Global and regional seroprevalence of coxiellosis in small ruminants: A systematic review and meta-analysis

Q Fever-Related Community Infections: United States Exposure to Coxiella burnetii

Coxiella burnetii is a significant infectious pathogen that causes Q fever. Q fever is thought to be uncommon in the US and most human cases are believed to occur in agricultural livestock workers. However, the extent of US community exposure to C. burnetii is not known with certainty. Using nationally representative 2003-2004 US National Health and Nutrition Examination Survey serologic, demographic, and occupational history data, the magnitude of US adult general population exposure to C. burnetii, excluding agricultural-sector workers, was estimated. Exposure was defined as positive serum IgG antibodies in an immunofluorescence assay (e.g., current or past infection). A total of 3.0% (95% CI: 2.0-4.4) of the US population met the criteria for C. burnetii exposure, representing some 6.2 million persons. Overall, 86.9% (95% CI: 75.5-98.4) of the seropositive persons had no lifetime history of work in the agricultural sector (5.5 million persons). This was consistently true across all US demographic groups: aged 20-59 years, 87.3%; aged 60+ years, 85.7%; men, 86.1%; women, 87.6%; non-Hispanic Whites, 82%; non-Hispanic Blacks, 95.8%; Mexican Americans, 89.4%; immigrants from Mexico, 83.5%; and other immigrants, 96.8%. As a proportion of C. burnetii infections result in acute Q fever and chronic Q fever conveys significant mortality, the community-level risks to the general public may be significant. It is recommended that a 6-year sample of the most recent NHANES stored sera be analyzed to determine the current community C. burnetii exposure rates. Also, analyzing an additional 2005-2008 stored sera sample would provide an opportunity to assess the time trends and long-term health impacts.

Acute Q Fever after Kidney Transplantation: A Case Report

Aims/Background Patients receiving kidney transplant experience immunosuppression, which increases the risk of bacterial, viral, fungal, and parasitic infections. Q fever is a potentially fatal infectious disease that affects immunocompromised renal transplant recipients and has implications in terms of severe consequences for the donor's kidney. Case Presentation A patient with acute Q fever infection following kidney transplantation was admitted to the Tsinghua Changgung Hospital in Beijing, China, in March 2021. Next-generation sequencing (NGS) was used to diagnose Q fever in the patient. Based on the patient's blood test, we detected Rickettsia, the causative agent of Q fever and a zoonotic disease that can manifest in acute or chronic forms in humans. Comprehensive data on clinical symptoms, blood tests, chest computed tomography (CT), NGS, Immunoglobulin G (IgG) antibody titer, and therapeutic efficacy associated with Q fever infection following renal transplantation in this patient were gathered. Conclusion This is the first reported case of acute Q fever occurring in a Chinese renal transplant recipient detected using metagenomic NGS. This case underscores the need to consider acute Q fever as a possible differential diagnosis in kidney transplant recipients with fever of unknown origin.