The effect of C. burnetii infection on the cytokine response of PBMCs from pregnant goats

In humans, infection with Coxiella burnetii, the causative agent of Q fever, leads to acute or chronic infection, both associated with specific clinical symptoms. In contrast, no symptoms are observed in goats during C. burnetii infection, although infection of the placenta eventually leads to premature delivery, stillbirth and abortion. It is unknown whether these differences in clinical outcome are due to the early immune responses of the goats. Therefore, peripheral blood mononuclear cells (PBMCs) were isolated from pregnant goats. In total, 17 goats were included in the study. Six goats remained naive, while eleven goats were infected with C. burnetii. Toll-like receptor (TLR) and cytokine mRNA expression were measured after in vitro stimulation with heat-killed C. burnetii at different time points (prior infection, day 7, 35 and 56 after infection). In naive goats an increased expression of interleukin (IL)-1β, tumor necrosis factor (TNF)-α, IL-10 and interferon (IFN)-γ mRNA upon C. burnetii stimulation was detected. In addition, TLR2 expression was strongly up-regulated. In goats infected with C. burnetii, PBMCs re-stimulated in vitro with C. burnetii, expressed significantly more TNF-α mRNA and IFN-γ mRNA compared to naive goats. In contrast, IL-10 mRNA production capacity was down-regulated during C. burnetii infection. Interestingly, at day 7 after inoculation a decreased IFN-γ protein level was observed in stimulated leukocytes in whole blood from infected goats, whereas at other time-points increased production of IFN-γ protein was seen. Our study shows that goats initiate a robust pro-inflammatory immune response against C. burnetii in vitro. Furthermore, PBMCs from C. burnetii infected goats show augmented pro-inflammatory cytokine responses compared to PBMCs from non-infected goats. However, despite this pro-inflammatory response, goats are not capable of clearing the C. burnetii infection.

Seroepidemiologic survey in Thailand of Coxiella burnetii infection in cattle and chickens and presence in ticks attached to dairy cattle

A seroepidemiologic survey of Coxiella burnetii in cattle and chickens in Thailand was carried out using indirect fluorescent antibody test. Nine of the 130 serum samples from cattle were positive for antibodies against C. burnetii, with antibody titers ranging from 32 to 64. Only one of 113 serum samples from chickens was seropositive, with antibody titer of 16. No C. burnetii-specific DNA was detected using restriction fragment length polymorphism-nested PCR in spleens of cattle and chickens. However, coxiella DNA was detected in two of 102 engorged Rhipicephalus microplus ticks attached to dairy cattle. These results indicated that infestation of C. burnetii among cattle and chickens is considerably low in Thailand.

Increasing prevalence of Coxiella burnetii seropositive Danish dairy cattle herds

A study based on bulk tank milk samples from 120 randomly selected dairy cattle herds was conducted to estimate the prevalence of Coxiella burnetii seropositive dairy herds, to describe the geographical distribution, and to identify risk factors. Using the CHEKIT Q-fever Antibody ELISA Test Kit (IDEXX), the study revealed a prevalence of 79.2% seropositive herds, 18.3% seronegative herds, and 2.5% serointermediate herds based on the instructions provided by the manufacturer. Multifactorial logistic regression showed statistically significant associations (P < 0.01) between C. burnetii seropositivity and increasing herd size (OR = 1.02 per cow increment) and increasing regional average number of cattle per dairy herd (OR = 1.02 per animal increment). Herds >150 cows had 17.9 times higher odds of testing positive compared to herds <80 cows. The regional average number of cattle herds per square kilometer was borderline significantly related to the occurrence of seropositive dairy herds (P = 0.06). The results indicate an increased prevalence of seropositive dairy herds since the previous survey in 2008 and an adverse impact of increasing herd size and cattle density on the risk of seropositivity.

Molecular and serologic detection of Coxiella burnetii in native Korean goats (Capra hircus coreanae)

The occurrence of Q fever in native Korean goats (Capra hircus coreanae) was investigated for the first time in the country using ELISA and PCR. A total of 597 blood samples were collected from goats belonging to five different provinces of Korea. To detect Coxiella burnetii, sera were separated from the whole blood and analysed by ELISA; DNA was extracted directly from the whole blood and analysed by PCR. Overall, 114 (19.1%, 95% C.I.=16.1-22.4) and 57 goats (9.5%, 95% C.I.=7.5-12.2) tested positive for C. burnetii in the ELISA- and PCR-based screening, respectively, while 18 goats (3.0%, 95% C.I.=1.9-4.7) tested positive in both the assays. There was a significant difference between the number of ELISA- and PCR-positive goats (P<0.05). The seroprevalence of Q fever was significantly higher among the adult goats (≥1y, 22.0%) than among the young goats (<1y, 13.8%) (P<0.05). While the results of the serologic analysis showed no seasonal variation, data from the PCR-based assay indicated that there were a higher number of positive cases during the cold seasons. Because Q fever infection has high rates of prevalence in native Korean goats, further studies on humans at a high risk of contracting this disease should be conducted. The PCR-based assay used in this study is a useful method for the direct detection of C. burnetii in blood samples from small ruminants.

