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Choi Y, Yeh JY, Lee JK, Michelow IC, Park S. Risk factors associated with Coxiella burnetii in wild boars: A study in South Korea. Prev Vet Med 2024; 225:106157. [PMID: 38452603 DOI: 10.1016/j.prevetmed.2024.106157] [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: 08/31/2023] [Revised: 01/04/2024] [Accepted: 02/13/2024] [Indexed: 03/09/2024]
Abstract
Coxiella burnetii is a Gram-negative bacterium that causes the zoonotic disease Q fever. Wild boars serve as reservoirs for C. burnetii. This study aimed to identify the risk factors associated with C. burnetii infection in wild boars. We analyzed the data from 975 wild boar samples collected from June to November 2021 in South Korea. We utilized the indirect ELISA to detect antibodies against C. burnetii. A sample optical density to positive-control optical density value exceeding 50% was classified as positive. We gathered data on the forestation, terrain, weather, agriculture, and animal density of the region where the samples were collected. Continuous variables were categorized into tertiles. We performed a univariate logistic regression analysis and included variables with a p-value < 0.2 in the final multivariable logistic regression model. In our multivariable logistic regression analysis to identify risk factors for C. burnetii infection in wild boars, we used a forward selection method to enter variables based on the order of their significance. We performed the final multivariable logistic regression analyses using either continuous variables or variables categorized into tertiles. The prevalence of C. burnetii was 14.6% (n=142). Locations with the highest maximum wind speeds (3.92-8.24 m/s) showed a 59% increase in infection odds compared to locations with the lowest speeds (1.45-3.25 m/s)(p=0.044). For each 1 m/s increase in maximum wind speed, infection odds increased by 24.1% (p=0.037). Regions with the highest percentage of paddy fields per area (8.3-45%) showed a 76% increase in infection odds compared to regions with the lowest percentage (0-1.5%)(p=0.011). For each 1% increase in the proportion of paddy fields per area, infection odds increased by 3.3% (p=0.003). High maximum wind speed and a high percentage of paddy field were identified as significant risk factors for C. burnetii infection in wild boars.
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Affiliation(s)
- Yongyeon Choi
- Graduate School of Urban Public Health, University of Seoul, Seoul, Republic of Korea
| | - Jung-Yong Yeh
- Department of Life Sciences, College of Life Sciences and Bioengineering, Incheon National University, Incheon, South Korea
| | - Jong Koo Lee
- Department of Life Sciences, College of Life Sciences and Bioengineering, Incheon National University, Incheon, South Korea
| | - Ian C Michelow
- Department of Pediatrics, Division of Infectious Diseases and Immunology, Connecticut Children's Medical Center, Hartford, USA; Department of Pediatrics, University of Connecticut School of Medicine, Farmington, USA
| | - Sangshin Park
- Graduate School of Urban Public Health, University of Seoul, Seoul, Republic of Korea; Department of Urban Big Data Convergence, University of Seoul, Seoul, Republic of Korea; Department of Pathology and Laboratory Medicine, Brown University Medical School, Providence, USA.
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Jaubert J, Atiana L, Larrieu S, De Vos P, Somon-Payet C, Porcherat S, Mboussou Y, Naze F, Picot S, Boukerrou M, Robillard PY, Gérardin P. Q fever seroprevalence in parturient women: the EQRUN cross-sectional study on Reunion Island. BMC Infect Dis 2020; 20:261. [PMID: 32245372 PMCID: PMC7118902 DOI: 10.1186/s12879-020-04969-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 03/12/2020] [Indexed: 11/30/2022] Open
Abstract
Background Q fever (Coxiella burnetii infection) has been associated with adverse perinatal outcomes. After investigating the obstetrical importance of Q fever on Reunion island and demonstrating an association between incident Q fever and miscarriage, we conducted a cross-sectional serosurvey to assess the prevalence of Coxiella burnetii infection among parturient women. Methods Between January 9 and July 24, 2014, within the level-4 maternity of Saint Pierre hospital and the level-1 maternity of Le Tampon, we proposed to screen all parturient women for Coxiella burnetii serology. Seropositivity was defined using indirect immunofluorescence for a dilution of phase 2 IgG titre ≥1:64. Further dilutions were chosen to discriminate recent or active infections from past or prevalent infections (< 1:128) and classify these as either possible (1:128), or probable (≥1:256). Recurrent miscarriage, stillbirth, preterm birth, small-for-gestational as well as a composite outcome of these adverse pregnancy outcomes were compared according to seropositivity using bivariate analysis or propensity score matching of seropositive and seronegative women on confounding factors. Results Among 1112 parturient women screened for Q fever over this 7-month period, 203 (18.3%) were seropositive. Overall weighted seroprevalence was of 20.1% (95%CI, 17.7–22.5%). Weighted seroprevalence of probable infections was 4.7% (95%CI 3.4–5.9%), while > 90% of positive serologies corresponded to past infections or false positives. Seropositivity was associated with none of the abovementioned adverse perinatal outcomes, whether in unpaired or matched analyses on propensity score. Conclusion The magnitude and the pattern of seroprevalence suggest that Q fever is endemic on Reunion island. In this context, we found no significant contribution of prevalent Coxiella burnetii infection to adverse pregnancy outcomes. Although reassuring, these data put in our endemic context, with a previously demonstrated increased risk of incident Q fever associated miscarriage, encourage us to protect pregnant women against the risk of new infection, periconceptional or early in pregnancy.
