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Hamad G, Ranmuthugala G. Q fever awareness in Australia: A scoping review. Aust N Z J Public Health 2023; 47:100099. [PMID: 38016201 DOI: 10.1016/j.anzjph.2023.100099] [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: 01/10/2023] [Revised: 09/08/2023] [Accepted: 10/04/2023] [Indexed: 11/30/2023] Open
Abstract
OBJECTIVE To investigate the level of Q fever awareness in Australia. METHODS A scoping review was conducted by searching the electronic databases Medline, PubMed and Web of Science using keywords for Q fever, awareness, knowledge, and Australian locations. The search was initially limited to articles published in the 10 years prior to June 2022 and then extended up to and including August 2023; yielding 387 records. RESULTS Fifteen articles were assessed as being eligible. These articles reported on surveys and interviews conducted with farmers, veterinary practitioners and nurses, medical practitioners, policy makers, researchers, industry representatives, animal science students, cat breeders, wildlife rehabilitators, and agriculture show attendees. Farmers were the largest group represented. Level of Q fever awareness amongst these communities, including those at high-risk, was generally low. The need for increased awareness was recognised. General practitioner awareness levels were low and recognised to be so by high-risk groups. Awareness of preventive measures including vaccination was greater among those with greater awareness and risk. CONCLUSION With the availability of a highly effective vaccine in Australia, there is a need to increase Q fever knowledge and awareness among high-risk groups and primary health care practitioners. IMPLICATIONS FOR PUBLIC HEALTH Strategies to increase awareness and knowledge of Q fever risks and prevention strategies may assist with reducing Q fever burden in Australia.
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Affiliation(s)
- George Hamad
- Department of Rural Health, Melbourne Medical School, The University of Melbourne, Australia
| | - Geetha Ranmuthugala
- Department of Rural Health, Melbourne Medical School, The University of Melbourne, Australia; School of Rural Medicine, University of New England, Australia.
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2
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Redden P, Parker K, Henderson S, Fourie P, Agnew L, Stenos J, Graves S, Govan B, Norton R, Ketheesan N. Q fever - immune responses and novel vaccine strategies. Future Microbiol 2023; 18:1185-1196. [PMID: 37850346 DOI: 10.2217/fmb-2023-0117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 08/07/2023] [Indexed: 10/19/2023] Open
Abstract
Q fever is a zoonotic disease caused by the bacterium Coxiella burnetii. It is an occupational risk for employees of animal industries and is associated with contact with wildlife and domestic animals. Although Q fever infection may be asymptomatic, chronic sequelae such as endocarditis occur in 5% of symptomatic individuals. Disease outcomes may be predicted through measurement of immune correlates. Vaccination is the most efficient method to prevent Q fever. Currently, Q-VAX is the only licenced human vaccine. Q-VAX is highly effective; however, individuals previously exposed to C. burnetii are at risk of adverse reactions. This review examines the immunological responses of acute and chronic Q fever and the efforts to provide a safer and cost-effective Q fever vaccine.
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Affiliation(s)
- Patricia Redden
- School of Science & Technology, University of New England, New South Wales, 2351, Australia
| | - Kaitland Parker
- School of Science & Technology, University of New England, New South Wales, 2351, Australia
| | - Sinead Henderson
- School of Science & Technology, University of New England, New South Wales, 2351, Australia
| | - Phillip Fourie
- School of Science & Technology, University of New England, New South Wales, 2351, Australia
| | - Linda Agnew
- School of Science & Technology, University of New England, New South Wales, 2351, Australia
- Griffith Health Group, Griffith University, Queensland, 4222, Australia
| | - John Stenos
- Australian Rickettsial Reference Laboratory, Barwon Health, Geelong, Victoria, 3220, Australia
| | - Stephen Graves
- Australian Rickettsial Reference Laboratory, Barwon Health, Geelong, Victoria, 3220, Australia
| | - Brenda Govan
- College of Public Health, Medicine & Vet Sciences, James Cook University, Queensland, 4811, Australia
| | - Robert Norton
- Pathology Queensland, Queensland Health, Townsville Hospital, Queensland, 4814, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, 4072, Australia
| | - Natkunam Ketheesan
- School of Science & Technology, University of New England, New South Wales, 2351, Australia
- Griffith Health Group, Griffith University, Queensland, 4222, Australia
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Sam G, Stenos J, Graves SR, Rehm BHA. Q fever immunology: the quest for a safe and effective vaccine. NPJ Vaccines 2023; 8:133. [PMID: 37679410 PMCID: PMC10484952 DOI: 10.1038/s41541-023-00727-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 08/24/2023] [Indexed: 09/09/2023] Open
Abstract
Q fever is an infectious zoonotic disease, caused by the Gram-negative bacterium Coxiella burnetii. Transmission occurs from livestock to humans through inhalation of a survival form of the bacterium, the Small Cell Variant, often via handling of animal parturition products. Q fever manifests as an acute self-limiting febrile illness or as a chronic disease with complications such as vasculitis and endocarditis. The current preventative human Q fever vaccine Q-VAX poses limitations on its worldwide implementation due to reactogenic responses in pre-sensitized individuals. Many strategies have been undertaken to develop a universal Q fever vaccine but with little success to date. The mechanisms of the underlying reactogenic responses remain only partially understood and are important factors in the development of a safe Q fever vaccine. This review provides an overview of previous and current experimental vaccines developed for use against Q fever and proposes approaches to develop a vaccine that establishes immunological memory while eliminating harmful reactogenic responses.
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Affiliation(s)
- Gayathri Sam
- Centre for Cell Factories and Biopolymers, Griffith Institute for Drug Discovery, Griffith University, Brisbane, QLD, 4111, Australia
| | - John Stenos
- Australian Rickettsial Reference Laboratory, University Hospital, Geelong, VIC, 3220, Australia
| | - Stephen R Graves
- Australian Rickettsial Reference Laboratory, University Hospital, Geelong, VIC, 3220, Australia
- Elizabeth Macarthur Agricultural Institute, NSW Department of Primary Industries, Menangle, NSW, 2567, Australia
| | - Bernd H A Rehm
- Centre for Cell Factories and Biopolymers, Griffith Institute for Drug Discovery, Griffith University, Brisbane, QLD, 4111, Australia.
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, 4222, Australia.
