1
|
Ghanem-Zoubi N, Atiya-Nasagi Y, Stoyanov E, Szwarcwort M, Darawsha B, Paul M, Shinar E. Cross-Sectional Study of Q Fever Seroprevalence among Blood Donors, Israel, 2021. Emerg Infect Dis 2024; 30:941-946. [PMID: 38666592 PMCID: PMC11060453 DOI: 10.3201/eid3005.230645] [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] [Indexed: 05/02/2024] Open
Abstract
We evaluated Q fever prevalence in blood donors and assessed the epidemiologic features of the disease in Israel in 2021. We tested serum samples for Coxeilla burnetii phase I and II IgG using immunofluorescent assay, defining a result of >200 as seropositive. We compared geographic and demographic data. We included 1,473 participants; 188 (12.7%) were seropositive. The calculated sex- and age-adjusted national seroprevalence was 13.9% (95% CI 12.2%-15.7%). Male sex and age were independently associated with seropositivity (odds ratio [OR] 1.6, 95% CI 1.1-2.2; p = 0.005 for male sex; OR 1.2, 95% CI 1.01-1.03; p<0.001 for age). Residence in the coastal plain was independently associated with seropositivity for Q fever (OR 1.6, 95% CI 1.2-2.3; p<0.001); residence in rural and farming regions was not. Q fever is highly prevalent in Israel. The unexpected spatial distribution in the nonrural coastal plain suggests an unrecognized mode of transmission.
Collapse
Affiliation(s)
| | | | - Evgeniy Stoyanov
- Rambam Health Care Campus, Haifa, Israel (N. Ghanem-Zoubi, M. Szwarcwort, M. Paul)
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa (N. Ghanem-Zoubi, B. Darawsha, M. Paul)
- Israel Institute for Biological Research, Ness-Ziona, Israel (Y. Atiya-Nasagi)
- Magen David Adom National Blood Services, Ramat Gan, Israel (E. Stoyanov, E. Shinar)
| | - Moran Szwarcwort
- Rambam Health Care Campus, Haifa, Israel (N. Ghanem-Zoubi, M. Szwarcwort, M. Paul)
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa (N. Ghanem-Zoubi, B. Darawsha, M. Paul)
- Israel Institute for Biological Research, Ness-Ziona, Israel (Y. Atiya-Nasagi)
- Magen David Adom National Blood Services, Ramat Gan, Israel (E. Stoyanov, E. Shinar)
| | - Basel Darawsha
- Rambam Health Care Campus, Haifa, Israel (N. Ghanem-Zoubi, M. Szwarcwort, M. Paul)
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa (N. Ghanem-Zoubi, B. Darawsha, M. Paul)
- Israel Institute for Biological Research, Ness-Ziona, Israel (Y. Atiya-Nasagi)
- Magen David Adom National Blood Services, Ramat Gan, Israel (E. Stoyanov, E. Shinar)
| | - Mical Paul
- Rambam Health Care Campus, Haifa, Israel (N. Ghanem-Zoubi, M. Szwarcwort, M. Paul)
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa (N. Ghanem-Zoubi, B. Darawsha, M. Paul)
- Israel Institute for Biological Research, Ness-Ziona, Israel (Y. Atiya-Nasagi)
- Magen David Adom National Blood Services, Ramat Gan, Israel (E. Stoyanov, E. Shinar)
| | - Eilat Shinar
- Rambam Health Care Campus, Haifa, Israel (N. Ghanem-Zoubi, M. Szwarcwort, M. Paul)
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa (N. Ghanem-Zoubi, B. Darawsha, M. Paul)
- Israel Institute for Biological Research, Ness-Ziona, Israel (Y. Atiya-Nasagi)
- Magen David Adom National Blood Services, Ramat Gan, Israel (E. Stoyanov, E. Shinar)
| |
Collapse
|
2
|
Bailly S, Hozé N, Bisser S, Zhu-Soubise A, Fritzell C, Fernandes-Pellerin S, Mbouangoro A, Rousset D, Djossou F, Cauchemez S, Flamand C. Transmission dynamics of Q fever in French Guiana: A population-based cross-sectional study. LANCET REGIONAL HEALTH. AMERICAS 2022; 16:100385. [PMID: 36777152 PMCID: PMC9903881 DOI: 10.1016/j.lana.2022.100385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 08/20/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022]
Abstract
