2017 (D.C.K.); Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Ga (M.N.); Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Ind (J.M.); and Mallinckrodt Institute of Radiology (M.A.B., S.B.) and Department of Infectious Diseases (T.C.B.), Washington University School of Medicine, St Louis, Mo
| | - Thomas C Bailey
- From the Department of Radiology, Baylor University Medical Center, 3500 Gaston Ave, Dallas, Texas 75246-2017 (D.C.K.); Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Ga (M.N.); Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Ind (J.M.); and Mallinckrodt Institute of Radiology (M.A.B., S.B.) and Department of Infectious Diseases (T.C.B.), Washington University School of Medicine, St Louis, Mo
| | - Sanjeev Bhalla
- From the Department of Radiology, Baylor University Medical Center, 3500 Gaston Ave, Dallas, Texas 75246-2017 (D.C.K.); Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Ga (M.N.); Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Ind (J.M.); and Mallinckrodt Institute of Radiology (M.A.B., S.B.) and Department of Infectious Diseases (T.C.B.), Washington University School of Medicine, St Louis, Mo
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Brophy M, Walker KR, Adamson JE, Ravenscraft A. Tropical and Temperate Lineages of Rhipicephalus sanguineus s.l. Ticks (Acari: Ixodidae) Host Different Strains of Coxiella-like Endosymbionts. JOURNAL OF MEDICAL ENTOMOLOGY 2022; 59:2022-2029. [PMID: 36124671 DOI: 10.1093/jme/tjac132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Indexed: 06/15/2023]
Abstract
Nonpathogenic bacteria likely play important roles in the biology and vector competence of ticks and other arthropods. Coxiella, a gram-negative gammaproteobacterium, is one of the most commonly reported maternally inherited endosymbionts in ticks and has been associated with over 40 tick species. Species-specific Coxiella-like endosymbionts (CLEs) have been reported in the brown dog tick, Rhipicephalus sanguineus sensu lato (Acari: Ixodidae), throughout the world, while recent research suggests low Coxiella diversity among tick species. We investigated CLE diversity among R. sanguineus s.l. ticks across Arizona. We detected 37 recurrent sequence variants (SVs) of the symbiont, indicating greater diversity in these symbiotic bacteria than previously reported. However, two SVs accounted for the vast majority of 16S rRNA amplicon reads. These two dominant CLEs were both closely related to Candidatus C. mudrowiae, an identified symbiont of Rhipicephalus turanicus ticks. One strain strongly associated with the tropical lineage of R. sanguineus s.l. while the other was found almost exclusively in the temperate lineage, supporting the conclusion that CLEs are primarily vertically transmitted. However, occasional mismatches between tick lineage and symbiont SV indicate that horizontal symbiont transfer may occur, perhaps via cofeeding of ticks from different lineages on the same dog. This study advances our understanding of CLE diversity in Rh. sanguineus s.l.
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Affiliation(s)
- Maureen Brophy
- Department of Entomology, The University of Arizona, Tucson, AZ 85721, USA
| | - Kathleen R Walker
- Department of Entomology, The University of Arizona, Tucson, AZ 85721, USA
| | - Johnathan E Adamson
- Department of Biology, The University of Texas Arlington, Arlington, TX 76019, USA
| | - Alison Ravenscraft
- Department of Biology, The University of Texas Arlington, Arlington, TX 76019, USA
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Sluder AE, Raju Paul S, Moise L, Dold C, Richard G, Silva-Reyes L, Baeten LA, Scholzen A, Reeves PM, Pollard AJ, Garritsen A, Bowen RA, De Groot AS, Rollier C, Poznansky MC. Evaluation of a Human T Cell-Targeted Multi-Epitope Vaccine for Q Fever in Animal Models of Coxiella burnetii Immunity. Front Immunol 2022; 13:901372. [PMID: 35651616 PMCID: PMC9149306 DOI: 10.3389/fimmu.2022.901372] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 04/20/2022] [Indexed: 11/24/2022] Open
Abstract
T cell-mediated immunity plays a central role in the control and clearance of intracellular Coxiella burnetii infection, which can cause Q fever. Therefore, we aimed to develop a novel T cell-targeted vaccine that induces pathogen-specific cell-mediated immunity to protect against Q fever in humans while avoiding the reactogenicity of the current inactivated whole cell vaccine. Human HLA class II T cell epitopes from C. burnetii were previously identified and selected by immunoinformatic predictions of HLA binding, conservation in multiple C. burnetii isolates, and low potential for cross-reactivity with the human proteome or microbiome. Epitopes were selected for vaccine inclusion based on long-lived human T cell recall responses to corresponding peptides in individuals that had been naturally exposed to the bacterium during a 2007-2010 Q fever outbreak in the Netherlands. Multiple viral vector-based candidate vaccines were generated that express concatemers of selected epitope sequences arranged to minimize potential junctional neo-epitopes. The vaccine candidates caused no antigen-specific reactogenicity in a sensitized guinea pig model. A subset of the vaccine epitope peptides elicited antigenic recall responses in splenocytes from C57BL/6 mice previously infected with C. burnetii. However, immunogenicity of the vaccine candidates in C57BL/6 mice was dominated by a single epitope and this was insufficient to confer protection against an infection challenge, highlighting the limitations of assessing human-targeted vaccine candidates in murine models. The viral vector-based vaccine candidates induced antigen-specific T cell responses to a broader array of epitopes in cynomolgus macaques, establishing a foundation for future vaccine efficacy studies in this large animal model of C. burnetii infection.