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Mathews KO, Savage C, Norris JM, Phalen D, Malikides N, Sheehy PA, Bosward KL. Risk factors associated with self-reported Q fever in Australian wildlife rehabilitators: Findings from an online survey. Zoonoses Public Health 2023; 70:69-80. [PMID: 36225093 PMCID: PMC10091799 DOI: 10.1111/zph.13002] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 09/01/2022] [Accepted: 09/19/2022] [Indexed: 01/07/2023]
Abstract
Australian wildlife rehabilitators (AWR) are at increased risk of developing Q fever, a serious zoonotic disease caused by the intracellular bacterium Coxiella burnetii. Previous studies have suggested that Australian wildlife may be a potential C. burnetii infection source for humans. However, a recent serological survey of AWR found no association between C. burnetii exposure and direct contact with any wildlife species. To further explore the potential risk that wildlife may pose, this study aimed to identify associations between self-reported Q fever in AWR and risk factors for exposure to C. burnetii. An online cross-sectional survey was implemented in 2018 targeting AWR nationwide. Risk factors for self-reported Q fever were determined using multivariable logistic regression. Medically diagnosed Q fever was self-reported in 4.5% (13/287) of unvaccinated respondents. Rehabilitators who self-reported medically diagnosed Q fever were significantly more likely to: primarily rehabilitate wildlife at a veterinary clinic (OR 17.87, 95% CI: 3.09-110.92), have domestic ruminants residing on the property where they rehabilitate wildlife (OR 11.75, 95% CI: 2.91-57.42), have been educated at a High School/Technical and Further Education level (OR 10.29, 95% CI: 2.13-84.03) and be aged >50 years (OR 6.61, 95% CI: 1.60-38.35). No association was found between self-reported Q fever and direct contact with wildlife. These findings support previous work suggesting that AWR are at increased risk of C. burnetii infection and may develop Q fever potentially via exposure to traditional infection sources including livestock, other domestic animals, or contaminated environments, in association with their rehabilitation practices and lifestyle. Although Q fever vaccination is recommended for AWR, vaccine uptake is low in this population. Future studies should aim to determine the level of Q fever awareness and identify barriers to Q fever vaccination in this at-risk group. The difficulty in accessing the AWR population also highlights the need for a national centralized AWR database.
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Affiliation(s)
- Karen O Mathews
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
| | | | - Jacqueline M Norris
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia.,Sydney Institute for Infectious Diseases, The University of Sydney, Sydney, New South Wales, Australia
| | - David Phalen
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
| | | | - Paul A Sheehy
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
| | - Katrina L Bosward
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia.,Sydney Institute for Infectious Diseases, The University of Sydney, Sydney, New South Wales, Australia
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Mathews KO, Norris JM, Phalen D, Malikides N, Savage C, Sheehy PA, Bosward KL. Factors associated with Q fever vaccination in Australian wildlife rehabilitators. Vaccine 2023; 41:201-210. [PMID: 36424259 DOI: 10.1016/j.vaccine.2022.10.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 10/10/2022] [Accepted: 10/31/2022] [Indexed: 11/23/2022]
Abstract
Australian wildlife rehabilitators (AWR) are at risk of contracting Q fever, a serious zoonotic disease caused by Coxiella burnetii. Despite Australian government recommendations for AWR to receive Q fever vaccination (QFV), and the availability of a safe and effective vaccine in Australia, shortfalls in vaccine uptake have been observed in AWR. This study aimed to determine factors associated with QFV status and describe AWR attitudes and potential barriers towards QFV. Data were obtained from a nationwide, online, cross-sectional survey of AWR undertaken in 2018. Approximately-three quarters (200/265; 75.5 %) of those that had heard of Q fever were also aware of the Q fever vaccine, and of those, 25.5 % (51/200) were vaccinated. Barriers to QFV, among unvaccinated respondents who had also heard of Q fever and the vaccine (149/200; 74.5 %), included concerns regarding the safety, efficacy, and importance of the Q fever vaccine. Complacency toward vaccination, convenience of vaccination, and a lack of Q fever knowledge were also notable barriers. Only 27.7 % (41/148) of respondents reported having had vaccination recommended to them. Multivariable logistic regression identified that vaccinated AWR were more likely to be aged ≤ 50 years (OR 4.51, 95 % CI: 2.14-10.11), have had a university level education (OR 2.78, 95 % CI: 1.39-5.73), have resided in New South Wales/Australian Capital Territory and Queensland than in other Australian jurisdictions (OR 2.9, 95 % CI: 1.10-8.83 and OR 4.82, 95 % CI: 1.64-16.00 respectively) and have attended an animal birth (OR 2.14, 95 % CI: 1.02-4.73). Knowledge gaps regarding Q fever and QFV in AWR demonstrated the need for interventions to raise the awareness of the potential health consequences of C. burnetii exposure and Q fever prevention. Education programs to allow AWR to develop an informed perspective of Q fever and QFV, coupled with improvements in vaccine affordability and the implementation of programs to enhance accessibility, may also increase vaccine uptake.
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Affiliation(s)
- Karen O Mathews
- The University of Sydney, Sydney School of Veterinary Science, Faculty of Science, Camden, NSW, Australia
| | - Jacqueline M Norris
- The University of Sydney, Sydney School of Veterinary Science, Faculty of Science, Camden, NSW, Australia; Sydney Institute for Infectious Diseases, University of Sydney, Sydney 2006, New South Wales, Australia
| | - David Phalen
- The University of Sydney, Sydney School of Veterinary Science, Faculty of Science, Camden, NSW, Australia
| | | | | | - Paul A Sheehy
- The University of Sydney, Sydney School of Veterinary Science, Faculty of Science, Camden, NSW, Australia
| | - Katrina L Bosward
- The University of Sydney, Sydney School of Veterinary Science, Faculty of Science, Camden, NSW, Australia; Sydney Institute for Infectious Diseases, University of Sydney, Sydney 2006, New South Wales, Australia.