Background Q fever is a zoonosis caused by Coxiella burnetii which is among the major agents of community-acquired pneumonia in French Guiana. Despite its relatively high incidence, its epidemiology in French Guiana remains unclear, and all previous studies have considered transmission from livestock unlikely, suggesting that a wild reservoir is responsible for transmission. Methods A country-wide seroprevalence survey of 2697 participants from French Guiana was conducted. Serum samples were tested for phase II IgG antibodies by ELISA and indirect immunofluorescence assays (IFAs). Factors associated with Q fever were investigated, and a serocatalytic model was used to reconstruct the annual force of infection. Findings The overall weighted seroprevalence was estimated at 9.6% (95% confidence interval (CI): 8.2%-11.0%). The model revealed constant, low-level circulation across French Guiana, particularly affecting middle-aged males (odds ratio (OR): 3.0, 95% credible interval (CrI): 1.7-5.8) and individuals living close to sheep farms (OR: 4, 95% CrI: 1.5-12). The overall annual number of cases was estimated at 579 (95% CrI: 492-670). In the region around Cayenne, the main urban municipality, the high seroprevalence was explained by an outbreak that may have occurred between 1996 and 2003 and that infected 10% (95% CrI: 6.9%-14%) of the population and males and females alike. Interpretation This study reveals for the first time Q fever dynamics of transmission and the role of domestic livestock in transmission in French Guiana and highlights the urgent need to reinforce Q fever surveillance in livestocks of the entire Guianese territory. Funding This study was supported by the "European Regional Development Fund" under EPI-ARBO grant agreement (GY0008695), the "Regional Health Agency of French Guiana" and the "National Center of Spatial Studies". The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Collapse
Affiliation(s)
- Sarah Bailly
- Epidemiology Unit, Institut Pasteur in French Guiana, Cayenne, French Guiana
| | - Nathanaël Hozé
- Mathematical Modeling of Infectious Diseases Unit, Institut Pasteur, Université Paris Cité, UMR2000, CNRS, Paris, France
| | - Sylvie Bisser
- Medical Laboratory, Institut Pasteur in French Guiana, Cayenne, French Guiana
| | | | - Camille Fritzell
- Epidemiology Unit, Institut Pasteur in French Guiana, Cayenne, French Guiana
| | | | - Adija Mbouangoro
- Medical Laboratory, Institut Pasteur in French Guiana, Cayenne, French Guiana
| | - Dominique Rousset
- Virology Laboratory, Institut Pasteur in French Guiana, Cayenne, French Guiana
| | - Félix Djossou
- Infectious and Tropical Disease Unit, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Simon Cauchemez
- Mathematical Modeling of Infectious Diseases Unit, Institut Pasteur, Université Paris Cité, UMR2000, CNRS, Paris, France
| | - Claude Flamand
- Epidemiology Unit, Institut Pasteur in French Guiana, Cayenne, French Guiana,Mathematical Modeling of Infectious Diseases Unit, Institut Pasteur, Université Paris Cité, UMR2000, CNRS, Paris, France,Corresponding author.
| |
Collapse
|
3
|
Reukers DFM, de Boer PT, Loohuis AO, Wever PC, Bleeker-Rovers CP, van Gageldonk-Lafeber AB, van der Hoek W, Timen A. Targeted Screening for Chronic Q Fever, the Netherlands. Emerg Infect Dis 2022; 28:1403-1409. [PMID: 35731163 PMCID: PMC9239892 DOI: 10.3201/eid2807.212273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Early detection of and treatment for chronic Q fever might prevent potentially life-threatening complications. We performed a chronic Q fever screening program in general practitioner practices in the Netherlands 10 years after a large Q fever outbreak. Thirteen general practitioner practices located in outbreak areas selected 3,419 patients who had specific underlying medical conditions, of whom 1,642 (48%) participated. Immunofluorescence assay of serum showed that 289 (18%) of 1,642 participants had a previous Coxiella burnetii infection (IgG II titer >1:64), and 9 patients were suspected of having chronic Q fever (IgG I y titer >1:512). After medical evaluation, 4 of those patients received a chronic Q fever diagnosis. The cost of screening was higher than estimated earlier, but the program was still cost-effective in certain high risk groups. Years after a large Q fever outbreak, targeted screening still detected patients with chronic Q fever and is estimated to be cost-effective.