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Affiliation(s)
- Ann E Sluder
- Vaccine and Immunotherapy Center, Massachusetts General Hospital, Boston, MA, United States
| | - Susan Raju Paul
- Vaccine and Immunotherapy Center, Massachusetts General Hospital, Boston, MA, United States
| | | | - Christina Dold
- Oxford Vaccine Group, Department of Paediatrics, The National Institute for Health Research (NIHR) Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
| | | | - Laura Silva-Reyes
- Oxford Vaccine Group, Department of Paediatrics, The National Institute for Health Research (NIHR) Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
| | - Laurie A Baeten
- Department of Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
| | | | - Patrick M Reeves
- Vaccine and Immunotherapy Center, Massachusetts General Hospital, Boston, MA, United States
| | - Andrew J Pollard
- Oxford Vaccine Group, Department of Paediatrics, The National Institute for Health Research (NIHR) Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
| | | | - Richard A Bowen
- Department of Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
| | | | - Christine Rollier
- Oxford Vaccine Group, Department of Paediatrics, The National Institute for Health Research (NIHR) Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
| | - Mark C Poznansky
- Vaccine and Immunotherapy Center, Massachusetts General Hospital, Boston, MA, United States
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High endemicity of Q fever in French Guiana: A cross sectional study (2007–2017). PLoS Negl Trop Dis 2022; 16:e0010349. [PMID: 35584144 PMCID: PMC9197051 DOI: 10.1371/journal.pntd.0010349] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 06/14/2022] [Accepted: 03/22/2022] [Indexed: 11/19/2022] Open
Abstract
Q fever (QF) is a zoonosis caused by Coxiella burnetii (Cb). French Guiana (FG) had a high incidence but no data have been published since 2006. The objective of this study was to update the incidence and epidemiological data on QF in FG. A retrospective study of all FG Q fever serodiagnosis between 2007 and 2017 was carried out. Among the 695 patients included, the M/F sex-ratio was 2.0 and the median age of 45.3 years (IQR 33.7–56.3). The annual QF incidence rate was 27.4 cases (95%CI: 7.1–47.7) per 100,000 inhabitants ranging from 5.2 in 2007 to 40.4 in 2010. Risk factors associated with Q fever compared to general population were male gender, being born in mainland France, an age between 30 to 59 years-old and a residence in Cayenne and surroundings. The incidence of QF in FG remains high and stable and the highest in the world. We present here a study showing the exceptional nature of the incidence of Q fever in French Guiana. Indeed, this zoonosis due to the bacterium Coxiella burnetii, is a real public health problem in French Guiana, a French ultra-marine territory located in the North East of South America. The study found an endemic state with a stable incidence between 2010 and 2017 around 25–30 cases per 100,000 inhabitants per year. More than 90% of cases are concentrated in the territory’s capital, Cayenne, and its surroundings. The risk factors for Q fever are being male, being between 30 and 59 years old, which are risk factors found elsewhere, but also living in Cayenne and its surroundings and being born in mainland France or Europe.
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Cherry CC, Nichols Heitman K, Bestul NC, Kersh GJ. Acute and chronic Q fever national surveillance - United States, 2008-2017. Zoonoses Public Health 2021; 69:73-82. [PMID: 34626097 DOI: 10.1111/zph.12896] [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: 04/26/2021] [Revised: 09/21/2021] [Accepted: 09/24/2021] [Indexed: 11/30/2022]
Abstract
Q fever is a zoonotic disease caused by the bacterium Coxiella burnetii and can manifest in an acute or chronic form. Many persons with acute Q fever are asymptomatic, but some develop a febrile illness, pneumonia or hepatitis. Chronic infections are rare and occur in less than 5% of persons exposed. Forms of chronic Q fever include endocarditis, infection of vascular grafts or aneurysms, osteomyelitis and osteoarthritis. Acute and chronic Q fever are nationally notifiable diseases, and presented here are the incidence, demographics and distribution of acute and chronic Q fever in the United States during 2008-2017. We summarized passive surveillance data from the Centers for Disease Control and Prevention's (CDC) National Notifiable Diseases Surveillance System (NNDSS) and supplemental case report forms (CRFs). Health departments reported 1,109 cases of acute Q fever and 272 chronic Q fever cases to NNDSS during this period. The 10-year average annual incidence for acute Q fever was 0.36 cases per million persons, and the average annual incidence for chronic Q fever was 0.09. Males accounted for nearly 75% of both acute and chronic Q fever cases. Average annual incidence was highest among persons aged 60-69 years for both acute and chronic Q fever (0.70 cases per million persons and 0.25, respectively). As reported through CRFs, many Q fever cases did not have a known exposure to C. burnetii; 60% (n = 380) of acute Q fever cases did not report exposure to animals in the 2 months before symptom onset. Almost 90% (n = 558) did not report exposure to unpasteurized milk. Only 40% (n = 247) of persons with reported Q fever were employed in high-risk occupations. Even though Q fever is a rare disease in the United States, incidence doubled from 2008 to 2017.
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Affiliation(s)
- Cara C Cherry
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kristen Nichols Heitman
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Nicolette C Bestul
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, Tennessee, USA
| | - Gilbert J Kersh
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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8
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Priestley RA, Smith CB, Miller HK, Kersh GJ. Coxiella burnetii infections in mice: Immunological responses to contemporary genotypes found in the US. Virulence 2021; 12:2461-2473. [PMID: 34516359 PMCID: PMC8451504 DOI: 10.1080/21505594.2021.1975527] [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] [Indexed: 10/24/2022] Open
Abstract
Coxiella burnetii is an obligate intracellular bacterium that causes the human disease Q fever, which can manifest as an acute flu-like illness or a long-term chronic illness, such as endocarditis. Three genotypes (ST8, ST16, and ST20) of Coxiella burnetii are commonly found in the contemporary US and are associated with specific animal hosts. Although all three genotypes have been isolated from humans with Q fever, studies comparing virulence between C. burnetii sequence types have been rare. Here, groups of mice were infected via aerosol inoculation with isolates derived from cow's milk, environmental, animal, and human samples. Mice were monitored for weight loss and blood samples were takenweekly. Animals were euthanized at 2- and 12-weeks post-infection, and bacterial burden was determined for tissues by real-time PCR. The levels of anti-Coxiella antibodies and selected inflammatory cytokines were determined for serum samples. Weight loss and splenomegaly were observed in mice infected with ST20 and ST16 isolates but were absent in the mice infected with ST8 isolates. Bacterial concentrations in the tissues were lower in the ST8 isolates at 2 weeks post-infection relative to all other isolates. ST16 and ST20 isolates induced robust antibody and cytokine responses, while ST8 isolates produced significantly lower anti-C. burnetii titers early in the infection but saw increased titers in some animals several weeks post-infection. The data suggest that the ST8 isolates are less virulent in this mouse model, as they produce less robust antibody responses that are slow to develop, relative to the ST16 and ST20 isolates.