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Hobbs MJ, Ketheesan N, Eastwood K, Massey P, Ranmuthugala G, Norton R, Quirk FH. Q Fever awareness and risk profiles among agricultural show attendees. Aust J Rural Health 2022; 30:601-607. [PMID: 35816572 PMCID: PMC9796403 DOI: 10.1111/ajr.12896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 04/15/2022] [Accepted: 05/09/2022] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE To assess awareness and risk of Q fever among agricultural show attendees. SETTING University of New England's Farm of the Future Pavilion, 2019, Sydney Royal Agricultural Show. PARTICIPANTS Participants were ≥18 years, fluent in English, Australian residents, and gave their informed consent. MAIN OUTCOME MEASURES Participants reported whether they had ever heard of Q fever and then completed the 'Q Tool' (www.qfevertool.com), which was used to assess participants' demographics and risk profiles. Cross-tabulations and logistic regression analyses were used to examine the relationship between these factors. RESULTS A total of 344 participants were recruited who, in general, lived in major NSW cities and were aged 40-59 years. 62% were aware of Q fever. Living in regional/remote areas and regular contact with livestock, farms, abattoirs and/or feedlots increased the likelihood of Q fever awareness. Direct or indirect contact with feral animals was not associated with Q fever awareness after controlling for the latter risk factors. 40% of participants had a high, 21% a medium, and 30% a low risk of exposure. Slightly less than 10% reported a likely existing immunity or vaccination against Q fever. Among those who were not immune, living in a regional or remote area and Q fever awareness were independently associated with increased likelihood of exposure. CONCLUSIONS Awareness of Q fever was relatively high. Although 61% of participants had a moderate to high risk of exposure to Q fever, they had not been vaccinated. This highlights the need to explore barriers to vaccination including accessibility of providers and associated cost.
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Affiliation(s)
- Megan J. Hobbs
- New England Institute of Healthcare Research, UNEArmidaleNSWAustralia,School of Rural Medicine, UNEArmidaleNSWAustralia
| | - Natkunam Ketheesan
- New England Institute of Healthcare Research, UNEArmidaleNSWAustralia,Q Fever Research Consortium, UNEArmidaleNSWAustralia,School of Science and Technology, UNEArmidaleNSWAustralia
| | - Keith Eastwood
- Q Fever Research Consortium, UNEArmidaleNSWAustralia,School of Medicine and Public HealthUniversity of NewcastleCallaghanNSWAustralia,Population HealthHunter New England Local Health DistrictNew LambtonNSWAustralia
| | - Peter Massey
- Q Fever Research Consortium, UNEArmidaleNSWAustralia,Population HealthHunter New England Local Health DistrictNew LambtonNSWAustralia
| | - Geetha Ranmuthugala
- New England Institute of Healthcare Research, UNEArmidaleNSWAustralia,School of Rural Medicine, UNEArmidaleNSWAustralia,Q Fever Research Consortium, UNEArmidaleNSWAustralia
| | - Robert Norton
- Q Fever Research Consortium, UNEArmidaleNSWAustralia,Townsville Hospital Health Service, Queensland HealthDouglasQldAustralia,School of Biomedical SciencesUniversity of QueenslandSt LuciaQldAustralia
| | - Frances H. Quirk
- New England Institute of Healthcare Research, UNEArmidaleNSWAustralia,School of Rural Medicine, UNEArmidaleNSWAustralia,Q Fever Research Consortium, UNEArmidaleNSWAustralia
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Graves SR, Islam A, Webb LD, Marsh I, Plain K, Westman M, Conlan XA, Carbis R, Toman R, Stenos J. An O-Specific Polysaccharide/Tetanus Toxoid Conjugate Vaccine Induces Protection in Guinea Pigs against Virulent Challenge with Coxiella burnetii. Vaccines (Basel) 2022; 10:vaccines10091393. [PMID: 36146471 PMCID: PMC9503072 DOI: 10.3390/vaccines10091393] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/15/2022] [Accepted: 08/17/2022] [Indexed: 11/16/2022] Open
Abstract
Q fever is caused by the bacterium Coxiella burnetii and is spread to humans from infected animals especially goats, sheep and cattle, predominantly when giving birth. There is an effective human vaccine (Q-VAX) against Q fever, and although Q fever is a worldwide problem, the vaccine is only used in Australia due to difficulties associated with its use and the risk of adverse reactions. The desire to protect humans, particularly farmers and abattoir workers, from Q fever prompted the development of a new safe and effective human vaccine without all the difficulties associated with the current vaccine. Candidate vaccines were prepared using purified O-specific polysaccharide (OSP) extracted from the lipopolysaccharide of virulent (phase 1) C. burnetii, strain Nine Mile, which was then conjugated to a tetanus toxoid (TT) carrier protein. Two vaccines were prepared using OSP from C. burnetii grown in embryonated eggs (vaccine A) and axenic media (vaccine B). Vaccines with or without alum adjuvant were used to vaccinate guinea pigs, which were later challenged by intranasal inoculation with virulent C. burnetii. Both vaccines protected guinea pigs from fever and loss of weight post challenge. Post-mortem samples of the spleen, liver and kidney of vaccinated guinea pigs contained substantially less C. burnetii DNA as measured by PCR than those of the unvaccinated control animals. This study demonstrated that a C. burnetii OSP-TT conjugate vaccine is capable of inducing protection against virulent C. burnetii in guinea pigs. Additionally, OSP derived from C. burnetii grown in axenic media compared to OSP from embryonated eggs is equivalent in terms of providing a protective immune response.