Collapse
|
4
|
Duplaix L, Turgeon P, Lévesque B, Rocheleau JP, Leboeuf A, Picard I, Manguiat K, Wood H, Arsenault J. Seroprevalence and risk factors of antibodies against Coxiella burnetii among dog owners in southwestern Québec, Canada. Epidemiol Infect 2021; 149:1-45. [PMID: 34176524 PMCID: PMC8314959 DOI: 10.1017/s0950268821001412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 05/13/2021] [Accepted: 06/22/2021] [Indexed: 11/18/2022] Open
Abstract
Coxiella burnetii is a zoonotic agent responsible for human Q fever, a potentially severe disease that can lead to persistent infection. This cross-sectional study aimed to estimate the seroprevalence to C. burnetii antibodies and its association with potential risk factors in the human population of five regions of Québec, Canada. A serum bank comprising sera from 474 dog owners was screened by an enzyme-linked immunosorbent assay followed by confirmation of positive or equivocal sera by an indirect immunofluorescence assay. Observed seroprevalences of 1.2% (95% confidence interval (CI): 0.0–6.6), 2.6% (95% CI: 0.5–7.4) and 5.9% (95% CI: 3.4–9.6) were estimated in the regions of Montréal, Lanaudière and Montérégie, respectively, which all included at least 83 samples. Having lived or worked on a small ruminant farm (prevalence odds ratio (POR) = 5.4; 95% CI: 1.6–17.7) and being a veterinarian or veterinary student (POR = 6.1; 95% CI: 1.6–24.0) were significantly associated with C. burnetii seropositivity. Antibodies against C. burnetii were detected in the human population of Québec. Although seropositivity to this agent was associated with occupational contact with domestic animals, antibodies were also detected in people with no reported professional exposure. No associations with ruminant farm proximity were identified.
Collapse
Affiliation(s)
- L. Duplaix
- Department of Pathology and Microbiology, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Québec, Canada
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Québec, Canada
| | - P. Turgeon
- Department of Pathology and Microbiology, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Québec, Canada
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Québec, Canada
- National Microbiology Laboratory, Public Health Agency of Canada (PHAC), Saint-Hyacinthe, Québec, Canada
| | - B. Lévesque
- Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Québec, Canada
| | - J.-P. Rocheleau
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Québec, Canada
- Cégep de Saint-Hyacinthe, Saint-Hyacinthe, Québec, Canada
| | - A. Leboeuf
- Ministère de l'Agriculture, des Pêcheries et de l'Alimentation du Québec (MAPAQ), ville de Québec, Québec, Canada
| | - I. Picard
- Ministère de l'Agriculture, des Pêcheries et de l'Alimentation du Québec (MAPAQ), ville de Québec, Québec, Canada
| | - K. Manguiat
- National Microbiology Laboratory, Public Health Agency of Canada (PHAC), Winnipeg, Manitoba, Canada
| | - H. Wood
- National Microbiology Laboratory, Public Health Agency of Canada (PHAC), Winnipeg, Manitoba, Canada
| | - J. Arsenault
- Department of Pathology and Microbiology, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Québec, Canada
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Québec, Canada
| |
Collapse
|
5
|
Relationship between Coxiella burnetii (Q fever) antibody serology and time spent outdoors. J Infect 2020; 81:90-97. [PMID: 32330524 DOI: 10.1016/j.jinf.2020.04.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 04/11/2020] [Accepted: 04/13/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND/AIM From 2007 through 2010, the Netherlands experienced the largest recorded Q fever outbreak to date. People living closer to Coxiella burnetii infected goat farms were at increased risk for acute Q fever. Time spent outdoors near infected farms may have contributed to exposure to C. burnetii. The aim of this study was to retrospectively evaluate whether hours/week spent outdoors, in the vicinity of previously C. burnetii infected goat farms, was associated with presence of antibodies against C. burnetii in residents of a rural area in the Netherlands. METHODS Between 2014-2015, we collected C. burnetii antibody serology and self-reported data about habitual hours/week spent outdoors near the home from 2494 adults. From a subgroup we collected 941 GPS tracks, enabling analyses of active mobility in the outbreak region. Participants were categorised as exposed if they spent time within specified distances (500m, 1000m, 2000m, or 4000m) of C. burnetii infected goat farms. We evaluated whether time spent near these farms was associated with positive C. burnetii serology using spline analyses and logistic regression. RESULTS People that spent more hours/week outdoors near infected farms had a significantly increased risk for positive C. burnetii serology (time spent within 2000m of a C. burnetii abortion-wave positive farm, OR 3.6 (1.2-10.6)), compared to people spending less hours/week outdoors. CONCLUSIONS Outdoor exposure contributed to the risk of becoming C. burnetii serology positive. These associations were stronger if people spent more time near C. burnetii infected farms. Outdoor exposure should, if feasible, be included in outbreak investigations.