Genotyping of Coxiella burnetii from domestic ruminants and human in Hungary: indication of various genotypes

BACKGROUND

Information about the genotypic characteristic of Coxiella burnetii from Hungary is lacking. The aim of this study is to describe the genetic diversity of C. burnetii in Hungary and compare genotypes with those found elsewhere. A total of 12 samples: (cattle, n = 6, sheep, n = 5 and human, n = 1) collected from across Hungary were studied by a 10-loci multispacer sequence typing (MST) and 6-loci multiple-locus variable-number of tandem repeat analysis (MLVA). Phylogenetic relationships among MST genotypes show how these Hungarian samples are related to others collected around the world.

RESULTS

Three MST genotypes were identified: sequence type (ST) 20 has also been identified in ruminants from other European countries and the USA, ST28 was previously identified in Kazakhstan, and the proposed ST37 is novel. All MST genotypes yielded different MLVA genotypes and three different MLVA genotypes were identified within ST20 samples alone. Two novel MLVA types 0-9-5-5-6-2 (AG) and 0-8-4-5-6-2 (AF) (Ms23-Ms24-Ms27-Ms28-Ms33-Ms34) were defined in the ovine materials correlated with ST28 and ST37. Samples from different parts of the phylogenetic tree were associated with different hosts, suggesting host-specific adaptations.

CONCLUSIONS

Even with the limited number of samples analysed, this study revealed high genetic diversity among C. burnetii in Hungary. Understanding the background genetic diversity will be essential in identifying and controlling outbreaks.

Relative contributions of neighbourhood and animal movements to Coxiella burnetii infection in dairy cattle herds

Q fever in dairy cattle herds occurs mainly after inhalation of contaminated aerosols generated from excreta by shedder animals. Propagation of Coxiella burnetii, the cause of the disease between ruminant herds could result from transmission between neighbouring herds and/or the introduction of infected shedder animals in healthy herds. The objective of this study were (i) to describe the spatial distribution C. burnetii-infected dairy cattle herds in two different regions: the Finistère District in France (2,829 herds) and the island of Gotland in Sweden (119 herds) and (ii) to quantify and compare the relative contributions of C. burnetii transmission related to neighbourhood and to animal movements on the risk for a herd to be infected. An enzyme--linked immunosorbent assay was used for testing bulk tank milk in May 2012 and June 2011, respectively. Only one geographical cluster of positive herds was identified in north-western Finistère. Logistic regression was used to assess the association of risk for a herd to test positively with local cattle density (the total number of cattle located in a 5 km radius circle) and the in-degree (ID) parameter, a measure of the number of herds from which each herd had received animals directly within the last 2 years. The risk for a herd to test positively was higher for herds with a higher local cattle density [odds ratio (OR) = 2.3, 95% confidence interval (CI) = 1.6-3.2, for herds with a local density between 100 and 120 compared to herds with a local density 60]. The risk was also higher for herds with higher IDs (OR = 2.3, 95% CI = 1.6-3.2, for herds with ID 3 compared to herds that did not introduce animals). The proportion of cases attributable to infections in the neighbourhood in high-density areas was twice the proportion attributable to animal movements, suggesting that wind plays a main role in the transmission.

[Aspects seroepidemiological studies on Q fever in unvaccinated dairy cattle herds]

Q fever is a zoonosis distributed worldwide and important in human as well as in veterinary medicine in Germany. In Baden-Wurttemberg, the pathogen is endemic. Usually Q fever is associated with infected sheep flocks. In contrast, however, in the animal disease reporting system (TSN) 88.1% of all listed Q fever infections during the last 12 years have been registered in cattle. Accordingly, in Baden-Württemberg and Freudenstadt 78.3 and, respectively, 62.5% of the Q fever cases were from cattle. Long term studies on appearance of Coxiella burnetii in normal herds of cattle are missing. Increasing vaccination of cattle herds against Q fever with the vaccine approved in Germany (no marker vaccine) complicates the future opportunities to gain data from serological studies. In the present study, a total of 1640 bovine sera taken from unvaccinated, clini- tion against C burnetii for analysis and comparison. The results show, depending on the test, a seroprevalence of 4.3% to 7.4%. Seasonal comparison revealed a significant increase of up to 9%.The month with the highest seroprevalence aver aged over three years was June with a prevalence of 24.7%. Overall, the findings of this study demonstrate that even the high number of entries does not fully capture the true prevalence of Q fever in cattle herds.

A model for the early identification of sources of airborne pathogens in an outdoor environment

Background

Source identification in areas with outbreaks of airborne pathogens is often time-consuming and expensive. We developed a model to identify the most likely location of sources of airborne pathogens.

Methods

As a case study, we retrospectively analyzed three Q fever outbreaks in the Netherlands in 2009, each with suspected exposure from a single large dairy goat farm. Model input consisted only of case residential addresses, day of first clinical symptoms, and human population density data. We defined a spatial grid and fitted an exponentially declining function to the incidence-distance data of each grid point. For any grid point with a fit significant at the 95% confidence level, we calculated a measure of risk. For validation, we used results from abortion notifications, voluntary (2008) and mandatory (2009) bulk tank milk sampling at large (i.e. >50 goats and/or sheep) dairy farms, and non-systematic vaginal swab sampling at large and small dairy and non-dairy goat/sheep farms. In addition, we performed a two-source simulation study.