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Affiliation(s)
- Rachael A Priestley
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, United States
| | - Cody B Smith
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, United States
| | - Halie K Miller
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, United States
| | - Gilbert J Kersh
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, United States
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Behzadi MY, Mostafavi E, Rohani M, Mohamadi A, Ahmadinezhad M, Moazzezy N, Shams-Ghahfarokhi M, Razzaghi-Abyaneh M. A Review on Important Zoonotic Bacterial Tick-Borne Diseases in the Eastern Mediterranean Region. J Arthropod Borne Dis 2021; 15:265-277. [PMID: 36578998 PMCID: PMC9759441 DOI: 10.18502/jad.v15i3.9814] [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: 05/10/2021] [Accepted: 08/03/2021] [Indexed: 12/31/2022] Open
Abstract
Background Zoonotic diseases as health concerns worldwide account for more than half of the emerging infectious diseases. Arachnids are powerful vectors to transmit several diseases to humans. Additionally, these emerging zoonotic diseases have been a considerable health threat in the Eastern Mediterranean Region of the WHO (EMRO) due to the large population living close to farms and international trade with nearby countries. Methods This review study is based on the reported three tick-borne diseases, Lyme disease, Tularemia, and Q fever, from Iran and other EMRO countries. To this end, we searched PubMed central, ISI web of Science, and Google with the related keywords in English at any time. The reported data are then sorted by countries for each disease. Results According to the published data, 15 countries in the region have one/more emerging infectious diseases. Q fever has been the most frequent infection in EMRO countries, while Lyme was less recorded. Furthermore, Iran is among the countries with documented history of all three investigated diseases. Conclusion Tick-borne disease is popular among EMRO countries, indicating that they have natural conditions for infections in animals and humans. It appears necessary to develop a disease management strategy and control programs against tick-borne diseases (TBDs). Moreover, the disease-resistant animal could be bred instead of susceptible livestock. Therefore, research studies to control TBDs should be regarded as a top priority plan.
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Affiliation(s)
- Manijeh Yousefi Behzadi
- Department of Epidemiology and Biostatics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
- National Reference Laboratory of Plague, Tularemia and Q fever, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Akanlu, Kabudar-Ahang, Hamadan, Iran
| | - Ehsan Mostafavi
- Department of Epidemiology and Biostatics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
- National Reference Laboratory of Plague, Tularemia and Q fever, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Akanlu, Kabudar-Ahang, Hamadan, Iran
| | - Mahdi Rohani
- Department of Microbiology, Pasteur Institute of Iran, Tehran, Iran
| | - Ali Mohamadi
- Department of Epidemiology and Biostatics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
| | - Mozhgan Ahmadinezhad
- Department of Epidemiology and Biostatics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
| | - Neda Moazzezy
- Molecular Biology Department, Pasteur Institute of Iran, Tehran, Iran
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Guzman RM, Howard ZP, Liu Z, Oliveira RD, Massa AT, Omsland A, White SN, Goodman AG. Natural genetic variation in Drosophila melanogaster reveals genes associated with Coxiella burnetii infection. Genetics 2021; 217:6117219. [PMID: 33789347 PMCID: PMC8045698 DOI: 10.1093/genetics/iyab005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 01/07/2021] [Indexed: 12/16/2022] Open
Abstract
The gram-negative bacterium Coxiella burnetii is the causative agent of Query (Q) fever in humans and coxiellosis in livestock. Host genetics are associated with C. burnetii pathogenesis both in humans and animals; however, it remains unknown if specific genes are associated with severity of infection. We employed the Drosophila Genetics Reference Panel to perform a genome-wide association study to identify host genetic variants that affect host survival to C. burnetii infection. The genome-wide association study identified 64 unique variants (P < 10−5) associated with 25 candidate genes. We examined the role each candidate gene contributes to host survival during C. burnetii infection using flies carrying a null mutation or RNAi knockdown of each candidate. We validated 15 of the 25 candidate genes using at least one method. This is the first report establishing involvement of many of these genes or their homologs with C. burnetii susceptibility in any system. Among the validated genes, FER and tara play roles in the JAK/STAT, JNK, and decapentaplegic/TGF-β signaling pathways which are components of known innate immune responses to C. burnetii infection. CG42673 and DIP-ε play roles in bacterial infection and synaptic signaling but have no previous association with C. burnetii pathogenesis. Furthermore, since the mammalian ortholog of CG13404 (PLGRKT) is an important regulator of macrophage function, CG13404 could play a role in host susceptibility to C. burnetii through hemocyte regulation. These insights provide a foundation for further investigation regarding the genetics of C. burnetii susceptibility across a wide variety of hosts.
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Affiliation(s)
- Rosa M Guzman
- School of Molecular Biosciences, College of Veterinary Medicine, Washington State University, Pullman, WA 99164, USA
| | - Zachary P Howard
- School of Molecular Biosciences, College of Veterinary Medicine, Washington State University, Pullman, WA 99164, USA
| | - Ziying Liu
- School of Molecular Biosciences, College of Veterinary Medicine, Washington State University, Pullman, WA 99164, USA
| | - Ryan D Oliveira
- Department of Veterinary Microbiology and Pathology, College of Veterinary Medicine, Washington State University, Pullman, WA 99164, USA
| | - Alisha T Massa
- Department of Veterinary Microbiology and Pathology, College of Veterinary Medicine, Washington State University, Pullman, WA 99164, USA
| | - Anders Omsland
- Paul G. Allen School for Global Animal Health, College of Veterinary Medicine, Washington State University, Pullman, WA 99164, USA
| | - Stephen N White
- Department of Veterinary Microbiology and Pathology, College of Veterinary Medicine, Washington State University, Pullman, WA 99164, USA.,USDA-ARS Animal Disease Research, Pullman, WA 99164, USA.,Center for Reproductive Biology, Washington State University, Pullman, WA 99164, USA
| | - Alan G Goodman
- School of Molecular Biosciences, College of Veterinary Medicine, Washington State University, Pullman, WA 99164, USA.,Paul G. Allen School for Global Animal Health, College of Veterinary Medicine, Washington State University, Pullman, WA 99164, USA
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11
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Braddick M, Woods ML, Prabhaharan S. Acute Q fever in third trimester pregnancy. BMJ Case Rep 2021; 14:e242558. [PMID: 34389589 PMCID: PMC8365830 DOI: 10.1136/bcr-2021-242558] [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] [Accepted: 08/02/2021] [Indexed: 11/03/2022] Open
Abstract
A 29-year-old gravida 2 para 1 woman presented at 29 weeks gestation with fevers, back pain, thrombocytopenia and hepatitis. PCR testing of blood samples detected Coxiella burnetii and paired serology later confirmed the diagnosis of acute Q fever in pregnancy. The patient was treated empirically with oral clarithromycin and experienced a symptomatic and biochemical improvement. Therapy was changed to oral trimethoprim/sulphamethoxazole but was complicated by a delayed cutaneous reaction, prompting recommencement of clarithromycin. Therapy continued until delivery of a healthy girl at 39 weeks and 3 days. Q fever in pregnancy is likely under-reported and is associated with the development of chronic infection and obstetric complications. Treatment with clarithromycin is an alternative to trimethoprim/sulphamethoxazole in the setting of drug intolerance.