Collapse
|
6
|
Abstract
From 2007 to 2010, the largest reported Q-fever epidemic occurred in the Netherlands with 4026 notified laboratory-confirmed cases. During the course of the epidemic, health-seeking behaviour changed and awareness among health professionals increased. Changes in laboratory workflows were implemented. The aim of this study was to analyse how these changes instigated adjustments of notification criteria and how these adjustments affected the monitoring and interpretation of the epidemic. We used the articles on laboratory procedures related to the epidemic and a description of the changes that were made to the notification criteria. We compared the output of a regional laboratory with notifications to the regional Public Health Service and the national register of infectious diseases. We compared the international notification criteria for acute Q-fever. Screening with ELISA IgM phase II and PCR was added to the diagnostic workflow. In the course of the epidemic, serology often revealed a positive IgG/IgM result although cases were not infected recently. With increasing background seroprevalence, the presence of IgM antibodies can only be suggestive for acute Q-fever and has to be confirmed either by seroconversion of IgG or a positive PCR result. Differences in sero-epidemiology make it unlikely that full harmonisation of notification criteria between countries is feasible.
Collapse
|
7
|
de Boer PT, de Lange MMA, Wielders CCH, Dijkstra F, van Roeden SE, Bleeker-Rovers CP, Oosterheert JJ, Schneeberger PM, van der Hoek W. Cost-effectiveness of Screening Program for Chronic Q Fever, the Netherlands. Emerg Infect Dis 2020; 26:238-246. [PMID: 31961297 PMCID: PMC6986831 DOI: 10.3201/eid2602.181772] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
In the aftermath of a large Q fever (QF) epidemic in the Netherlands during 2007-2010, new chronic QF (CQF) patients continue to be detected. We developed a health-economic decision model to evaluate the cost-effectiveness of a 1-time screening program for CQF 7 years after the epidemic. The model was parameterized with spatial data on QF notifications for the Netherlands, prevalence data from targeted screening studies, and clinical data from the national QF database. The cost-effectiveness of screening varied substantially among subpopulations and geographic areas. Screening that focused on cardiovascular risk patients in areas with high QF incidence during the epidemic ranged from cost-saving to €31,373 per quality-adjusted life year gained, depending on the method to estimate the prevalence of CQF. The cost per quality-adjusted life year of mass screening of all older adults was €70,000 in the most optimistic scenario.
Collapse
|
8
|
Jaubert J, Naze F, Camuset G, Larrieu S, Pascalis H, Guernier V, Naty N, Bertolotti A, Manaquin R, Mboussou Y, Atiana L, Picot S, Filleul L, Tortosa P, Cardinale E, Gérardin P. Seroprevalence of Coxiella burnetii (Q fever) Exposure in Humans on Reunion Island. Open Forum Infect Dis 2019; 6:ofz227. [PMID: 31281854 PMCID: PMC6602885 DOI: 10.1093/ofid/ofz227] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 05/14/2019] [Indexed: 12/04/2022] Open
Abstract
After the documentation of sporadic cases of Q fever endocarditis, we conducted a serosurvey to assess Coxiella burnetii exposure on Reunion Island. Two hundred forty-one stored frozen human sera were analyzed using an immunofluorescence assay. The weighted seroprevalence of Q fever was of 6.81% (95% confidence interval, 4.02%–9.59%). Despite the absence of infection in youths <20 years of age, exposure was not driven by age or by gender. There was a spatial disparity in exposure across the island, with higher prevalence being reported in regions where ruminant farms are present. The seroprevalence pattern suggests that Q fever is endemic on Reunion Island.