Results

Hotspots – areas most likely to contain the actual source – were identified at early outbreak stages, based on the earliest 2–10% of the case notifications. Distances between the hotspots and suspected goat farms varied from 300–1500 m. In regional likelihood rankings including all large dairy farms, the suspected goat farms consistently ranked first. The two-source simulation study showed that detection of sources is most clear if the distance between the sources is either relatively small or relatively large.

Conclusions

Our model identifies the most likely location of sources in an airborne pathogen outbreak area, even at early stages. It can help to reduce the number of potential sources to be investigated by microbial testing and to allow rapid implementation of interventions to limit the number of human infections and to reduce the risk of source-to-source transmission.

Vaccination using phase I vaccine is effective to control Coxiella burnetii shedding in infected dairy cattle herds

The effectiveness of the vaccination of dairy cows combined or not with antibiotics (i.e. oxytetracycline) to control Coxiella burnetii (Cb) shedding at herd level was investigated in 77 Q fever clinically affected herds. In addition to nulliparous heifers' vaccination, one out of the four following medical strategies was randomly assigned to dairy cows in each herd: vaccination (using a phase I vaccine) alone, vaccination combined with oxytetracycline, oxytetracycline alone or nothing. Their effectiveness to reduce Cb load in quarterly samples of bulk tank milk (BTM) and of pooled milk of primiparous (MP) was assessed through logistic hierarchical models. A significant reduction in Cb load was observed in herds where the vaccination of ≥80% of dairy cows was implemented; whereas the use of antibiotics was uneffective. Our findings support the interest of a whole vaccination strategy and provide evidence for decreasing the use of antibiotics in dairy cattle herds.

The impact of Q fever-phase-specific milk serology for the diagnosis of puerperal and chronic milk shedding of C. burnetii in dairy cows

C. burnetii infection might be associated with puerperal shedding; additionally, the chronic shedding of this pathogen in milk has been observed in individual animals. A longitudinal survey was performed in an endemically infected dairy cow herd with 100 cows in order to compare phase-specific milk-serology with pathogen shedding. From March 2010 through December 2011, 870 individual milk samples from 212 cows were analysed using both quantitative (q) PCR and phase-specific antibody-ELISA. The mean milk-shedding/cow was calculated for 137 cows with > or = 3 milk samples per cow. In addition, 110 puerperal swabs were collected after August 2010. The cows yielding three successive qPCR-positive milk samples or > 3 qPCR-positive milk samples, irrespective of the sequence of positive/negative results, were classified as chronic shedders (CS). Milk shedding was observed during the entire study, but a major period of puerperal shedding occurred from February through October 2011; 35/52 swabs tested positive, whereas only 3/58 swabs collected outside this period were positive. The PhI/PhII(+)-pattern in primiparous cows (< 36 months old) was consistent with puerperal shedding in the herd, but not at the individual level. This pattern was observed in older cows, irrespective of the period of puerperal shedding. Four primiparous CS-cows showed low-level mean shedding < 100 C.b./ml milk, and the PhI-titre increased from negative or weakly positive to more than 500 at the end of the first lactation. Puerperal shedding during the second parturition was observed in three of these cows. Six multiparous CS-cows with mean shedding exceeding 100 C.b./ml milk were characterised with stable PhI-titres of > or = 500. The three available puerperal swabs tested negative. Only one multiparous CS-cow showed low-level shedding and a PhI-titre below 500 for the entire study. In conclusion, the PhI-/PhII(+)-pattern in primiparous cows indicated puerperal shedding at the herd level, and a PhI-titre > or = 500 is a suitable screening method for the detection of chronic shedding in milk.

Q fever outbreak in a goat herd--diagnostic investigations and measures for control

This is a case report about a Q fever infection of a goat herd with abortions and excretions of pathogens accompanied by human infection and disease. Following a diagnosis of Q fever in a goat herd, all animals were vaccinated with an inactivated phase 1 vaccine. The herd was kept isolated and animals were neither removed nor introduced so that monitoring of the course of the Q fever infection of the individual dam was possible. Over a period of two years following the diagnosis of a Q fever infection (abortion), diagnostic investigations on detection of Coxiella (C.) burnetii were performed using quantitative Real-Time PCR (qPCR) and for serological studies complement fixation test (CFT) and ELISA. Excretion of pathogens decreased from > 500 000 units per genital swab in the first year to < 50 units in the second year after the initial diagnosis. Serological studies of the dams using CFT revealed a dominance of phase 2 antibodies with a proportion of 35.4% (17/48) positive animals in 2006. This level decreased to a value of 2.3% (2/87) two years later. The mixed phase 1 and 2 ELISA initially yielded 20.8% (10/48) positive dams with an increase to 98.9% (86/87) two years later. The control measures which were implemented after a round table meeting are illustrated and discussed.