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Affiliation(s)
- Stephen R. Graves
- Australian Rickettsial Reference Laboratory, University Hospital, Geelong, VIC 3220, Australia
- Elizabeth Macarthur Agricultural Institute, NSW Department of Primary Industries, Menangle, NSW 2567, Australia
- Correspondence:
| | - Aminul Islam
- Australian Rickettsial Reference Laboratory, University Hospital, Geelong, VIC 3220, Australia
- Elizabeth Macarthur Agricultural Institute, NSW Department of Primary Industries, Menangle, NSW 2567, Australia
| | - Lawrence D. Webb
- School of Life and Environmental Science, Deakin University, Waurn Ponds, VIC 3216, Australia
| | - Ian Marsh
- Elizabeth Macarthur Agricultural Institute, NSW Department of Primary Industries, Menangle, NSW 2567, Australia
| | - Karren Plain
- Elizabeth Macarthur Agricultural Institute, NSW Department of Primary Industries, Menangle, NSW 2567, Australia
| | - Mark Westman
- Elizabeth Macarthur Agricultural Institute, NSW Department of Primary Industries, Menangle, NSW 2567, Australia
| | - Xavier A. Conlan
- School of Life and Environmental Science, Deakin University, Waurn Ponds, VIC 3216, Australia
| | - Rodney Carbis
- Symbioticus Pty Ltd., Strathmore, VIC 3041, Australia
| | - Rudolf Toman
- Institute of Virology, Slovak Academy of Sciences, 845 05 Bratislava, Slovakia
| | - John Stenos
- Australian Rickettsial Reference Laboratory, University Hospital, Geelong, VIC 3220, Australia
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Profiling Risk Factors for Household and Community Spatiotemporal Clusters of Q Fever Notifications in Queensland between 2002 and 2017. Pathogens 2022; 11:pathogens11080830. [PMID: 35894053 PMCID: PMC9332293 DOI: 10.3390/pathogens11080830] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/07/2022] [Accepted: 07/20/2022] [Indexed: 02/05/2023] Open
Abstract
Q fever, caused by the bacterium Coxiella burnetii, is an important zoonotic disease worldwide. Australia has one of the highest reported incidences and seroprevalence of Q fever, and communities in the state of Queensland are at highest risk of exposure. Despite Australia’s Q fever vaccination programs, the number of reported Q fever cases has remained stable for the last few years. The extent to which Q fever notifications cluster in circumscribed communities is not well understood. This study aimed to retrospectively explore and identify the spatiotemporal variation in Q fever household and community clusters in Queensland reported during 2002 to 2017, and quantify potential within cluster drivers. We used Q fever notification data held in the Queensland Notifiable Conditions System to explore the geographical clustering patterns of Q fever incidence, and identified and estimated community Q fever spatiotemporal clusters using SatScan, Boston, MA, USA. The association between Q fever household and community clusters, and demographic and socioeconomic characteristics was explored using the chi-squared statistical test and logistic regression analysis. From the total 2175 Q fever notifications included in our analysis, we found 356 Q fever hotspots at a mesh-block level. We identified that 8.2% of Q fever notifications belonged to a spatiotemporal cluster. Within the spatiotemporal Q fever clusters, we found 44 (61%) representing household clusters and 20 (27.8%) were statistically significant with an average cluster size of 3 km radius. Our multivariable model shows statistical differences between cases belonging to clusters in comparison with cases outside clusters based on the type of reported exposure. In conclusion, our results demonstrate that clusters of Q fever notifications are temporally stable and geographically circumscribed, indicating a persistent common exposure. Furthermore, within individuals in household and community clusters, abattoir exposure (a traditional occupational exposure) was rarely reported by individuals.
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Yang Y, Shi Q, Jin Q, Yang Z, Li W, Han J, Mao J, Zheng B. Case Report: Metagenomic Next-Generation Sequencing Clinches the Diagnosis of Acute Q Fever and Verified by Indirect Immunofluorescence Assay. Front Med (Lausanne) 2022; 9:846526. [PMID: 35721056 PMCID: PMC9204269 DOI: 10.3389/fmed.2022.846526] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 05/04/2022] [Indexed: 11/13/2022] Open
Abstract
Q fever is a zoonotic infectious disease caused by Coxiella burnetii. The clinical symptoms of acute Q fever are usually atypical, and routine serological tests of C. burnetii are not readily available, making the diagnosis of Q fever a challenge. In this case, we report a male patient who had repeated fevers and was administered empirical anti-infective treatment, but the effect was poor. After conducting relevant laboratory and imagological examinations, the etiology has not yet been confirmed. Subsequently, metagenomic next-generation sequencing (mNGS) identified the sequence reads of C. burnetii from the patient's peripheral blood within 48 h, and then the diagnosis of acute Q fever was established. Moreover, the serological test of indirect immunofluorescence assay (IFA) of the C. burnetii antibody was further performed in the Centers for Disease Control, certifying the result of mNGS. The patient was ultimately treated with doxycycline and recovered well. mNGS is an unbiased and comprehensive method in infrequent or culture-negative pathogen identification. To our knowledge, this is the first case of acute Q fever identified by mNGS and confirmed by IFA in Taizhou, China. A further large-scale prospective clinical cohort study is worth carrying out to compare the diagnostic efficiency of mNGS with traditional serological methods and PCR in acute Q fever.
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Affiliation(s)
- Yide Yang
- Department of Infectious Diseases, Taizhou Municipal Hospital, Taizhou, China
| | - Qingmiao Shi
- Jinan Microecological Biomedicine Shandong Laboratory, Jinan, China.,State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Qian Jin
- Department of Infectious Diseases, Taizhou Municipal Hospital, Taizhou, China
| | - Zhangnv Yang
- Department of Microbiology, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | | | - Jianfeng Han
- Sansure Biotech Inc. Medical Affairs Department, National Joint Local Engineering Research Center for Genetic Diagnosis of Infection Diseases and Tumours, Beijing, China
| | - Juanjuan Mao
- Department of Infectious Diseases, Taizhou Municipal Hospital, Taizhou, China
| | - Beiwen Zheng
- Jinan Microecological Biomedicine Shandong Laboratory, Jinan, China.,State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
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ALKAN S. … İlindeki Q ateşi olgularının retrospektif olarak değerlendirilmesi. MUSTAFA KEMAL ÜNIVERSITESI TIP DERGISI 2022. [DOI: 10.17944/mkutfd.1052874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Amaç: Q ateşi, özellikle risk grubundaki bireylerde akut ve kronik formda görülebilen, özgül olmayan semptomları nedeniyle tanısı atlanabilen, zoonotik bir hastalıktır. Önceleri sıklıkla yanlış tanı alan bu hastalık olguları, ülkemizden de son yıllarda bildirilmeye başlamıştır. Bu çalışmada Q ateşi olgularının klinik ve laboratuvar parametrelerini retrospektif olarak değerlendirmeyi ve Q ateşi farkındalığını arttırmayı amaçladık.
Gereç ve Yöntem: Retrospektif gözlemsel çalışmamızda, 1 Ocak 2018–1 Mart 2021 tarihleri arasında hastanemizde takip ve tedavi edilen, 18 yaş üstü, kesin tanı almış, Q ateşi olguları değerlendirildi. Hastalara ait yaş, cinsiyet, meslek, ikamet edilen yer gibi demografik veriler, kene teması öyküleri, hastalığın geliştiği zaman dilimi (yıl, mevsim, ay), eşlik eden komorbiditeler, semptomlar, fizik muayene ve laboratuvar bulguları, tedaviler, hastaların iyileşme ve mortalite durumları irdelendi.