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Affiliation(s)
- Julien Jaubert
- 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
| | - Sophie Larrieu
- CIRE Océan Indien, Santé Publique France, French National Public Health Agency, Saint Denis, Reunion, France
| | | | - Claudine Somon-Payet
- Maternité, Pôle Femme Mère Enfant, CHU de la Réunion, St Pierre, Reunion, France
| | - Sylvaine Porcherat
- INSERM CIC 1410 Epidémiologie Clinique, Centre Hospitalier Universitaire, Groupe Hospitalier Sud Réunion, CHU Réunion, BP 350, 97448, Saint Pierre, Cedex-Reunion, France
| | - Yoan Mboussou
- 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
| | - Sandrine Picot
- Laboratoire de Bactériologie, Virologie et Parasitologie, Centre Hospitalier Universitaire (CHU) de la Réunion, Saint Pierre, Reunion, France
| | - Malik Boukerrou
- Maternité, Pôle Femme Mère Enfant, CHU de la Réunion, St Pierre, Reunion, France.,CEPOI-EA7388, Pôle Femme Mère Enfant, CHU de la Réunion, Saint Pierre, Reunion, France
| | - Pierre-Yves Robillard
- Maternité, Pôle Femme Mère Enfant, CHU de la Réunion, St Pierre, Reunion, France.,CEPOI-EA7388, Pôle Femme Mère Enfant, CHU de la Réunion, Saint Pierre, Reunion, France
| | - Patrick Gérardin
- INSERM CIC 1410 Epidémiologie Clinique, Centre Hospitalier Universitaire, Groupe Hospitalier Sud Réunion, CHU Réunion, BP 350, 97448, Saint Pierre, Cedex-Reunion, France. .,UM 134 PIMIT Processus Infectieux en Milieu Insulaire Tropical, Université de La Réunion, INSERM 1187, CNRS 9192, IRD 249, CYROI, Sainte Clotilde, Reunion, France.
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Tenhagen BA, Werner N, Käsbohrer A, Kreienbrock L. [Transmission pathways for resistant bacteria between animals and humans: antibiotics resistance in the One Health context]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2019; 61:515-521. [PMID: 29616289 DOI: 10.1007/s00103-018-2717-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
People and animals share the same environment and antibiotics are used in both. Thus, antibiotics resistance is a major common issue for human and veterinary medicine. The potential impact of antibiotics use in animals on resistance in humans is frequently the focus of debate. In this paper the transmission pathways of resistant bacteria between animals and humans are described and the question is addressed whether a reduction in antibiotics use in animals contributes to the improvement of the resistance situation in humans. Direct contact between humans and animals, transmission of bacteria via food, and indirect transmission via emissions in the environment and the subsequent exposure of humans via the environment are the major transmission routes to be considered. It can thus be established that the relevance of these various transmission routes varies significantly among bacterial species. Furthermore, despite numerous investigations, the exact significance of transmission pathways and the bacteria transferred for the resistance situation in humans cannot yet be precisely quantified. There is evidence that antibiotics use in animals fosters the spread of resistant organisms in animals. Recent studies also suggest that there might be a relationship between antibiotics use in animals and the occurrence of resistance in humans. However, this relationship is complex, and for a better understanding of it and the role of the various transmission pathways, further collaborative studies between veterinary and medical science are needed.