Rapid, simple and sensitive detection of Q fever by loop-mediated isothermal amplification of the htpAB gene

Background

Q fever is the most widespread zoonosis, and domestic animals are the most common sources of transmission. It is not only difficult to distinguish from other febrile diseases because of the lack of specific clinical manifestations in humans, but it is also difficult to identify the disease in C. burnetii-carrying animals because of the lack of identifiable features. Conventional serodiagnosis requires sera from the acute and convalescent stages of infection, which are unavailable at early diagnosis. Nested PCR and real-time PCR require equipment. In this study, we developed a Loop-Mediated Isothermal Amplification (LAMP) assay to identify C. burnetii rapidly and sensitively.

Methods

A universal LAMP primer set was designed to detect the repeated sequence IS1111a of the htpAB gene of C. burnetii using PrimerExplorer V4 software. The sensitivity of the LAMP assay was evaluated using known quantities of recombined reference plasmids containing the targeted genes. The specificity of the developed LAMP assay was determined using 26 members of order Rickettsiae and 18 other common pathogens. The utility of the LAMP assay was further compared with real time PCR by the examination 24 blood samples including 6 confirmed and 18 probable Q fever cases, which diagnosed by IFA serological assessment and real time PCR. In addition, 126 animal samples from 4 provinces including 97 goats, 7 cattle, 18 horses, 3 marmots and 1 deer were compared by these two methods.

Results

The limits of detection of the LAMP assay for the htpAB gene were 1 copy per reaction. The specificity of the LAMP assay was 100%, and no cross-reaction was observed among the bacteria used in the study. The positive rate of unknown febrile patients was 33.3%(95%CI 30.2%–36.4%) for the LAMP assay and 8.3%(95%CI 7.4%–9.2%) for the real time PCR(P<0.05). Similarly, the total positive rate of animals was 7.9%(95%CI 7.1%–8.7%) for the LAMP assay and 0.8%(95%CI 0.7%–0.9%)for the real time PCR(P<0.01). Using the developed LAMP assay, Q fever in the Yi Li area, Xinjiang Province, was confirmed.

Conclusions

The LAMP assay is a potential tool to support the diagnosis of Q fever in humans and domestic animals in the field, especially in the rural areas of China, because of its rapid and sensitive detection without the aid of sophisticated equipment or a complicated protocol.

Serological investigations indicate that Q fever is present nationwide in China. However, this zoonosis is poorly understood, and nearly all cases of Q fever are retrospectively diagnosed because of the lack of laboratory diagnosis techniques. Traditional serodiagnosis requires a pair of serum samples from the acute and convalescent stages of infection, which is not useful as an early test of C. burnetii. In this study, we developed a rapid, simple and sensitive loop-mediated isothermal amplification (LAMP) assay that targets the htpAB gene of C. burnetii, in which the lowest limits of the LAMP assay were 1 copy per reaction and the specificity of the LAMP assay was 100%. The sensitivity of the LAMP was significantly higher than that of the real time PCR on evaluation of its utility of detection clinical Q fever patients samples and domestic animals samples. Using the developed LAMP assay, Q fever was first confirmed in the Yi Li area, Xinjiang Province, and the positive rate was 33.3% for unknown febrile patients and 21.0% for domestic animals. Here we concluded that the developed LAMP assay is ideal for the early diagnosis of Q fever, especially in rural areas in China.

Seroprevalence of Q fever in sheep and goat flocks with a history of abortion in Iran between 2011 and 2012

The purpose of this study was to estimate the seroprevalence of Coxiella burnetii infection in sheep and goat flocks with a history of abortion in different areas of Iran. One thousand and one hundred ovine and 180 caprine samples from 43 sheep and goat flocks in four counties located in the Northeast (Mashhad), Central (Isfahan), Western (Arak), and Southwest (Shiraz) Iran were collected randomly between March 2011 and April 2012. The CHEKIT Q fever ELISA kit was used to identify specific antibodies against C. burnetii in sheep and goats. The results showed that the overall seroprevalence of C. burnetii in sheep and goats was 19.5% and 27.2%, respectively. There was a significant difference in seropositivity between sheep and goats (p<0.05). Central Iran significantly had the highest prevalence among the studied areas, especially in goat coxiellosis (23.8% and 40.8% in sheep and goats, respectively). The lowest prevalence in sheep was 12.8% in Northeast Iran while in Western Iran C. burnetii antibodies were absent in goats. The higher prevalence of Q fever in Central Iran may be partly due to persistent favourable conditions to spread C. burnetii in this area including drought and dust storms that originated from neighbouring Iraq and Kuwait. In conclusion, the present study demonstrated the relatively high prevalence of Q fever in sheep and goat flocks with a history of abortion. Therefore, Q fever could be responsible for considerable numbers of ovine and caprine abortions in Iran.

Q fever in humans and farm animals in four European countries, 1982 to 2010

Q fever is a disease of humans, caused by Coxiella burnetii, and a large range of animals can be infected. This paper presents a review of the epidemiology of Q fever in humans and farm animals between 1982 and 2010, using case studies from four European countries (Bulgaria, France, Germany and the Netherlands). The Netherlands had a large outbreak between 2007 and 2010, and the other countries a history of Q fever and Q fever research. Within all four countries, the serological prevalence of C. burnetii infection and reported incidence of Q fever varies broadly in both farm animals and humans. Proximity to farm animals and contact with infected animals or their birth products have been identified as the most important risk factors for human disease. Intrinsic farm factors, such as production systems and management, influence the number of outbreaks in an area. A number of disease control options have been used in these four countries, including measures to increase diagnostic accuracy and general awareness, and actions to reduce spillover (of infection from farm animals to humans) and human exposure. This study highlights gaps in knowledge, and future research needs.