Collapse
Affiliation(s)
- Julien Jaubert
- Laboratoire de Bactériologie, Virologie et Parasitologie, Centre Hospitalier Universitaire (CHU) de la Réunion, Saint Pierre, Reunion, France
| | - Florence Naze
- Laboratoire de Bactériologie, Virologie et Parasitologie, Centre Hospitalier Universitaire (CHU) de la Réunion, Saint Pierre, Reunion, France
| | - Guillaume Camuset
- Service des Maladies Infectieuses, CHU de la Réunion, Saint Pierre, Reunion, France
| | - Sophie Larrieu
- Cellule d'Intervention Régionale et d'Epidémiologie, Océan Indien, Santé Publique France, French National Public Health Agency, Saint Denis, Reunion, France
| | - Hervé Pascalis
- UM 134 PIMIT Processus Infectieux en Milieu Insulaire Tropical, Université de La Réunion, INSERM 1187, CNRS 9192, IRD 249, CYROI, Sainte Clotilde, Reunion, France
| | - Vanina Guernier
- Geelong Centre for Emerging Infectious Diseases, Deakin University, Geelong, Victoria, Australia
| | - Nadège Naty
- INSERM Centre d'Investigation Clinique 1410 Epidémiologie Clinique, CHU Réunion, Saint Pierre, Reunion, France
| | - Antoine Bertolotti
- Service des Maladies Infectieuses, CHU de la Réunion, Saint Pierre, Reunion, France.,INSERM Centre d'Investigation Clinique 1410 Epidémiologie Clinique, CHU Réunion, Saint Pierre, Reunion, France
| | - Rodolphe Manaquin
- Service des Maladies Infectieuses, CHU de la Réunion, Saint Pierre, Reunion, France
| | - Yoan Mboussou
- Laboratoire de Bactériologie, Virologie et Parasitologie, Centre Hospitalier Universitaire (CHU) de la Réunion, Saint Pierre, Reunion, France
| | - Laura Atiana
- Laboratoire de Bactériologie, Virologie et Parasitologie, Centre Hospitalier Universitaire (CHU) de la Réunion, Saint Pierre, Reunion, France
| | - Sandrine Picot
- Laboratoire de Bactériologie, Virologie et Parasitologie, Centre Hospitalier Universitaire (CHU) de la Réunion, Saint Pierre, Reunion, France
| | - Laurent Filleul
- Cellule d'Intervention Régionale et d'Epidémiologie, Océan Indien, Santé Publique France, French National Public Health Agency, Saint Denis, Reunion, France
| | - Pablo Tortosa
- UM 134 PIMIT Processus Infectieux en Milieu Insulaire Tropical, Université de La Réunion, INSERM 1187, CNRS 9192, IRD 249, CYROI, Sainte Clotilde, Reunion, France
| | - Eric Cardinale
- UMR ASTRE, Centre de Coopération Internationale en Recherche Agronomique pour le Développement (CIRAD) CYROI platform, Sainte Clotilde, Reunion, France.,UMR 1309 ASTRE, Institut National de Recherche Agronomique (INRA), Montpellier, France
| | - Patrick Gérardin
- UM 134 PIMIT Processus Infectieux en Milieu Insulaire Tropical, Université de La Réunion, INSERM 1187, CNRS 9192, IRD 249, CYROI, Sainte Clotilde, Reunion, France.,INSERM Centre d'Investigation Clinique 1410 Epidémiologie Clinique, CHU Réunion, Saint Pierre, Reunion, France
| |
Collapse
|
9
|
Borlée F, Yzermans CJ, Oostwegel FSM, Schellevis F, Heederik D, Smit LAM. Attitude toward livestock farming does not influence the earlier observed association between proximity to goat farms and self-reported pneumonia. Environ Epidemiol 2019; 3:e041. [PMID: 33778336 PMCID: PMC7952105 DOI: 10.1097/ee9.0000000000000041] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 01/13/2019] [Indexed: 11/26/2022] Open
Abstract
Attitudes toward environmental risks may be a source of bias in environmental health studies because concerns about environmental hazards may influence self-reported outcomes. OBJECTIVE The main aim was to assess whether earlier observed associations between proximity to goat farms and self-reported pneumonia were biased by participants' attitude toward farming. METHODS We developed an attitude-score for 2,457 participants of the Dutch Livestock Farming and Neighbouring Residents' Health Study (veehouderij en gezondheid omwonenden) by factor analysis of 13 questionnaire items related to attitude toward livestock farming. Linear regression analysis was used to assess associations between attitude and potential determinants. The effect of attitude on the association between goat farm proximity and pneumonia was analyzed by evaluating (1) misclassification of the outcome, (2) effect modification by attitude, and (3) exclusion of participants reporting health problems due to farms in their environment. RESULTS In general, the study population had a positive attitude toward farming, especially if participants were more familiar with farming. Older participants, females, ex-smokers, and higher-educated individuals had a more negative attitude. Both self-reported respiratory symptoms and exposure to livestock farms were associated with a more negative attitude. Misclassification of self-reported pneumonia was nondifferential with regard to participants' attitude. Furthermore, no indication was found that the association between proximity to goat farms and pneumonia was modified by attitude. Excluding subjects who attributed their health symptoms to livestock farms did also not change the association. CONCLUSIONS The association between goat farm proximity and pneumonia was not substantially biased by study participants' attitude toward livestock farming.