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Affiliation(s)
- Bernd-Alois Tenhagen
- Fachgruppe Epidemiologie, Zoonosen und Antibiotikaresistenz, Bundesinstitut für Risikobewertung, Max-Dohrn-Str. 8-10, 10589, Berlin, Deutschland.
| | - Nicole Werner
- Institut für Biometrie, Epidemiologie und Informationsverarbeitung, WHO Collaborating Centre for Research and Training for Health at the Human-Animal-Environment Interface, Tierärztliche Hochschule Hannover, Hannover, Deutschland
| | - Annemarie Käsbohrer
- Fachgruppe Epidemiologie, Zoonosen und Antibiotikaresistenz, Bundesinstitut für Risikobewertung, Max-Dohrn-Str. 8-10, 10589, Berlin, Deutschland.,Institut für Öffentliches Veterinärwesen, Veterinärmedizinische Universität Wien, Wien, Österreich
| | - Lothar Kreienbrock
- Institut für Biometrie, Epidemiologie und Informationsverarbeitung, WHO Collaborating Centre for Research and Training for Health at the Human-Animal-Environment Interface, Tierärztliche Hochschule Hannover, Hannover, Deutschland
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Clark NJ, Soares Magalhães RJ. Airborne geographical dispersal of Q fever from livestock holdings to human communities: a systematic review and critical appraisal of evidence. BMC Infect Dis 2018; 18:218. [PMID: 29764368 PMCID: PMC5952368 DOI: 10.1186/s12879-018-3135-4] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Accepted: 05/07/2018] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Q fever is a zoonotic disease caused by Coxiella burnetii. This bacterium survives harsh conditions and attaches to dust, suggesting environmental dispersal is a risk factor for outbreaks. Spatial epidemiology studies collating evidence on Q fever geographical contamination gradients are needed, as human cases without occupational exposure are increasing worldwide. METHODS We used a systematic literature search to assess the role of distance from ruminant holdings as a risk factor for human Q fever outbreaks. We also collated evidence for other putative drivers of C. burnetii geographical dispersal. RESULTS In all documented outbreaks, infective sheep or goats, not cattle, was the likely source. Evidence suggests a prominent role of airborne dispersal; Coxiella burnetii travels up to 18 km on gale force winds. In rural areas, highest infection risk occurs within 5 km of sources. Urban outbreaks generally occur over smaller distances, though evidence on attack rate gradients is limited. Wind speed / direction, spreading of animal products, and stocking density may all contribute to C. burnetii environmental gradients. CONCLUSIONS Q fever environmental gradients depend on urbanization level, ruminant species, stocking density and wind speed. While more research is needed, evidence suggests that residential exclusion zones around holdings may be inadequate to contain this zoonotic disease, and should be species-specific.
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Affiliation(s)
- Nicholas J Clark
- UQ Spatial Epidemiology Laboratory, School of Veterinary Science, The University of Queensland, Gatton, QLD, 4343, Australia
| | - Ricardo J Soares Magalhães
- UQ Spatial Epidemiology Laboratory, School of Veterinary Science, The University of Queensland, Gatton, QLD, 4343, Australia.
- Children's Health and Environment Program, Child Health Research Centre, The University of Queensland, South Brisbane, QLD, 4101, Australia.
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SLOAN-GARDNER TS, MASSEY PD, HUTCHINSON P, KNOPE K, FEARNLEY E. Trends and risk factors for human Q fever in Australia, 1991-2014. Epidemiol Infect 2017; 145:787-795. [PMID: 27927265 PMCID: PMC9507770 DOI: 10.1017/s0950268816002843] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 10/14/2016] [Accepted: 11/07/2016] [Indexed: 12/13/2022] Open
Abstract
Australian abattoir workers, farmers, veterinarians and people handling animal birthing products or slaughtering animals continue to be at high risk of Q fever despite an effective vaccine being available. National Notifiable Diseases Surveillance System data were analysed for the period 1991-2014, along with enhanced risk factor data from notified cases in the states of New South Wales and Queensland, to examine changes in the epidemiology of Q fever in Australia. The national Q fever notification rate reduced by 20% [incident rate ratio (IRR) 0·82] following the end of the National Q fever Management Program in 2006, and has increased since 2009 (IRR 1·01-1·34). Highest rates were in males aged 40-59 years (5·9/100 000) and 87% of Q fever cases occurred in New South Wales and Queensland. The age of Q fever cases and proportion of females increased over the study period. Based on the enhanced risk factor data, the most frequently listed occupation for Q fever cases involved contact with livestock, followed by 'no known risk' occupations. More complete and comparable enhanced risk factor data, at the State/Territory and national levels, would aid in further understanding of the epidemiology of Q fever.