Bulgular: Çalışmaya yaş ortalaması 49,23±12,07 yıl, 7’si (%57) erkek olan 14 olgu dahil edildi. Olguların sadece 5’i (%35,7) çiftçi, dördü (%28,57) hayvancılık yapıyordu. Kırsal alanda yaşama 9 (%64,28) olguda mevcuttu. En sık semptomlar ateş yüksekliği (%100), öksürük (%71,42) ve miyalji (%57,14) idi. Olguların tamamı akut Q ateşi olgusu olup, endokardit hiçbir olguda saptanmadı.
Sonuç: Ülkemizin Q ateşi hastalığı için olası endemik bölgelerden olması nedeniyle, özellikle kırsal kesimde yaşayan, hayvancılıkla uğraşma, pastörize edilmemiş süt/süt ürünü tüketme gibi risk faktörleri olan hastalarda pnömoni başta olmak üzere birçok hastalığın ayırıcı tanısında düşünülmesi gerektiğini vurgulamak istedik.
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Affiliation(s)
- Sevil ALKAN
- Çanakkale On sekiz Mart Üniversitesi Tıp Fakültesi, Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı, Çanakkale
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11
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Orr B, Malik R, Westman ME, Norris JM. Seroprevalence of Coxiella burnetii in pig-hunting dogs from north Queensland, Australia. Aust Vet J 2022; 100:230-235. [PMID: 35156193 PMCID: PMC9306716 DOI: 10.1111/avj.13151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 01/26/2022] [Indexed: 12/24/2022]
Abstract
The causative agent of Q fever, Coxiella burnetii, is endemic to Queensland and is one of the most important notifiable zoonotic diseases in Australia. The reservoir species for C. burnetii are classically ruminants, including sheep, cattle and goats. There is increasing evidence of C. burnetii exposure in dogs across eastern and central Australia. The present study aimed to determine if pig-hunting dogs above the Tropic of Capricorn in Queensland had similar rates of C. burnetii exposure to previous serosurveys of companion dogs in rural north-west New South Wales. A total of 104 pig-hunting dogs had serum IgG antibody titres to phase I and phase 2 C. burnetii determined using an indirect immunofluorescence assay test. Almost one in five dogs (18.3%; 19/104; 95% confidence interval 9.6%-35.5%) were seropositive to C. burnetii, with neutered dogs more likely to test positive compared to entire dogs (P = 0.0497). Seropositivity of the sampled pig-hunting dogs was one of the highest recorded in Australia. Thirty-nine owners of the pig-hunting dogs completed a survey, revealing 12.8% (5/39) had been vaccinated against Q fever and 90% (35/39) were aware that both feral pigs and dogs could potentially be sources of C. burnetii. Our findings indicate that pig hunters should be aware of the risk of exposure to Q fever during hunts and the sentinel role their dogs may play in C. burnetii exposure.
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Affiliation(s)
- B Orr
- Sydney School of Veterinary Science, The University of Sydney, Sydney, New South Wales, Australia
| | - R Malik
- Centre for Veterinary Education, The University of Sydney, Sydney, New South Wales, Australia.,School of Veterinary and Animal Science, Charles Sturt University, Wagga Wagga, New South Wales, Australia
| | - M E Westman
- Sydney School of Veterinary Science, The University of Sydney, Sydney, New South Wales, Australia.,Elizabeth Macarthur Agricultural Institute (EMAI), Menangle, New South Wales, Australia
| | - J M Norris
- Sydney School of Veterinary Science, The University of Sydney, Sydney, New South Wales, Australia.,The Sydney Institute for Infectious Diseases, University of Sydney, Sydney, New South Wales, Australia
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12
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Rahaman MR, Hodgetts K, Milazzo A, Marshall H, Chaber AL, Crabb D, Bi P. Q fever prevention in Australia: general practitioner and stakeholder perspectives on preparedness and the potential of a One Health approach. Aust N Z J Public Health 2021; 46:196-202. [PMID: 34941007 DOI: 10.1111/1753-6405.13198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 09/01/2021] [Accepted: 11/01/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To examine stakeholder perspectives on the factors of an effective approach to reduce Q fever risk including disease prevention, and the perceived potential benefits of a One Health framework. METHODS Semi-structured interviews were conducted with general practitioners (GPs), veterinarians, government authorities, researchers, and representatives from the farming industry. Transcripts were thematically analysed. RESULTS Six major themes were identified as key factors underpinning an effective approach to Q fever: understanding Q fever burden; effective surveillance; the role of general practitioners and other stakeholders; barriers and enablers of vaccination; an integrated approach; and increased Q fever awareness. Most participants perceived GPs to play a central role in disease detection, notification, treatment and prevention through health promotion and vaccination, despite GPs acknowledging limited awareness of Q fever. Participants suggested leadership is required from the Department of Health (DoH) to foster inter-sectoral communication and collaboration. CONCLUSIONS A One Health approach holds opportunities for zoonosis prevention. We recommend that medical curricula and professional development be enhanced, zoonosis working group networks strengthened, government-industry partnerships established, and relevant stakeholders included within an integrated program. Implications for public health: Updating medical curricula, GP professional development programs and inter-sectoral collaboration led by health departments may reduce Q fever burden.