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Affiliation(s)
- Maxwell Braddick
- Infectious Diseases, Townsville Hospital and Health Service, Townsville, Queensland, Australia
| | - Marion L Woods
- Infectious Diseases, Townsville Hospital and Health Service, Townsville, Queensland, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Suji Prabhaharan
- General Medicine, Townsville Hospital and Health Service, Townsville, Queensland, Australia
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12
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Lucas AE, Torres Y, Shah NB, Choudhary M. An Atypical Case of Acute Q Fever Presenting with Inflammatory Polyarthritis. Am J Med 2021; 134:e275-e276. [PMID: 33221282 DOI: 10.1016/j.amjmed.2020.09.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 09/29/2020] [Accepted: 09/30/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Aaron E Lucas
- University of Pittsburgh Medical Center, Pittsburgh, PA.
| | | | - Neel B Shah
- University of Pittsburgh Medical Center, Pittsburgh, PA
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13
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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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14
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Akamine CM, Perez ML, Lee JH, Ing MB. Q Fever in Southern California: a Case Series of 20 Patients from a VA Medical Center. Am J Trop Med Hyg 2020; 101:33-39. [PMID: 31115296 PMCID: PMC6609200 DOI: 10.4269/ajtmh.18-0283] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Query fever (Q fever), caused by Coxiella burnetii, was first described in southern California in 1947. It was found to be endemic and enzoonotic to the region and associated with exposure to livestock. We describe a series of 20 patients diagnosed with Q fever at a Veterans Affairs hospital in southern California, with the aim of contributing toward the understanding of Q fever in this region. Demographics, laboratory data, diagnostic imaging, risk factors, and treatment regimens were collected via a retrospective chart review of patients diagnosed with Q fever at our institution between 2000 and 2016. Cases were categorized as acute or chronic and confirmed or probable. The majority presented with an acute febrile illness (90%). There was a delay in ordering diagnostic serology from the time of symptom onset (acute cases, average 31.9 days; chronic cases, average 63 days), and 15% progressed from acute to chronic infection. Of the chronic cases, 22.2% had endocarditis, 22.2% had endovascular infection, and 11.1% had both endocarditis and endovascular infection. The geographic distribution revealed that 20% resided in rural areas. Of the cases of Q fever that died, death attributed to Q fever was associated with an average diagnostic delay of 65.5 days. Acute Q fever is underreported in this region largely because of its often nonspecific clinical presentation.
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Affiliation(s)
- Christine M Akamine
- Department of Internal Medicine, Loma Linda University Health, Loma Linda, California
| | - Mario L Perez
- Division of Infectious Diseases, Kaiser Permanente Fontana Medical Center, Fontana, California
| | - Jea Hyun Lee
- Division of Infectious Diseases, Kaiser Permanente Fontana Medical Center, Fontana, California
| | - Michael B Ing
- Infectious Diseases Section, Veterans Affairs Loma Linda Healthcare System, Loma Linda, California
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15
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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.
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16
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Robison A, Snyder DT, Christensen K, Kimmel E, Hajjar AM, Jutila MA, Hedges JF. Expression of human TLR4/myeloid differentiation factor 2 directs an early innate immune response associated with modest increases in bacterial burden during Coxiella burnetii infection. Innate Immun 2019; 25:401-411. [PMID: 31180798 PMCID: PMC6900644 DOI: 10.1177/1753425919855420] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 04/24/2019] [Accepted: 05/13/2019] [Indexed: 01/25/2023] Open
Abstract
Human TLR4 (hTLR4) and mouse TLR4 molecules respond differently to hypo-acylated LPS. The LPS of Coxiella burnetii is hypo-acylated and heavily glycosylated and causes a minimal response by human cells. Thus, we hypothesized that mice expressing hTLR4 molecules would be more susceptible to C. burnetii infection. Our results show that transgenic mice expressing hTLR4 and the human myeloid differentiation factor 2 (MD-2) adaptor protein (hTLR4/MD-2) respond similarly to wild type mice with respect to overall disease course. However, differences in bacterial burdens in tissues were noted, and lung pathology was increased in hTLR4/MD2 compared to wild type mice. Surprisingly, bone marrow chimera experiments indicated that hTLR4/MD-2 expression on non-hematopoietic cells, rather than the target cells for C. burnetii infection, accounted for increased bacterial burden. Early during infection, cytokines involved in myeloid cell recruitment were detected in the plasma of hTLR4/MD2 mice but not wild type mice. This restricted cytokine response was accompanied by neutrophil recruitment to the lung in hTLR4/MD2 mice. These data suggest that hTLR4/MD-2 alters early responses during C. burnetii infection. These early responses are precursors to later increased bacterial burdens and exacerbated pathology in the lung. Our data suggest an unexpected role for hTLR4/MD-2 in non-hematopoietic cells during C. burnetii infection.
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Affiliation(s)
- Amanda Robison
- Department of Microbiology and Immunology, Montana State University, USA
| | - Deann T Snyder
- Department of Microbiology and Immunology, Montana State University, USA
| | - Kelly Christensen
- Department of Microbiology and Immunology, Montana State University, USA
| | - Emily Kimmel
- Department of Microbiology and Immunology, Montana State University, USA
| | - Adeline M Hajjar
- Department of Comparative Medicine, School of Medicine, University of Washington, USA
| | - Mark A Jutila
- Department of Microbiology and Immunology, Montana State University, USA
| | - Jodi F Hedges
- Department of Microbiology and Immunology, Montana State University, USA
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17
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Trends in Q fever serologic testing by immunofluorescence from four large reference laboratories in the United States, 2012-2016. Sci Rep 2018; 8:16670. [PMID: 30420599 PMCID: PMC6232148 DOI: 10.1038/s41598-018-34702-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 10/22/2018] [Indexed: 12/29/2022] Open
Abstract
Laboratory testing for Q fever (Coxiella burnetii) is essential for a differential diagnosis, yet little is known about Q fever diagnostic testing practices in the United States. We retrospectively analyzed Q fever immunoglobulin G (IgG) indirect immunofluorescence assay (IFA) testing data between 1/1/2012–10/31/2016 from ARUP, LabCorp, Mayo Medical Laboratories, and Quest Diagnostics. Data included IgG phase I and phase II titers, patient age and sex, and state and date of specimen collection. On average, 12,821 specimens were tested for Q fever annually by the participating laboratories. Of 64,106 total specimens, 84.1% tested negative for C. burnetii-specific antibodies. Positive titers ranged from 16 to 262,144 against both phase I and phase II antigens. Submission of specimens peaked during the summer months, and more specimens were submitted from the West North Central division. Testing occurred more frequently in males (53%) and increased with age. In conclusion, few U.S. Q fever cases are reported, despite large volumes of diagnostic specimens tested. Review of commercial laboratory data revealed a lack of paired serology samples and patterns of serology titers that differ from case reporting diagnostic criteria.