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Affiliation(s)
- T. S. SLOAN-GARDNER
- Office of Health Protection, Department of Health, Woden, ACT, Australia
- National Centre for Epidemiology & Population Health, Research School of Population Health, Australian National University, ACT, Australia
| | - P. D. MASSEY
- Hunter New England Population Health, NSW, Australia
- College of Medicine & Dentistry, James Cook University, QLD, Australia
| | | | - K. KNOPE
- Office of Health Protection, Department of Health, Woden, ACT, Australia
| | - E. FEARNLEY
- National Centre for Epidemiology & Population Health, Research School of Population Health, Australian National University, ACT, Australia
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Eldin C, Mélenotte C, Mediannikov O, Ghigo E, Million M, Edouard S, Mege JL, Maurin M, Raoult D. From Q Fever to Coxiella burnetii Infection: a Paradigm Change. Clin Microbiol Rev 2017; 30:115-190. [PMID: 27856520 PMCID: PMC5217791 DOI: 10.1128/cmr.00045-16] [Citation(s) in RCA: 528] [Impact Index Per Article: 75.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Coxiella burnetii is the agent of Q fever, or "query fever," a zoonosis first described in Australia in 1937. Since this first description, knowledge about this pathogen and its associated infections has increased dramatically. We review here all the progress made over the last 20 years on this topic. C. burnetii is classically a strict intracellular, Gram-negative bacterium. However, a major step in the characterization of this pathogen was achieved by the establishment of its axenic culture. C. burnetii infects a wide range of animals, from arthropods to humans. The genetic determinants of virulence are now better known, thanks to the achievement of determining the genome sequences of several strains of this species and comparative genomic analyses. Q fever can be found worldwide, but the epidemiological features of this disease vary according to the geographic area considered, including situations where it is endemic or hyperendemic, and the occurrence of large epidemic outbreaks. In recent years, a major breakthrough in the understanding of the natural history of human infection with C. burnetii was the breaking of the old dichotomy between "acute" and "chronic" Q fever. The clinical presentation of C. burnetii infection depends on both the virulence of the infecting C. burnetii strain and specific risks factors in the infected patient. Moreover, no persistent infection can exist without a focus of infection. This paradigm change should allow better diagnosis and management of primary infection and long-term complications in patients with C. burnetii infection.
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Affiliation(s)
- Carole Eldin
- URMITE, UMR CNRS 7278, IRD 198, INSERM U1095, Faculté de Médecine, Marseille, France
| | - Cléa Mélenotte
- URMITE, UMR CNRS 7278, IRD 198, INSERM U1095, Faculté de Médecine, Marseille, France
| | - Oleg Mediannikov
- URMITE, UMR CNRS 7278, IRD 198, INSERM U1095, Faculté de Médecine, Marseille, France
| | - Eric Ghigo
- URMITE, UMR CNRS 7278, IRD 198, INSERM U1095, Faculté de Médecine, Marseille, France
| | - Matthieu Million
- URMITE, UMR CNRS 7278, IRD 198, INSERM U1095, Faculté de Médecine, Marseille, France
| | - Sophie Edouard
- URMITE, UMR CNRS 7278, IRD 198, INSERM U1095, Faculté de Médecine, Marseille, France
| | - Jean-Louis Mege
- URMITE, UMR CNRS 7278, IRD 198, INSERM U1095, Faculté de Médecine, Marseille, France
| | - Max Maurin
- Institut de Biologie et de Pathologie, CHU de Grenoble, Grenoble, France
| | - Didier Raoult
- URMITE, UMR CNRS 7278, IRD 198, INSERM U1095, Faculté de Médecine, Marseille, France
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KHAYYAT KHAMENEIE M, ASADI J, KHALILI M, ABIRI Z. The First Serological Study of Coxiella burnetii among Pregnant Women in Iran. IRANIAN JOURNAL OF PUBLIC HEALTH 2016; 45:523-30. [PMID: 27252922 PMCID: PMC4888180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/29/2022]
Abstract