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Affiliation(s)
- Md R Rahaman
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Australian Capital Territory.,School of Public Health, The University of Adelaide, South Australia
| | | | - Adriana Milazzo
- School of Public Health, The University of Adelaide, South Australia
| | - Helen Marshall
- Adelaide Medical School and Robinson Research Institute, The University of Adelaide, South Australia.,Women's and Children's Health Network, South Australia
| | - Anne-Lise Chaber
- School of Animal and Veterinary Sciences, The University of Adelaide, South Australia
| | | | - Peng Bi
- School of Public Health, The University of Adelaide, South Australia
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13
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Mathews KO, Toribio JA, Norris JM, Phalen D, Wood N, Graves SR, Sheehy PA, Bosward KL. Coxiella burnetii seroprevalence and Q fever in Australian wildlife rehabilitators. One Health 2021; 12:100197. [PMID: 33319024 PMCID: PMC7725937 DOI: 10.1016/j.onehlt.2020.100197] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 11/12/2020] [Accepted: 11/17/2020] [Indexed: 12/27/2022] Open
Abstract
Coxiella burnetii is the causative bacterium of the zoonotic disease Q fever, which is recognised as a public health concern globally. Macropods have been suggested as a potential source of C. burnetii infection for humans. The aim of this cross-sectional study was to determine the prevalence of C. burnetii exposure in a cohort of Australian wildlife rehabilitators (AWRs) and assess Q fever disease and vaccination status within this population. Blood samples were collected from adult participants attending the Australian Wildlife Rehabilitation Conference in Sydney in July 2018. Participants completed a questionnaire at the time of blood collection. Antibody titres (IgG, IgA and IgM) against phase I and phase II C. burnetii antigens as determined by immunofluorescence assay, revealed that of the unvaccinated participants, 6.1% (9/147) had evidence of exposure to C. burnetii. Of the total participants, 8.1% (13/160) had received Q fever vaccination, four of whom remained seropositive at the time of blood collection. Participants reporting occupational contact with ruminants, were eight times more likely to have been vaccinated against Q fever, than those reporting no occupational animal contact (OR 8.1; 95% CI 1.85-45.08). Three AWRs (2%) reported having had medically diagnosed Q fever, two of whom remained seropositive at the time of blood collection. Despite the lack of association between macropod contacts and C. burnetii seropositivity in this cohort, these findings suggest that AWRs are approximately twice as likely to be exposed to C. burnetii, compared with the general Australian population. This provides support for the recommendation of Q fever vaccination for this potentially 'at-risk' population. The role of macropods in human Q fever disease remains unclear, and further research into C. burnetii infection in macropods including: infection rate and transmission cycles between vectors, macropods as reservoirs, other animals and humans is required.
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Key Words
- Australia, wildlife rehabilitators
- Australian Statistical Geography Standard, ASGS
- Australian Wildlife Rehabilitation Conference, AWRC
- Australian wildlife rehabilitators, AWRs
- Coxiella burnetii
- Indirect immunofluorescence assay, IFA
- Macropods, kangaroos
- Personal protection equipment, PPE
- Q fever
- Q fever disease status, QFDS
- Q fever disease, QFD
- Q fever serostatus, QFSS
- Q fever vaccination status, QFVS
- Q fever vaccination, QFV
- Seroprevalence
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Affiliation(s)
- Karen O. Mathews
- The University of Sydney, Sydney School of Veterinary Science, Faculty of Science, Camden, NSW, Australia
| | - Jenny-Ann Toribio
- The University of Sydney, Sydney School of Veterinary Science, Faculty of Science, Camden, NSW, Australia
| | - Jacqueline M. Norris
- The University of Sydney, Sydney School of Veterinary Science, Faculty of Science, Camden, NSW, Australia
| | - David Phalen
- The University of Sydney, Sydney School of Veterinary Science, Faculty of Science, Camden, NSW, Australia
| | - Nicholas Wood
- The University of Sydney, Discipline of Paediatrics and Child Health, Sydney Medical School, Camperdown, NSW, Australia
- National Centre for Immunisation Research and Surveillance, Westmead, NSW, Australia
| | - Stephen R. Graves
- Australian Rickettsial Reference Laboratory, University Hospital Geelong, Victoria 3220, Australia
| | - Paul A. Sheehy
- The University of Sydney, Sydney School of Veterinary Science, Faculty of Science, Camden, NSW, Australia
| | - Katrina L. Bosward
- The University of Sydney, Sydney School of Veterinary Science, Faculty of Science, Camden, NSW, Australia
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14
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Tellis AN, Rowe SM, Coilparampil R, Jenkins C, Dart A, Zadoks RN, Regnerus CD, Bosward KL. Evaluation of three immunological assays to mitigate the risk of transboundary spread of Coxiella burnetii by alpacas. Transbound Emerg Dis 2021; 69:793-804. [PMID: 33655708 DOI: 10.1111/tbed.14051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 02/07/2021] [Accepted: 02/27/2021] [Indexed: 11/30/2022]
Abstract
Coxiella burnetii causes coxiellosis in animals and Q fever in humans, a potentially debilitating zoonotic disease commonly transmitted through domestic ruminants. To prevent transboundary spread of C. burnetii, animals may be tested prior to export. In alpacas, this process is complicated by the lack of scientific evidence for C. burnetii infection in the species, and the unique composition of camelid antibodies, which may cause false-positive results in assays developed for ruminants. We evaluated a complement fixation test (CFT; currently recommended for alpacas in New Zealand), an enzyme-linked immunosorbent assay (ELISA) and an immunofluorescence assay (IFA). Positive analytical control samples were generated through vaccination of alpacas with a human Q fever vaccine, whereas negative analytical control samples were sourced from New Zealand (deemed free of C. burnetii). Immunological assays were conducted on 131 alpaca sera submitted for export testing. Test characteristics (sensitivity, specificity, positive and negative predictive values) for CFT, ELISA and IFA were determined using Bayesian latent class analysis. Due to anticomplementary activity, 37 (28.2%) of the CFT results were inconclusive, making CFT unsuitable for routine use. Of the remaining 94 samples, 10.6%, 0% and 7.4% were positive for C. burnetii antibodies based on CFT, ELISA and IFA, respectively, yielding estimated sensitivities of 58%, 26% and 78%, and estimated specificities of 95%, 98% and 95%, with the estimates for sensitivity being imprecise, as evidenced by wide 95% credible intervals. Positive predictive values were similar across assays, albeit very low at the estimated seroprevalence of 5%. Our results indicate that, of the tests available, IFA appears to be the most appropriate for use in alpacas. Higher sensitivity of antibody detection, use of antigen detection assays and availability of samples from individuals with evidence of infection could provide additional insight into the risk of transboundary spread of C. burnetii by alpacas.