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18
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Chronic Q Fever Infection Mimicking Hematological Malignancy. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2018. [DOI: 10.1097/ipc.0000000000000639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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19
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Pérez-Arellano JL, Carranza Rodríguez C, Gutierrez C, Bolaños Rivero M. [Epidemiology of Q fever in Spain (2018)]. REVISTA ESPANOLA DE QUIMIOTERAPIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE QUIMIOTERAPIA 2018; 31:386-405. [PMID: 30027720 PMCID: PMC6194867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 07/07/2018] [Accepted: 07/09/2018] [Indexed: 10/29/2022]
Abstract
Q fever is an anthropozoonosis whose causative agent is Coxiella burnetii, which has an important impact from the human and animal health point of view. In this review, a brief historical reference of the infection by C. burnetii and Q fever has been made initially. In a second section the basic epidemiological aspects of this infection are described (reservoirs/ sources of infection, form of transmission and epidemiological forms). Subsequently, the data of the infection by C. burnetii in Spain will be are indicated, particularly the clinical series, the seroepidemiological studies in humans, the affectation of different types of mammals and the participation of the ticks in the biological cycle. In addition, basic data on C. burnetii infection/ disease in other regions of the world will be are also included. Finally, and taking into account the previous data will indicate the main epidemiological characteristics of Q fever at present.
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Affiliation(s)
- J L Pérez-Arellano
- Prof. J. L Pérez Arellano, Unidad de Enfermedades Infecciosas y Medicina Tropical. Hospital Universitario Insular de Gran Canaria. Avda Marítima del Sur 35080. Las Palmas de Gran Canaria. Spain.
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20
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Straily A, Dahlgren FS, Peterson A, Paddock CD. Surveillance for Q Fever Endocarditis in the United States, 1999-2015. Clin Infect Dis 2018; 65:1872-1877. [PMID: 29140515 DOI: 10.1093/cid/cix702] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 08/04/2017] [Indexed: 01/01/2023] Open
Abstract
Background Q fever is a worldwide zoonosis caused by Coxiella burnetii. In some persons, particularly those with cardiac valve disease, infection with C. burnetii can cause a life-threatening infective endocarditis. There are few descriptive analyses of Q fever endocarditis in the United States. Methods Q fever case report forms submitted during 1999-2015 were reviewed to identify reports describing endocarditis. Cases were categorized as confirmed or probable using criteria defined by the Council for State and Territorial Epidemiologists (CSTE). Demographic, laboratory, and clinical data were analyzed. Results Of 140 case report forms reporting endocarditis, 49 met the confirmed definition and 36 met the probable definition. Eighty-two percent were male and the median age was 57 years (range, 16-87 years). Sixty-seven patients (78.8%) were hospitalized, and 5 deaths (5.9%) were reported. Forty-five patients (52.9%) had a preexisting valvulopathy. Eight patients with endocarditis had phase I immunoglobulin G antibody titers >800 but did not meet the CSTE case definition for Q fever endocarditis. Conclusions These data summarize a limited set of clinical and epidemiological features of Q fever endocarditis collected through passive surveillance in the United States. Some cases of apparent Q fever endocarditis could not be classified by CSTE laboratory criteria, suggesting that comparison of phase I and phase II titers could be reexamined as a surveillance criterion. Prospective analyses of culture-negative endocarditis are needed to better assess the clinical spectrum and magnitude of Q fever endocarditis in the United States.
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Affiliation(s)
| | - F Scott Dahlgren
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Amy Peterson
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Christopher D Paddock
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
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21
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Alvarez J, Whitten T, Branscum AJ, Garcia-Seco T, Bender JB, Scheftel J, Perez A. Understanding Q Fever Risk to Humans in Minnesota Through the Analysis of Spatiotemporal Trends. Vector Borne Zoonotic Dis 2018; 18:89-95. [DOI: 10.1089/vbz.2017.2132] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Julio Alvarez
- Department of Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, St Paul, Minnesota
| | - Tory Whitten
- Minnesota Department of Health, St Paul, Minnesota
| | - Adam J. Branscum
- Biostatistics Program, Oregon State University, Corvallis, Oregon
| | | | - Jeff B. Bender
- Department of Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, St Paul, Minnesota
| | | | - Andres Perez
- Department of Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, St Paul, Minnesota
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22
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Oliveira RD, Mousel MR, Pabilonia KL, Highland MA, Taylor JB, Knowles DP, White SN. Domestic sheep show average Coxiella burnetii seropositivity generations after a sheep-associated human Q fever outbreak and lack detectable shedding by placental, vaginal, and fecal routes. PLoS One 2017; 12:e0188054. [PMID: 29141023 PMCID: PMC5687729 DOI: 10.1371/journal.pone.0188054] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 10/31/2017] [Indexed: 12/21/2022] Open
Abstract
Coxiella burnetii is a globally distributed zoonotic bacterial pathogen that causes abortions in ruminant livestock. In humans, an influenza-like illness results with the potential for hospitalization, chronic infection, abortion, and fatal endocarditis. Ruminant livestock, particularly small ruminants, are hypothesized to be the primary transmission source to humans. A recent Netherlands outbreak from 2007–2010 traced to dairy goats resulted in over 4,100 human cases with estimated costs of more than 300 million euros. Smaller human Q fever outbreaks of small ruminant origin have occurred in the United States, and characterizing shedding is important to understand the risk of future outbreaks. In this study, we assessed bacterial shedding and seroprevalence in 100 sheep from an Idaho location associated with a 1984 human Q fever outbreak. We observed 5% seropositivity, which was not significantly different from the national average of 2.7% for the U.S. (P>0.05). Furthermore, C. burnetii was not detected by quantitative PCR from placentas, vaginal swabs, or fecal samples. Specifically, a three-target quantitative PCR of placenta identified 0.0% shedding (exact 95% confidence interval: 0.0%-2.9%). While presence of seropositive individuals demonstrates some historical C. burnetii exposure, the placental sample confidence interval suggests 2016 shedding events were rare or absent. The location maintained the flock with little or no depopulation in 1984 and without C. burnetii vaccination during or since 1984. It is not clear how a zero-shedding rate was achieved in these sheep beyond natural immunity, and more work is required to discover and assess possible factors that may contribute towards achieving zero-shedding status. We provide the first U.S. sheep placental C. burnetii shedding update in over 60 years and demonstrate potential for C. burnetii shedding to reach undetectable levels after an outbreak event even in the absence of targeted interventions, such as vaccination.