BACKGROUND Q fever is a zoonotic disease caused by Coxiella burnetii. There is no information about this disease in pregnant women in Iran. The aim of this study was to investigate the seroprevalence of C. burnetii infection among pregnant women in southwestern (Ahvaz) and northern (Parsabad) Iran and further to comparison its prevalence in normal and abnormal pregnancies. METHODS A total of 400 samples were collected randomly from pregnant women who referred to diagnostic laboratories of Ahvaz and Parsabad in 2014. An indirect ELISA kit, designed in Veterinary Faculty, was used to detect the specific antibodies against phase II humanC. burnetii in serum samples. RESULTS The overall prevalence of C. burnetii in sera from pregnant women was 29.3% (95% confidence interval (CI): 25-34%). The prevalence of C. burnetii infection was significantly different in Ahvaz and Parsabad with, respectively, 22 (95% CI: 16-28%) and 36.5% (95% CI: 30-43%). Total prevalence of C. burnetii infection in serum was significantly higher in women with abnormal pregnancy history (39.8%) compared with normal pregnancies (23.8%). Furthermore, maternal age had significant association with seropositivity and the prevalence increased with maternal age. This could be due to higher probability of encountering C. burnetii in older women. CONCLUSION The present study demonstrated ahigh seroprevalence of C. burnetii infection among pregnant women in Iran for the first time. Seropositivity was associated with adverse pregnancy outcomes and maternal age. The pregnant women who experienced abnormal pregnancy had higher seroprevalence of C. burnetii compared to women with normal pregnancy.
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Affiliation(s)
| | - Javad ASADI
- AJA University of Medical Sciences, Tehran, Iran,Corresponding Author:
| | - Mohammad KHALILI
- Dept. of Pathobiology, School of Veterinary Medicine, Shahid Bahonar University of Kerman, Kerman, Iran
| | - Zeinab ABIRI
- Dept. of Pathobiology, School of Veterinary Medicine, Shahid Bahonar University of Kerman, Kerman, Iran
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Slok ENE, Dijkstra F, de Vries E, Rietveld A, Wong A, Notermans DW, van Steenbergen JE. Estimation of acute and chronic Q fever incidence in children during a three-year outbreak in the Netherlands and a comparison with international literature. BMC Res Notes 2015; 8:456. [PMID: 26384483 PMCID: PMC4575485 DOI: 10.1186/s13104-015-1389-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 08/24/2015] [Indexed: 11/23/2022] Open
Abstract
Background In the Dutch 2007–2009 Q fever outbreak Coxiella burnetii was transmitted aerogenically from dairy goat farms to those living in the surrounding areas. Relatively few children were reported. The true number of pediatric infections is unknown. In this study, we estimate the expected number of acute and chronic childhood infections. Methods As Coxiella was transmitted aerogenic to those living near infected dairy goat farms, we could use adult seroprevalence data to estimate infection risk for inhabitants, children and
adults alike. Using Statistics Netherlands data we estimated the number of children at (high) risk for developing chronic Q fever. Literature was reviewed for childhood (0–15 years) Q fever reports and disease rates. We compared this with Dutch reported and our estimated data for 2007–2009. Results In The Netherlands epidemic, 44 children were reported (1.2 % of total notifications). The childhood incidence was 0.15 compared to 2.6 per 10,000 inhabitants for adults. No complications were reported. Based on the expected similarity in childhood and adult exposure we assume that 9.8 % of children in the high-risk area had Q fever infection, resulting
in 1562 acute infections during the Q fever epidemic interval. Based on the prevalence of congenital heart disease, at least 13 children are at high risk for developing chronic Q fever. In medical literature, 42 case reports described 140 childhood Q fever cases with a serious outcome (four deaths). In chronic Q fever, cardiac infections were predominant. Four outbreaks were reported involving children, describing 11 childhood cases. 36 National and/or regional studies reported seroprevalences varying between 0 and 70 %. Conclusion In the 3-year Dutch epidemic, few childhood cases were reported, with pulmonary symptoms leading, and none with a serious presentation. With an estimated 13 high-risk children for chronic infection in the high exposure area, and probably forty in the whole country, we may expect several chronic Q fever complications in the coming years in paediatric practice. Electronic supplementary material The online version of this article (doi:10.1186/s13104-015-1389-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Edwin N E Slok
- National Institute for Public Health and the Environment, Centre for Infectious Disease Control, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands.