Coxiella burnetii associated reproductive disorders in domestic animals--a critical review

The bacterium Coxiella burnetii has been detected in the fetal membranes, birth fluids and vaginal mucus, as well as in the milk and other excretions of several domestic mammals. The finding of C. burnetii in association with abortion, parturition and in the postpartum period has led to the hypothesis that C. burnetii causes a range of reproductive diseases. This review critically evaluates the scientific basis for this hypothesis in domestic mammals.The review demonstrates a solid evidence for the association between C. burnetii infection and sporadic cases of abortion, premature delivery, stillbirth and weak offspring in cattle, sheep and goats. C. burnetii induced in-herd epidemics of this complete expression of reproductive failure have been reported for sheep and goats, but not for cattle. The single entities occur only as part of the complex and not as single events such as generally increased stillbirth rate. Studies show that C. burnetii initially infects the placenta and that subsequent spread to the fetus may occur either haematogenous or by the amniotic-oral route. The consequences for the equine, porcine, canine and feline conceptus remains to the elucidated but that infection of the conceptus may occur is documented for most species. There is no solid evidence to support a hypothesis of C. burnetii causing disorders such as subfertility, endometritis/metritis, or retained fetal membranes in any kind of domestic animal species.There is a strong need to validate non-pathology based methods such as polymerase chain reaction for their use in diagnostic and research in relation to establishing C. burnetii as the cause of abortion and to adapt an appropriate study design and include adequate control animals when linking epidemiological findings to C. burnetii or when evaluating effects of vaccination in production herds.

Coxiella burnetii in humans, domestic ruminants, and ticks in rural western Kenya

We conducted serological surveys for Coxiella burnetii in archived sera from patients that visited a rural clinic in western Kenya from 2007 to 2008 and in cattle, sheep, and goats from the same area in 2009. We also conducted serological and polymerase chain reaction-based surveillance for the pathogen in 2009-2010, in human patients with acute lower respiratory illness, in ruminants following parturition, and in ticks collected from ruminants and domestic dogs. Antibodies against C. burnetii were detected in 30.9% (N = 246) of archived patient sera and in 28.3% (N = 463) of cattle, 32.0% (N = 378) of goats, and 18.2% (N = 159) of sheep surveyed. Four of 135 (3%) patients with acute lower respiratory illness showed seroconversion to C. burnetii. The pathogen was detected by polymerase chain reaction in specimens collected from three of six small ruminants that gave birth within the preceding 24 hours, and in five of 10 pools (50%) of Haemaphysalis leachi ticks collected from domestic dogs.

Long-term monitoring of a Coxiella burnetii-infected sheep flock after vaccination and antibiotic treatment under field conditions

The purpose of this study was to pursue the development of a sheep flock for a period of 18 months after a Q fever outbreak. In a flock with approximately 250 ewes losses of 18% were caused by abortions and weak offspring. Q fever was diagnosed in April 2009 after detection of Coxiella (C.) burnetii in one placenta and two aborted fetuses by PCR. Shortly afterwards Q fever was diagnosed in humans. Between July 2009 and December 2010 the sheep were sampled regularly. Six weeks before lambing the flock was initially immunised with Coxevac. Moreover, pregnant ewes were treated with oxytetracyclines during late gestation until lambing. Seroprevalence increased from 39% before vaccination up to 98% afterwards. After these measures bacteraemia and shedding of C burnetii decreased significantly, indicating that during an acute outbreak the vaccination with Coxevac can reduce the shedding of C burnetii effectively, although vaccination is performed without medical approval for sheep and in late pregnancy. Both measures should be taken into consideration in acute Q fever outbreaks to reduce or even avoid transmission to humans.

Q fever--selected issues

Q fever is an infectious disease of humans and animals caused by Gram-negative coccobacillus Coxiella burnetii, belonging to the Legionellales order, Coxiellaceae family. The presented study compares selected features of the bacteria genome, including chromosome and plasmids QpH1, QpRS, QpDG and QpDV. The pathomechanism of infection--starting from internalization of the bacteria to its release from infected cell are thoroughly described. The drugs of choice for the treatment of acute Q fever are tetracyclines, macrolides and quinolones. Some other antimicrobials are also active against C. burnetii, namely, telitromycines and tigecyclines (glicylcycline). Q-VAX vaccine induces strong and long-term immunity in humans. Coxevac vaccine for goat and sheep can reduce the number of infections and abortions, as well as decrease the environmental transmission of the pathogen. Using the microarrays technique, about 50 proteins has been identified which could be used in the future for the production of vaccine against Q fever. The routine method of C. burnetii culture is proliferation within cell lines; however, an artificial culture medium has recently been developed. The growth of bacteria in a reduced oxygen (2.5%) atmosphere was obtained after just 6 days. In serology, using the IF method as positive titers, the IgM antibody level >1:64 and IgG antibody level >1:256 (against II phase antigens) has been considered. In molecular diagnostics of C. burnetii infection, the most frequently used method is PCR and its modifications; namely, nested PCR and real time PCR which detect target sequences, such as htpAB and IS1111, chromosome genes (com1), genes specific for different types of plasmids and transposase genes. Although Q fever was diagnosed in Poland in 1956, the data about the occurrence of the disease are incomplete. Comprehensive studies on the current status of Q fever in Poland, with special focus on pathogen reservoirs and vectors, the sources of infection and molecular characteristics of bacteria should be conducted.