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Affiliation(s)
- Anastasia N Tellis
- School of Life and Environmental Sciences, Faculty of Science, The University of Sydney, Camperdown, New South Wales, Australia
| | - Sam M Rowe
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Camden, New South Wales, Australia
| | - Ronald Coilparampil
- NSW Department of Primary Industries, Elizabeth Macarthur Agricultural Institute, Menangle, New South Wales, Australia
| | - Cheryl Jenkins
- NSW Department of Primary Industries, Elizabeth Macarthur Agricultural Institute, Menangle, New South Wales, Australia
| | - Andrew Dart
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Camden, New South Wales, Australia
| | - Ruth N Zadoks
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Camden, New South Wales, Australia
| | | | - Katrina L Bosward
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Camden, New South Wales, Australia
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15
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Ma GC, Norris JM, Mathews KO, Chandra S, Šlapeta J, Bosward KL, Ward MP. New insights on the epidemiology of Coxiella burnetii in pet dogs and cats from New South Wales, Australia. Acta Trop 2020; 205:105416. [PMID: 32105667 DOI: 10.1016/j.actatropica.2020.105416] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 02/03/2020] [Accepted: 02/20/2020] [Indexed: 02/07/2023]
Abstract
Q fever is considered one of the most important zoonoses in Australia. Whilst ruminants are the primary reservoirs for Coxiella burnetii, and the major source of human infection, human cases have also been reported following contact with pet dogs and cats. This study aimed to estimate the prevalence of seropositivity to, and bacterial shedding of, C. burnetii by pet dogs and cats in a region with a high human Q fever incidence and explore risk factors for C. burnetii exposure. Samples (serum, whole blood, reproductive tissue, reproductive swabs) and questionnaires (completed by the pet's owner) were collected from dogs and cats from eight communities across remote New South Wales (NSW), Australia. Overall 86/330 dogs (26.1%, 95% CI 21.3-30.8%) and 19/145 cats (13.1%, 95% CI 7.6-18.6%) were seropositive to C. burnetii. Seroprevalence varied significantly between communities and was highest in communities within 150 km of a 2015 human Q fever outbreak. Feeding raw kangaroo was identified as a risk factor for seropositivity (adjusted OR 3.37, 95% CI 1.21-9.43). Coxiella burnetii DNA was not detected from any dog or cat whole blood, reproductive tissue or vaginal/preputial swab using qPCR targeting the IS1111 and com1 genes. Our findings suggest that companion animals are frequently exposed to C. burnetii in western NSW. Geographical variation in C. burnetii seroprevalence amongst companion animals - which corresponds with a human Q fever outbreak - suggests a shared environmental source of infection is likely with important consequences for public and animal health. The lack of detection of C. burnetii DNA from healthy companion animals suggests that pet dogs and cats are not an important reservoir for human Q fever infection outside a narrow periparturient window.
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Affiliation(s)
- Gemma C Ma
- Sydney School of Veterinary Science, Faculty of Science, the University of Sydney, New South Wales, Australia.
| | - Jacqueline M Norris
- Sydney School of Veterinary Science, Faculty of Science, the University of Sydney, New South Wales, Australia
| | - Karen O Mathews
- Sydney School of Veterinary Science, Faculty of Science, the University of Sydney, New South Wales, Australia
| | - Shona Chandra
- Sydney School of Veterinary Science, Faculty of Science, the University of Sydney, New South Wales, Australia
| | - Jan Šlapeta
- Sydney School of Veterinary Science, Faculty of Science, the University of Sydney, New South Wales, Australia
| | - Katrina L Bosward
- Sydney School of Veterinary Science, Faculty of Science, the University of Sydney, New South Wales, Australia
| | - Michael P Ward
- Sydney School of Veterinary Science, Faculty of Science, the University of Sydney, New South Wales, Australia
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16
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Hackert VH, Hoebe CJPA, Dukers-Muijrers N, Krafft T, Kauhl B, Henning K, Karges W, Sprague L, Neubauer H, Al Dahouk S. Q fever: Evidence of a massive yet undetected cross-border outbreak, with ongoing risk of extra mortality, in a Dutch-German border region. Transbound Emerg Dis 2020; 67:1660-1670. [PMID: 32027783 PMCID: PMC7383856 DOI: 10.1111/tbed.13505] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 01/20/2020] [Accepted: 01/31/2020] [Indexed: 12/11/2022]
Abstract
Background Following outbreaks in other parts of the Netherlands, the Dutch border region of South Limburg experienced a large‐scale outbreak of human Q fever related to a single dairy goat farm in 2009, with surprisingly few cases reported from neighbouring German counties. Late chronic Q fever, with recent spikes of newly detected cases, is an ongoing public health concern in the Netherlands. We aimed to assess the scope and scale of any undetected cross‐border transmission to neighbouring German counties, where individuals unknowingly exposed may carry extra risk of overlooked diagnosis. Methods (A) Seroprevalence rates in the Dutch area were estimated fitting an exponential gradient to the geographical distribution of notified acute human Q fever cases, using seroprevalence in a sample of farm township inhabitants as baseline. (B) Seroprevalence rates in 122 neighbouring German postcode areas were estimated from a sample of blood donors living in these areas and attending the regional blood donation centre in January/February 2010 (n = 3,460). (C) Using multivariate linear regression, including goat and sheep densities, veterinary Q fever notifications and blood donor sampling densities as covariates, we assessed whether seroprevalence rates across the entire border region were associated with distance from the farm. Results (A) Seroprevalence in the outbreak farm's township was 16.1%. Overall seroprevalence in the Dutch area was 3.6%. (B) Overall seroprevalence in the German area was 0.9%. Estimated mean seroprevalence rates (per 100,000 population) declined with increasing distance from the outbreak farm (0–19 km = 2,302, 20–39 km = 1,122, 40–59 km = 432 and ≥60 km = 0). Decline was linear in multivariate regression using log‐transformed seroprevalence rates (0–19 km = 2.9 [95% confidence interval (CI) = 2.6 to 3.2], 20 to 39 km = 1.9 [95% CI = 1.0 to 2.8], 40–59 km = 0.6 [95% CI = −0.2 to 1.3] and ≥60 km = 0.0 [95% CI = −0.3 to 0.3]). Conclusions Our findings were suggestive of widespread cross‐border transmission, with thousands of undetected infections, arguing for intensified cross‐border collaboration and surveillance and screening of individuals susceptible to chronic Q fever in the affected area.