Collapse
Affiliation(s)
- Floor Borlée
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
- Netherlands Institute for Health Services Research, NIVEL, Utrecht, The Netherlands
| | - C. Joris Yzermans
- Netherlands Institute for Health Services Research, NIVEL, Utrecht, The Netherlands
| | - Floor S. M. Oostwegel
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - François Schellevis
- Netherlands Institute for Health Services Research, NIVEL, Utrecht, The Netherlands
- Department of General Practice & Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Dick Heederik
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Lidwien A. M. Smit
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| |
Collapse
|
10
|
Chronic Q Fever with Vascular Involvement: Progressive Abdominal Pain in a Patient with Aortic Aneurysm Repair in the United States. Case Rep Infect Dis 2019; 2019:5369707. [PMID: 30915246 PMCID: PMC6399537 DOI: 10.1155/2019/5369707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 01/30/2019] [Indexed: 11/18/2022] Open
Abstract
Q fever is a zoonotic bacterial infection caused by Coxiella burnetii. Chronic Q fever comprises less than five percent of all Q fever cases and, of those, endocarditis is the most common presentation (up to 78% of cases), followed by vascular involvement. Risk factors for chronic Q fever with vascular involvement include previous vascular surgery, preexisting valvular defects, aneurysms, and vascular prostheses. The most common symptoms of chronic Q fever with vascular involvement are nonspecific, including weight loss, fatigue, and abdominal pain. Criteria for diagnosis of chronic Q fever include clinical evidence of infection and laboratory criteria (antibody detection, detection of Coxiella burnetii DNA, or growth in culture). Treatment of chronic Q fever with vascular involvement includes a prolonged course of doxycycline and hydroxychloroquine (≥18 months) as well as early surgical intervention, which has been shown to improve survival. Mortality is high in untreated chronic Q fever. We report a case of chronic Q fever with vascular involvement in a 77-year-old man with prior infrarenal aortic aneurysm repair, who lived near a livestock farm in the southeastern United States.
Collapse
|
11
|
Cross AR, Baldwin VM, Roy S, Essex-Lopresti AE, Prior JL, Harmer NJ. Zoonoses under our noses. Microbes Infect 2019; 21:10-19. [PMID: 29913297 PMCID: PMC6386771 DOI: 10.1016/j.micinf.2018.06.001] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 06/06/2018] [Accepted: 06/07/2018] [Indexed: 11/22/2022]
Abstract
One Health is an effective approach for the management of zoonotic disease in humans, animals and environments. Examples of the management of bacterial zoonoses in Europe and across the globe demonstrate that One Health approaches of international surveillance, information-sharing and appropriate intervention methods are required to successfully prevent and control disease outbreaks in both endemic and non-endemic regions. Additionally, a One Health approach enables effective preparation and response to bioterrorism threats.
Collapse
Affiliation(s)
- Alice R Cross
- Living Systems Institute, College of Life and Environmental Sciences, University of Exeter, Exeter EX4 4QD United Kingdom.
| | - Victoria M Baldwin
- Defence Science and Technology Laboratory, Porton Down, Salisbury SP4 0JQ United Kingdom
| | - Sumita Roy
- Living Systems Institute, College of Life and Environmental Sciences, University of Exeter, Exeter EX4 4QD United Kingdom
| | | | - Joann L Prior
- Living Systems Institute, College of Life and Environmental Sciences, University of Exeter, Exeter EX4 4QD United Kingdom; Defence Science and Technology Laboratory, Porton Down, Salisbury SP4 0JQ United Kingdom; London School of Hygiene & Tropical Medicine, Kepple Street, London WC1E 7HT United Kingdom
| | - Nicholas J Harmer
- Living Systems Institute, College of Life and Environmental Sciences, University of Exeter, Exeter EX4 4QD United Kingdom
| |
Collapse
|