A seroepidemiological survey of Q fever among sheep in Mazandaran province, northern Iran

Q fever is a zoonosis caused by Coxiella burnetii which infects various hosts, including humans and animals. As Q fever is considered a public health problem and there is little epidemiological information on the status of the disease in various parts of Iran, the presented study was carried out to evaluate the seroepidemiology of Q fever among sheep in the province of Mazandaran, northern Iran. 253 samples from sheep were collected from the western, central and eastern regions of Mazandaran province in 2010-2011. Serum samples were analyzed by IgG ELISA test. The seroconversion rate was 23.7%. A significant statistical difference (P <0.001) was seen between the seroconversion rate of the central (33.8%) and eastern (27.2%) regions, compared to the western regions (8.5%). Seroprevalence of Q fever IgG in sheep did not vary by age and gender.

[The immune structure against q fever and tick-bite spotted fever group rickettsioses in the population and domestic animals of the Republic of Guinea]

The circulation of the rickettsiae R.africae and C.brunetii, the causative agents of African tick-bite spotted fever and Q fever, was first ascertained throughout the territory of the Republic of Guinea. The immune stratum against R.africae among the population varied 1.1 to 25.4% or 10.6+/-0.7% on average and that among the livestock did 0.6 to 18.8% or 7.6+/-0.6% on average. The proportion of sera to C,brunettii in the population was in the rage from 0.8 to 10.5% or 2.4+/-0.3% on average; that in livestock was 3.2 to 18.7% or 8.0+/-0.6% on average. However, many aspects of the circulation of rickettsiae, the pathology and importance of these fevers in the structure of morbidity in Guinea remain still unclarified and call for further investigations, by applying the current laboratory diagnostic tests for rickettsiosial diseases.

Q fever in pregnant goats: pathogenesis and excretion of Coxiella burnetii

Coxiella burnetii is an intracellular bacterial pathogen that causes Q fever. Infected pregnant goats are a major source of human infection. However, the tissue dissemination and excretion pathway of the pathogen in goats are still poorly understood. To better understand Q fever pathogenesis, we inoculated groups of pregnant goats via the intranasal route with a recent Dutch outbreak C. burnetii isolate. Tissue dissemination and excretion of the pathogen were followed for up to 95 days after parturition. Goats were successfully infected via the intranasal route. PCR and immunohistochemistry showed strong tropism of C. burnetii towards the placenta at two to four weeks after inoculation. Bacterial replication seemed to occur predominantly in the trophoblasts of the placenta and not in other organs of goats and kids. The amount of C. burnetii DNA in the organs of goats and kids increased towards parturition. After parturition it decreased to undetectable levels: after 81 days post-parturition in goats and after 28 days post-parturition in kids. Infected goats gave birth to live or dead kids. High numbers of C. burnetii were excreted during abortion, but also during parturition of liveborn kids. C. burnetii was not detected in faeces or vaginal mucus before parturition. Our results are the first to demonstrate that pregnant goats can be infected via the intranasal route. C. burnetii has a strong tropism for the trophoblasts of the placenta and is not excreted before parturition; pathogen excretion occurs during birth of dead as well as healthy animals. Besides abortions, normal deliveries in C. burnetii-infected goats should be considered as a major zoonotic risk for Q fever in humans.

Risk factor analysis for antibodies to Brucella, Leptospira and C. burnetii among cattle in the Adamawa Region of Cameroon: a cross-sectional study

Brucellosis, leptospirosis and Q fever are important livestock diseases, commonly responsible for significant production losses, yet their epidemiology in sub-Saharan Africa is largely unknown. Animal reservoirs pose the main risk of transmission to humans, where serious disease can occur. In the developing world setting, the flu-like symptoms of the acute stages of these diseases can be misdiagnosed as malaria, which can result in the administration of the wrong treatment, prolonged disease and increase in antibiotic resistance. Multivariable mixed-effects logistic regression models in this study revealed potential risk factors associated with the aforementioned pathogens in cattle in the Adamawa Region of Cameroon, with wildlife, namely, buffaloes, playing a major role in both Brucella and Coxiella burnetii seropositivity. Cattle mixing with other herds at night and cattle grazing in an area on a route taken by herds on transhumance appear to be positively associated with Leptospira seropositivity, while female cows and whether buffaloes are seen during grazing or transhumance are positively associated with C. burnetii seropositivity. On the other hand, animals that have been on transhumance in the past year and animals belonging to herdsmen of the Fulbe ethnic group appear to be protected against Leptospira and C. burnetii, respectively. Cattle of more than 2 years old appear to have increased odds of being seropositive to either pathogen. Further research is needed to confirm these findings and improve the knowledge of the epidemiology of these three pathogens in Africa, taking particular consideration of the wildlife involvement in the disease transmission.