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Affiliation(s)
- Volker H Hackert
- Department of Sexual Health, Infectious Diseases, and Environmental Health, South Limburg Public Health Service, Heerlen, The Netherlands.,Department of Social Medicine and Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University/MUMC+, Maastricht, The Netherlands
| | - Christian J P A Hoebe
- Department of Sexual Health, Infectious Diseases, and Environmental Health, South Limburg Public Health Service, Heerlen, The Netherlands.,Department of Social Medicine and Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University/MUMC+, Maastricht, The Netherlands
| | - Nicole Dukers-Muijrers
- Department of Sexual Health, Infectious Diseases, and Environmental Health, South Limburg Public Health Service, Heerlen, The Netherlands.,Department of Social Medicine and Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University/MUMC+, Maastricht, The Netherlands
| | - Thomas Krafft
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Boris Kauhl
- Department III, Civil Engineering and Geoinformatics, Beuth University of Applied Sciences, Berlin, Germany
| | - Klaus Henning
- Institute of Bacterial Infections and Zoonoses, Friedrich-Loeffler-Institut (FLI), Federal Research Institute for Animal Health, Jena, Germany
| | - Wolfram Karges
- Department of Internal Medicine III, RWTH Aachen University Hospital, Aachen, Germany
| | - Lisa Sprague
- Institute of Bacterial Infections and Zoonoses, Friedrich-Loeffler-Institut (FLI), Federal Research Institute for Animal Health, Jena, Germany
| | - Heinrich Neubauer
- Institute of Bacterial Infections and Zoonoses, Friedrich-Loeffler-Institut (FLI), Federal Research Institute for Animal Health, Jena, Germany
| | - Sascha Al Dahouk
- Department of Internal Medicine III, RWTH Aachen University Hospital, Aachen, Germany.,Department of Biological Safety, German Federal Institute for Risk Assessment (BfR), Berlin, Germany
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17
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Abstract
Q fever (caused by Coxiella burnetii) is thought to have an almost world-wide distribution, but few countries have conducted national serosurveys. We measured Q fever seroprevalence using residual sera from diagnostic laboratories across Australia. Individuals aged 1–79 years in 2012–2013 were sampled to be proportional to the population distribution by region, distance from metropolitan areas and gender. A 1/50 serum dilution was tested for the Phase II IgG antibody against C. burnetii by indirect immunofluorescence. We calculated crude seroprevalence estimates by age group and gender, as well as age standardised national and metropolitan/non-metropolitan seroprevalence estimates. Of 2785 sera, 99 tested positive. Age standardised seroprevalence was 5.6% (95% confidence interval (CI 4.5%–6.8%), and similar in metropolitan (5.5%; 95% CI 4.1%–6.9%) and non-metropolitan regions (6.0%; 95%CI 4.0%–8.0%). More males were seropositive (6.9%; 95% CI 5.2%–8.6%) than females (4.2%; 95% CI 2.9%–5.5%) with peak seroprevalence at 50–59 years (9.2%; 95% CI 5.2%–13.3%). Q fever seroprevalence for Australia was higher than expected (especially in metropolitan regions) and higher than estimates from the Netherlands (2.4%; pre-outbreak) and US (3.1%), but lower than for Northern Ireland (12.8%). Robust country-specific seroprevalence estimates, with detailed exposure data, are required to better understand who is at risk and the need for preventive measures.
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18
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Sellens E, Bosward KL, Norris JM, Wood N, Heller J, Graves S, Gidding HF. Coxiella burnetii seroprevalence in unvaccinated veterinary workers in Australia: Evidence to support Q fever vaccination. Zoonoses Public Health 2019; 67:79-88. [PMID: 31677254 DOI: 10.1111/zph.12658] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 07/09/2019] [Accepted: 10/02/2019] [Indexed: 12/12/2022]
Abstract
Q fever (caused by Coxiella burnetii) is a serious zoonotic disease that occurs almost worldwide. Occupational contact with animals increases the risk of exposure, and Q fever vaccination is recommended for veterinary workers in Australia. This study aimed to investigate C. burnetii seroprevalence among unvaccinated veterinary workers in Australia and determine factors associated with a positive serological result. During 2014 and 2015, convenience sampling at veterinary conferences and workplace vaccination clinics was undertaken. Participants completed a questionnaire and provided a blood sample for C. burnetii serology. Participants were predominantly veterinarians (77%), but veterinary support staff, animal scientists, and administration workers also participated. Blood samples (n = 192) were analysed by an immunofluorescence assay and considered positive where the phase I or phase II IgG titre was ≥1/50. Seroprevalence was 19% (36/192; 95% CI 14%-25%). A positive serological result was significantly associated with (a) working in outer regional/remote areas (odds ratio [OR] 6.2; 95% CI 1.9-20.8; reference = major cities; p = .009) and (b) having spent more than 50% of total career working with ruminants (OR 4.8; 95% CI 1.7-13.5; reference = <15% of career; p = .025). These findings confirm an increased risk of exposure to C. burnetii compared to the general population, providing new evidence to support Q fever vaccination of veterinary workers in Australia.
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Affiliation(s)
- Emily Sellens
- Faculty of Science, Sydney School of Veterinary Science, The University of Sydney, Camperdown, NSW, Australia
| | - Katrina L Bosward
- Faculty of Science, Sydney School of Veterinary Science, The University of Sydney, Camperdown, NSW, Australia
| | - Jacqueline M Norris
- Faculty of Science, Sydney School of Veterinary Science, The University of Sydney, Camperdown, NSW, Australia
| | - Nicholas Wood
- Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Camperdown, NSW, Australia.,National Centre for Immunisation Research and Surveillance, Westmead, NSW, Australia
| | - Jane Heller
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, NSW, Australia
| | - Stephen Graves
- Australian Rickettsial Reference Laboratory, University Hospital Geelong, Geelong, Vic., Australia
| | - Heather F Gidding
- National Centre for Immunisation Research and Surveillance, Westmead, NSW, Australia.,School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales, Sydney, NSW, Australia.,Clinical and Population Perinatal Health Research, Kolling Institute, Northern Sydney Local Health District, St Leonards, NSW, Australia.,The University of Sydney Northern Clinical School, The University of Sydney, Sydney, NSW, Australia
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19
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Francis JR, Robson JM. Q fever: more common than we think, and what this means for prevention. Med J Aust 2019; 210:305-306. [PMID: 30773646 DOI: 10.5694/mja2.50024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Joshua R Francis
- Royal Darwin Hospital, Darwin, NT.,Menzies School of Health Research, Darwin, NT
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