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Affiliation(s)
- Ryan D Oliveira
- Department of Veterinary Microbiology & Pathology, Washington State University, Pullman, Washington, United States of America
| | - Michelle R Mousel
- USDA-ARS Animal Disease Research, Pullman, Washington, United States of America.,Allen School for Global Animal Health, Washington State University, Pullman, Washington, United States of America
| | - Kristy L Pabilonia
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, United States of America
| | - Margaret A Highland
- USDA-ARS Animal Disease Research, Pullman, Washington, United States of America.,Allen School for Global Animal Health, Washington State University, Pullman, Washington, United States of America.,Washington Animal Disease Diagnostic Laboratory, Washington State University, Pullman, Washington, United States of America
| | - J Bret Taylor
- USDA-ARS Range Sheep Production Efficiency Research, Dubois, Idaho, United States of America
| | - Donald P Knowles
- Department of Veterinary Microbiology & Pathology, Washington State University, Pullman, Washington, United States of America.,USDA-ARS Animal Disease Research, Pullman, Washington, United States of America.,Allen School for Global Animal Health, Washington State University, Pullman, Washington, United States of America
| | - Stephen N White
- Department of Veterinary Microbiology & Pathology, Washington State University, Pullman, Washington, United States of America.,USDA-ARS Animal Disease Research, Pullman, Washington, United States of America.,Center for Reproductive Biology, Washington State University, Pullman, Washington, United States of America
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23
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Virk A, Mahmood M, Kalra M, Bower TC, Osmon DR, Berbari EF, Raoult D. Coxiella burnetii Multilevel Disk Space Infection, Epidural Abscess, and Vertebral Osteomyelitis Secondary to Contiguous Spread From Infected Abdominal Aortic Aneurysm or Graft: Report of 4 Cases Acquired in the US and Review of the Literature. Open Forum Infect Dis 2017; 4:ofx192. [PMID: 30581879 PMCID: PMC6299295 DOI: 10.1093/ofid/ofx192] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 08/31/2017] [Indexed: 11/13/2022] Open
Abstract
Background Chronic Coxiella burnetii infections such as vertebral osteomyelitis caused by contiguous spread from an infected abdominal aortic graft or aneurysm have been rarely reported and are associated with significant morbidity and mortality. Methods We present the first four reported US acquired cases of Coxiella burnetii vertebral osteomyelitis caused by contiguous spread from an infected abdominal aortic graft or aneurysm. Results Presenting symptoms included progressive back pain, malaise, and weight loss with recent or remote animal exposure. Typical imaging findings demonstrated a peri-aortic collection with extension to the paraspinal muscles and vertebrae. Antibiotic regimens included doxycycline with either hydroxychloroquine or a quinolone for at least 2 years or as chronic suppression. Conclusions C. burnetii vertebral osteomyelitis is rare and can occur by contiguous spread from an abdominal aneurysm or vascular graft infection. It should be suspected in patients where pre-antibiotic cultures are negative with animal/farming exposure.
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Affiliation(s)
- Abinash Virk
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Maryam Mahmood
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Manju Kalra
- Division of Vascular Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota
| | - Thomas C Bower
- Division of Vascular Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota
| | - Douglas R Osmon
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Elie F Berbari
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, Minnesota
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Adams DA, Thomas KR, Jajosky RA, Foster L, Baroi G, Sharp P, Onweh DH, Schley AW, Anderson WJ. Summary of Notifiable Infectious Diseases and Conditions - United States, 2015. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2017; 64:1-143. [PMID: 28796757 DOI: 10.15585/mmwr.mm6453a1] [Citation(s) in RCA: 108] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The Summary of Notifiable Infectious Diseases and Conditions - United States, 2015 (hereafter referred to as the summary) contains the official statistics, in tabular and graphical form, for the reported occurrence of nationally notifiable infectious diseases and conditions in the United States for 2015. Unless otherwise noted, data are final totals for 2015 reported as of June 30, 2016. These statistics are collected and compiled from reports sent by U.S. state and territories, New York City, and District of Columbia health departments to the National Notifiable Diseases Surveillance System (NNDSS), which is operated by CDC in collaboration with the Council of State and Territorial Epidemiologists (CSTE). This summary is available at https://www.cdc.gov/MMWR/MMWR_nd/index.html. This site also includes summary publications from previous years.
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Affiliation(s)
- Deborah A Adams
- Division of Health Informatics and Surveillance, Office of Public Health Scientific Services, CDC
| | - Kimberly R Thomas
- Division of Health Informatics and Surveillance, Office of Public Health Scientific Services, CDC
| | - Ruth Ann Jajosky
- Division of Health Informatics and Surveillance, Office of Public Health Scientific Services, CDC
| | - Loretta Foster
- Division of Health Informatics and Surveillance, Office of Public Health Scientific Services, CDC
| | - Gitangali Baroi
- Division of Health Informatics and Surveillance, Office of Public Health Scientific Services, CDC
| | - Pearl Sharp
- Division of Health Informatics and Surveillance, Office of Public Health Scientific Services, CDC
| | - Diana H Onweh
- Division of Health Informatics and Surveillance, Office of Public Health Scientific Services, CDC
| | - Alan W Schley
- Division of Health Informatics and Surveillance, Office of Public Health Scientific Services, CDC
| | - Willie J Anderson
- Division of Health Informatics and Surveillance, Office of Public Health Scientific Services, CDC
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25
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Doung-Ngern P, Chuxnum T, Pangjai D, Opaschaitat P, Kittiwan N, Rodtian P, Buameetoop N, Kersh GJ, Padungtod P. Seroprevalence of Coxiella burnetii Antibodies Among Ruminants and Occupationally Exposed People in Thailand, 2012-2013. Am J Trop Med Hyg 2017; 96:786-790. [PMID: 28115661 DOI: 10.4269/ajtmh.16-0336] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
AbstractLittle is known about the burden of Q fever in Thailand. We conducted a serological study to describe the prevalence of anti-Coxiella burnetii antibodies among ruminants and occupationally exposed persons in response to the report of the first two Q fever endocarditis patients in Thailand in 2012. We randomly selected ruminant sera from brucellosis surveillance and examined sera of 661 occupationally exposed subjects from two provinces of Thailand: Chiangmai and Nakornratchasima. Animal and human sera were tested using commercial enzyme-linked immunosorbent assay (ELISA). Environmental samples, vaginal swab, and milk from cows in Chiangmai farms with detectable anti-C. burnetii serum antibodies were tested using polymerase chain reaction (PCR). Among the 1,632 animal sera tested, 64 (3.9%) were seropositive. The prevalence was highest in dairy cattle (4.6%, 45/988), followed by goats (3.5%, 18/516) and sheep (2.1%, 1/48). The prevalence of anti-C. burnetii antibodies in each species varied significantly by province: the prevalence in cattle was higher in Chiangmai (5.5% versus 0%), however, the prevalence in sheep and goats was higher in Nakornratchasima (5.9% versus 1.0%). Four out of 60 milk samples were positive by PCR (6.7%). No environmental samples were positive. Among 661 human samples, 83 (12.6%) were ELISA positive. Seroprevalence was statistically higher in Chiangmai compare with Nakornratchasima (42.8% versus 3.0%). Coxiella burnetii infection exists in Thailand, but the prevalence varies by geographic distribution and animal reservoirs. Further studies focusing on the burden and risk factors of C. burnetii infection among high-risk groups should be conducted.