Smooth incidence maps give valuable insight into Q fever outbreaks in The Netherlands

From 2007 through 2009, The Netherlands faced large outbreaks of human Q fever. Control measures focused primarily on dairy goat farms because these were implicated as the main source of infection for the surrounding population. However, in other countries, outbreaks have mainly been associated with non-dairy sheep and The Netherlands has many more sheep than goats. Therefore, a public discussion arose about the possible role of non-dairy (meat) sheep in the outbreaks. To inform decision makers about the relative importance of different infection sources, we developed accurate and high-resolution incidence maps for detection of Q fever hot spots. In the high incidence area in the south of the country, full postal codes of notified Q fever patients with onset of illness in 2009, were georeferenced. Q fever cases (n = 1,740) were treated as a spatial point process. A 500 x 500 m grid was imposed over the area of interest. The number of cases and the population number were counted in each cell. The number of cases was modelled as an inhomogeneous Poisson process where the underlying incidence was estimated by 2-dimensional P-spline smoothing. Modelling of numbers of Q fever cases based on residential addresses and population size produced smooth incidence maps that clearly showed Q fever hotspots around infected dairy goat farms. No such increased incidence was noted around infected meat sheep farms. We conclude that smooth incidence maps of human notifications give valuable information about the Q fever epidemic and are a promising method to provide decision support for the control of other infectious diseases with an environmental source.

Serological screening of Coxiella burnetii (Q fever) and Brucella spp. in sheep flocks in the northern prefectures of Japan in 2007

Ovine sera collected from the northern Prefectures of Hokkaido, Iwate and Aomori in Japan, were examined for the presence of antibodies against Coxiella burnetii (Q fever) using the complement fixation test and, against Brucella spp., using both the rapid serum agglutination test and the complement fixation test. None of the sera tested were serologically positive to Brucella spp. A total of 21 animals (8.64%) out of 243 samples tested were seropositive to the C. burnetii antigen. Levels of infection were observed in all of the three Prefectures and in ten flocks of the fourteen sampled. Although no diagnostic measures were in place, the infection could not be linked to losses in sheep production or to the decreased fertility in ewes, a lower lambing rate and mortality in lambs. These data confirmed that Q fever is widespread in the sheep population in the area studied. Considering the zoonotic potential of the disease, further studies to investigate the epidemiology of Q fever in this region are required.

Dynamics of Coxiella burnetii antibodies and seroconversion in a dairy cow herd with endemic infection and excreting high numbers of the bacterium in the bulk tank milk

Possible factors related to seropositivity and seroconversion to Coxiella burnetii were examined in a dairy herd with a high Coxiella-seroprevalence and high excretion levels of the bacterium in the bulk tank milk. Antibodies were detected by using a commercial ELISA test in 50.7% of 603 parous cows. The likelihood of C. burnetii seropositivity significantly increased by factors of 1.87 and 1.61 for cows in their first and second terms of pregnancy, respectively, compared to non-pregnant cows. In 478 cows tested twice 12 months apart, the seroconversion rate was 5%. The likelihood of C. burnetii-seroconversion was 2.27 times lower in multiparous than in primiparous cows and 6.88 times higher in cows during their first 90 days in milk than dry-off cows. Our findings indicated a higher seroprevalence in the first and second terms of pregnancy, and that seroconversion mainly occurred in primiparous cows during their first 90 days in milk.

Investigations concerning the prevalence of Coxiella burnetii and Chlamydia abortus in sheep in correlation with management systems and abortion rate in Lower Saxony in 2004

The intracellular bacteria Coxiella (C) burnetii and Chlamydia (Chl) abortus induce abortion in sheep and also affect humans. While Chl. abortus only infrequently infects humans, C burnetii is the aetiological agent of numerous Q fever outbreaks during the last decades. There is only limited knowledge about the prevalence of both pathogens in sheep, although sheep are involved in almost all Q fever outbreaks in Germany. The aim of our study was to investigate the prevalence of both pathogens in flocks located in Lower Saxony, Germany, in correlation to the management form and abortion rate. Serum samples of 1714 sheep from 95 flocks located in Lower Saxony were investigated by ELISA. 2.7% of these samples were positive, 1.3% showed inconclusive results in the C. burnetii-ELISA. Elevated intra-flock seroprevalences were only detected in three migrating flocks. Chlamydia-specific antibodies could be detected in 15.1% serum samples of mainly shepherded and migrating flocks. In one of these flocks with a high intra-flock seroprevalence for C burnetii (27%) and Chlamydia (44.9%), C burnetii was detected in 21.6% of the placenta samples of normal births and in 12.5% of the colostrum samples by PCR. Aborted fetuses and the corresponding placentas were negative in C burnetii-PCR, but in most of them and also in many other placenta samples Chl. abortus could be detected by PCR and DNA microarray. This survey shows a low overall prevalence of C. burnetii in sheep in Lower Saxony in the year 2004. However, three migrating flocks with a high intra-flock prevalence are localized in the southern parts of Lower Saxony. Spreading of C burnetii could occur, because of the large radius of grazing of all three flocks.