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Affiliation(s)
- Pawinee Doung-Ngern
- Bureau of Epidemiology, Department of Diseases Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Teerasak Chuxnum
- Bureau of Epidemiology, Department of Diseases Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Decha Pangjai
- National Institute of Health, Department of Medical Science, Ministry of Public Health, Nonthaburi, Thailand
| | - Pattarin Opaschaitat
- National Institute of Animal Health, Department of Livestock Development, Bangkok, Thailand
| | - Nattinee Kittiwan
- National Institute of Animal Health, Department of Livestock Development, Bangkok, Thailand
| | - Pranee Rodtian
- The Fifth Regional Livestock Office, Department of Livestock Development, Chiangmai, Thailand
| | - Noppawan Buameetoop
- Bureau of Disease Control and Veterinary Services, Department of Livestock Development, Bangkok, Thailand
| | - Gilbert J Kersh
- Rickettsial Zoonoses Branch, National Center for Emerging Zoonoses and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Pawin Padungtod
- Global Disease Detection Regional Center, Thai MOPH - U.S. CDC Collaboration, Ministry of Public Health, Thailand and Global Disease Detection Branch, Division of Global Health Protection, Center for Global Health, Nonthaburi, Thailand
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Lai CH, Sun W, Lee CH, Lin JN, Liao MH, Liu SS, Chang TY, Tsai KF, Chang YC, Lin HH, Chen YH. The Epidemiology and Characteristics of Q fever and Co-infections with Scrub Typhus, Murine Typhus or Leptospirosis in Taiwan: A Nationwide Database Study. Zoonoses Public Health 2016; 64:517-526. [PMID: 27966835 DOI: 10.1111/zph.12333] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Indexed: 11/29/2022]
Abstract
Q fever (QF) is a worldwide zoonosis associated with outbreaks. Only a few nationwide studies regarding the surveillance and epidemiology of human QF have been reported. Although QF is endemic in Taiwan, a nationwide database investigation of the epidemiology and characteristics of QF and its associations with scrub typhus (ST), murine typhus (MT) and leptospirosis (LS) has never been reported. We analysed nationwide databases of suspected QF, ST, MT and LS cases from October 2007 to December 2014 obtained from the Centers for Disease Control, Taiwan. A total of 468 (4.2%) QF cases were identified among 11 109 suspected QF cases. QF cases were mainly distributed in the southern and Kaohsiung-Pingtung regions but rarely in the eastern region. Compared to non-QF cases, QF cases had significantly higher percentages of males (88.7 versus 66.2%) and high-risk occupations (farming, animal husbandry or veterinary medicine) (16.2 versus 10.5%). But the percentages of specific animal contact, including cattle (0.6 versus 0.8%) and goats (0.9 versus 1.0%), were low in both. The majority of suspected QF cases (89.4%) were simultaneously suspected with ST, MT or LS, and the combinations of suspected diseases differed between regions. The number of suspected QF cases from the eastern region decreased since 2009, which was not observed in other regions. A total of 1420 (12.8%) cases had confirmed diseases, including QF (453, 4.1%), QF+ST (7, 0.06%), QF+MT (4, 0.04%), QF+LS (4, 0.04%), MT (186, 1.7%), ST (545, 4.9%), ST+LS (11, 0.1%) and LS (210, 1.9%). Compared to cases of unknown disease, QF cases had larger percentages of high-risk occupations (16.2 versus 9.6%) but similar histories of animal contact (29.8 versus 25.1%). QF is an endemic disease in southern Taiwan. It is difficult to differentiate QF from ST, MT or LS only by high-risk occupations and history of animal contact, and co-infection of QF with these diseases should be considered.
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Affiliation(s)
- C-H Lai
- Division of Infectious Diseases, Department of Internal Medicine and Division of Infection Control Laboratory, E-Da Hospital and I-Shou University, Kaohsiung, Taiwan
| | - W Sun
- Infection Control Department, Pao-Chien Hospital, Pingtung, Taiwan
| | - C-H Lee
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,College of Medicine, Chang Gung University, Kaohsiung, Taiwan
| | - J-N Lin
- Division of Infectious Diseases, Department of Internal Medicine and Department of Critical Care Medicine, E-Da Hospital, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - M-H Liao
- Department of Veterinary Medicine, College of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung, Taiwan
| | - S-S Liu
- Department of Veterinary Medicine, College of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung, Taiwan
| | - T-Y Chang
- Division of Infectious Diseases, Pingtung Christian Hospital, Pingtung, Taiwan
| | - K-F Tsai
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Y-C Chang
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - H-H Lin
- Division of Infectious Diseases, Department of Internal Medicine and Division of Infection Control Laboratory, E-Da Hospital and I-Shou University, Kaohsiung, Taiwan
| | - Y-H Chen
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,School of Medicine, Graduate Institute of Medicine, Sepsis Research Center, Center for Dengue Fever Control and Research, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Biological Science and Technology, College of Biological Science and Technology, National Chiao Tung University, HsinChu, Taiwan
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27
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Lai CH, Chang LL, Lin JN, Liao MH, Liu SS, Lee HH, Lin HH, Chen YH. Association of Human Q Fever with Animal Husbandry, Taiwan, 2004-2012. Emerg Infect Dis 2016; 21:2217-20. [PMID: 26583537 PMCID: PMC4672411 DOI: 10.3201/eid2112.141997] [Citation(s) in RCA: 4] [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: 11/23/2022] Open
Abstract
In Taiwan, Q fever cases in humans began increasing in 2004 and peaked in 2007 but dramatically declined in 2008 and 2011. Cases were significantly correlated with the number of goats. The decline might be associated with the collateral effects of measures to control goat pox in 2008 and 2010.
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Type I Interferon Counters or Promotes Coxiella burnetii Replication Dependent on Tissue. Infect Immun 2016; 84:1815-1825. [PMID: 27068091 DOI: 10.1128/iai.01540-15] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 04/01/2016] [Indexed: 01/09/2023] Open
Abstract
Coxiella burnetii is an intracellular pathogen and the cause of Q fever. Gamma interferon (IFN-γ) is critical for host protection from infection, but a role for type I IFN in C. burnetii infection has not been determined. Type I IFN supports host protection from a related pathogen, Legionella pneumophila, and we hypothesized that it would be similarly protective in C. burnetii infection. In contrast to our prediction, IFN-α receptor-deficient (IFNAR(-/-)) mice were protected from C. burnetii-induced infection. Therefore, the role of type I IFN in C. burnetii infection was distinct from that in L. pneumophila Mice treated with a double-stranded-RNA mimetic were protected from C. burnetii-induced weight loss through an IFNAR-independent pathway. We next treated mice with recombinant IFN-α (rIFN-α). When rIFN-α was injected by the intraperitoneal route during infection, disease-induced weight loss was exacerbated. Mice that received rIFN-α by this route had dampened interleukin 1β (IL-1β) expression in bronchoalveolar lavage fluids. However, when rIFN-α was delivered to the lung, bacterial replication was decreased in all tissues. Thus, the presence of type I IFN in the lung protected from infection, but when delivered to the periphery, type I IFN enhanced disease, potentially by dampening inflammatory cytokines. To better characterize the capacity for type I IFN induction by C. burnetii, we assessed expression of IFN-β transcripts by human macrophages following stimulation with lipopolysaccharide (LPS) from C. burnetii Understanding innate responses in C. burnetii infection will support the discovery of novel therapies that may be alternative or complementary to the current antibiotic treatment.
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Biggs HM, Turabelidze G, Pratt D, Todd SR, Jacobs-Slifka K, Drexler NA, McCurdy G, Lloyd J, Evavold CL, Fitzpatrick KA, Priestley RA, Singleton J, Sun D, Tang M, Kato C, Kersh GJ, Anderson A. Coxiella burnetii Infection in a Community Operating a Large-Scale Cow and Goat Dairy, Missouri, 2013. Am J Trop Med Hyg 2016; 94:525-31. [PMID: 26811433 DOI: 10.4269/ajtmh.15-0726] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 12/06/2015] [Indexed: 11/07/2022] Open
Abstract
Coxiella burnetii is a zoonotic pathogen that causes Q fever in humans and is transmitted primarily from infected goats, sheep, or cows. Q fever typically presents as an acute febrile illness; however, individuals with certain predisposing conditions, including cardiac valvulopathy, are at risk for chronic Q fever, a serious manifestation that may present as endocarditis. In response to a cluster of Q fever cases detected by public health surveillance, we evaluated C. burnetii infection in a community that operates a large-scale cow and goat dairy. A case was defined as an individual linked to the community with a C. burnetii phase II IgG titer ≥ 128. Of 135 participants, 47 (35%) cases were identified. Contact with or close proximity to cows, goats, and their excreta was associated with being a case (relative risk 2.7, 95% confidence interval 1.3-5.3). Cases were also identified among individuals without cow or goat contact and could be related to windborne spread or tracking of C. burnetii on fomites within the community. A history of injection drug use was reported by 26/130 (20%) participants; follow-up for the presence of valvulopathy and monitoring for development of chronic Q fever may be especially important among this population.
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Affiliation(s)
- Holly M Biggs
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Missouri Department of Health and Senior Services, Jefferson City, Missouri
| | - George Turabelidze
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Missouri Department of Health and Senior Services, Jefferson City, Missouri
| | - Drew Pratt
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Missouri Department of Health and Senior Services, Jefferson City, Missouri
| | - Suzanne R Todd
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Missouri Department of Health and Senior Services, Jefferson City, Missouri
| | - Kara Jacobs-Slifka
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Missouri Department of Health and Senior Services, Jefferson City, Missouri
| | - Naomi A Drexler
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Missouri Department of Health and Senior Services, Jefferson City, Missouri
| | - Gail McCurdy
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Missouri Department of Health and Senior Services, Jefferson City, Missouri
| | - Jennifer Lloyd
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Missouri Department of Health and Senior Services, Jefferson City, Missouri
| | - Charles L Evavold
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Missouri Department of Health and Senior Services, Jefferson City, Missouri
| | - Kelly A Fitzpatrick
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Missouri Department of Health and Senior Services, Jefferson City, Missouri
| | - Rachael A Priestley
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Missouri Department of Health and Senior Services, Jefferson City, Missouri
| | - Joseph Singleton
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Missouri Department of Health and Senior Services, Jefferson City, Missouri
| | - David Sun
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Missouri Department of Health and Senior Services, Jefferson City, Missouri
| | - Minh Tang
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Missouri Department of Health and Senior Services, Jefferson City, Missouri
| | - Cecilia Kato
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Missouri Department of Health and Senior Services, Jefferson City, Missouri
| | - Gilbert J Kersh
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Missouri Department of Health and Senior Services, Jefferson City, Missouri
| | - Alicia Anderson
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Missouri Department of Health and Senior Services, Jefferson City, Missouri
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Maor Y, Sternik L, Orlov B, Rahav G, Keller N, Raanani E, Kogan A. Coxiella burnetii Endocarditis and Aortic Vascular Graft Infection: An Underrecognized Disease. Ann Thorac Surg 2016; 101:141-5. [DOI: 10.1016/j.athoracsur.2015.06.075] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Revised: 06/05/2015] [Accepted: 06/22/2015] [Indexed: 11/26/2022]
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31
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Affiliation(s)
- Joshua D Hartzell
- Infectious Diseases Service, Department of Medicine, Walter Reed National Military Medical Center, Bethesda, Maryland
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32
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Dahlgren FS, Haberling DL, McQuiston JH. Q fever is underestimated in the United States: a comparison of fatal Q fever cases from two national reporting systems. Am J Trop Med Hyg 2014; 92:244-6. [PMID: 25404074 DOI: 10.4269/ajtmh.14-0502] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Two national surveillance systems capturing reports of fatal Q fever were compared with obtained estimates of Q fever underreporting in the United States using capture-recapture methods. During 2000-2011, a total of 33 unique fatal Q fever cases were reported through case report forms submitted to the Centers for Disease Control and Prevention and through U.S. death certificate data. A single case matched between both data sets, yielding an estimated 129 fatal cases (95% confidence interval [CI] = 62-1,250) during 2000-2011. Fatal cases of Q fever were underreported through case report forms by an estimated factor of 14 and through death certificates by an estimated factor of 5.2.
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Affiliation(s)
- F Scott Dahlgren
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; Prion and Public Health Office, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Dana L Haberling
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; Prion and Public Health Office, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jennifer H McQuiston
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; Prion and Public Health Office, Centers for Disease Control and Prevention, Atlanta, Georgia
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