Q fever at the turn of the century

Q fever is an infectious zoonotic disease characterized by sudden fever, headache, and atypical pneumonia, caused by Coxiella burneti--an obligatory intracellular parasite. Based on phylogenetic analysis of the genes sequences, the classification was changed and C. burnetii species was included to the gamma subgroup of the proteobacteria, Legionellales order and Coxiellaceae family. This analysis showed more than 99% sequence similarity of 16SrRNA gene among the strains isolated in different regions of the world. Q fever is a widespread in the world zoonosis. Its main reservoir in the rural environment are farm animals: cows, sheep, goats, and urban pets such as dogs, cats, rabbits. In acute infection these bacteria are detected in various internal organs such as lungs, liver, spleen, and in excretion in urine, faeces and milk. During childbirth, they occur in large number in the amniotic fluid and placenta. Recently, it has been found that free-living amoeba Acanthamoeba castellani may also be a reservoir of the pathogen. The intra-amoebal location of C. burnetii cells was observed.

Q fever in The Netherlands: the role of local environmental conditions

The Netherlands is facing a Q fever epidemic in which dairy goats are implicated. People living close to an affected farm have an increased risk. However, no human cases were reported around a number of farms with serious Q fever problems. To assess the role of local environmental conditions which may add to the transmission or risk of Q fever, we gathered datasets on vegetation, land use, soil characteristics, and weather conditions in 5 km areas around infected farms. Areas without transmission had a higher vegetation density and relatively shallow groundwater conditions. Vegetation and soil moisture are relevant factors in the transmission of Coxiella burnetii from infected farms to humans, by reducing the amount of dust available for dispersion of the bacteria. The findings suggest that intensive goat and sheep husbandry should be avoided in areas that are characterized by a combination of arable land with deep groundwater and little vegetation.

Coxiella burnetii in western barred bandicoots (Perameles bougainville) from Bernier and Dorre Islands in Western Australia

The aim of this work is to investigate the presence of Coxiella burnetii in Perameles bougainville and their ticks on two islands off Western Australia. Haemaphysalis humerosa, Haemaphysalis ratti, and Haemaphysalis lagostrophi were collected from P. bougainville on Bernier and Dorre Islands from 2005 to 2007; only Amblyomma limbatum was collected from humans over the same interval. One of 13 tick samples and 1 of 12 P. bougainville fecal samples were positive for C. burnetii DNA using quantitative polymerase chain reaction. DNA fragments had >99% similarity to published C. burnetii sequences. Three of 35 P. bougainville sera tested positive for anti-C. burnetii antibodies using enzyme-linked immunosorbent assay. C. burnetii was found in P. bougainville feces and a H. humerosa tick on Dorre Island and Bernier Island, respectively. This is the first reported use of enzyme-linked immunosorbent assay for screening of P. bougainville sera. The risk of zoonotic Q fever infection for human visitors to these islands is considered relatively low, however, appropriate precautions should be taken when handling western barred bandicoots, their feces and their ticks on Bernier and Dorre Islands.

Modelling effectiveness of herd level vaccination against Q fever in dairy cattle

Q fever is a worldwide zoonosis caused by the bacterium Coxiella burnetii. The control of this infection in cattle is crucial: infected ruminants can indeed encounter reproductive disorders and represent the most important source of human infection. In the field, vaccination is currently advised in infected herds but the comparative effectiveness of different vaccination protocols has never been explored: the duration of the vaccination programme and the category of animals to be vaccinated have to be determined. Our objective was to compare, by simulation, the effectiveness over 10 years of three different vaccination strategies in a recently infected dairy cattle herd.A stochastic individual-based epidemic model coupled with a model of herd demography was developed to simulate three temporal outputs (shedder prevalence, environmental bacterial load and number of abortions) and to calculate the extinction rate of the infection. For all strategies, the temporal outputs were predicted to strongly decrease with time at least in the first years of vaccination. However, vaccinating only three years was predicted inadequate to stabilize these dynamic outputs at a low level. Vaccination of both cows and heifers was predicted as being slightly more effective than vaccinating heifers only. Although the simulated extinction rate of the infection was high for both scenarios, the outputs decreased slower when only heifers were vaccinated.Our findings shed new light on vaccination effectiveness related to Q fever. Moreover, the model can be further modified for simulating and assessing various Q fever control strategies such as environmental and hygienic measures.

Coxiella burnetii associated placental lesions and infection level in parturient cows

Cotyledons (n=170) from dairy cattle were analysed for Coxiella burnetii by real-time (rt) PCR targeting the IS1111a and icd genes. Positive cases (n=90) and a random selection of negative cases (n=20) were examined by histology, immunohistochemistry and, if infection level was high, by fluorescence in situ hybridisation. PCR results were compared to bulk tank milk (BTM) antibody levels. Placental infection was detected in cows from herds at all BTM antibody levels. However the likelihood of placental infection was generally higher in herds with intermediate or high BMT antibody levels than in herds with low antibody levels. Histological examination revealed a range of mostly mild cotyledonary changes; C. burnetii infection was only rarely associated with inflammation. This may explain why bovine Q fever is usually not clinically apparent. Nevertheless, infected cattle will shed C. burnetii at calving and this can occur even in herds without BTM antibodies.