| | - Frederika Dijkstra
- National Institute for Public Health and the Environment, Centre for Infectious Disease Control, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands.
| | - Esther de Vries
- Department of Paediatrics, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.
| | - Ariene Rietveld
- Department of Infectious Disease Control, Municipal Health Service 'Hart voor Brabant', 's-Hertogenbosch, The Netherlands.
| | - Albert Wong
- National Institute for Public Health and the Environment, Centre for Infectious Disease Control, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands. .,Department of Statistics, Mathematical Modelling and Data Logistics, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands.
| | - Daan W Notermans
- National Institute for Public Health and the Environment, Centre for Infectious Disease Control, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands.
| | - Jim E van Steenbergen
- National Institute for Public Health and the Environment, Centre for Infectious Disease Control, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands. .,Centre for Infectious Diseases, Leiden University Medical Centre, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.
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Meadows S, Jones-Bitton A, McEwen S, Jansen J, Menzies P. Coxiella burnetii seropositivity and associated risk factors in sheep in Ontario, Canada. Prev Vet Med 2015; 122:129-34. [PMID: 26376066 DOI: 10.1016/j.prevetmed.2015.07.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 07/16/2015] [Accepted: 07/21/2015] [Indexed: 11/16/2022]
Abstract
Coxiella burnetii is a zoonotic bacterium that can cause abortion in sheep in late gestation, as well as the delivery of stillborn, and non-viable lambs (Rodolakis, 2006). A cross-sectional study was conducted in Ontario, Canada, to investigate C. burnetii exposure in sheep. Between August 2010 and January 2012, sera from 2363 reproductively active ewes from 72 farms were tested for C. burnetii specific antibodies using the CHEKIT Q fever ELISA Test kit (IDEXX Laboratories). Overall, exposure was common; sheep-level seroprevalence was 14.7% (347/2363, 95% CI: 13.3-16.2), and was higher in dairy sheep (24.3%, 181/744) than meat sheep (10.2%, 166/1619) (p<0.0001). At the farm-level, 48.6% (35/72, 95% CI: 37.2-60.1) of farms had at least one seropositive sheep. A mixed multivariable logistic model that controlled for farm-level clustering, identified risk factors associated (p<0.05) with sheep seropositivity. Increasing female flock size (logarithmic scale) was associated with increased odds of seropositivity. By way of illustration, increasing the female flock size from 100 to 200 increased the odds of seropositivity by 2.26 times (95% CI: 1.5-3.5). Sheep that lambed in an airspace separate from the flock had 11.3 times (95% CI: 2.9-43.6) the odds of seropositivity relative to other sheep. The practice of loaning sheep that returned to the farm increased odds of seropositivity by 8.1 times (95% CI: 1.8-33.6). Lambing pen hygiene practices also influenced odds of seropositivity. Relative to sheep from farms where all lambing pen hygiene measures were practiced after lambing (i.e., adding bedding, removing birth materials and disinfection), sheep from farms that only added bedding, or those that just added bedding and removed birthing materials had 5.9 times (95% CI: 1.1-32.1) and 9.0 times (95% CI: 2.2-36.9) the odds of seropositivity, respectively. These results can be used to inform prevention and control strategies with the aim of reducing C. burnetii exposure in sheep.
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Affiliation(s)
- S Meadows
- Department of Population Medicine, University of Guelph, 50 Stone Road East, Guelph, Ontario N1G2W1, Canada.
| | - A Jones-Bitton
- Department of Population Medicine, University of Guelph, 50 Stone Road East, Guelph, Ontario N1G2W1, Canada
| | - S McEwen
- Department of Population Medicine, University of Guelph, 50 Stone Road East, Guelph, Ontario N1G2W1, Canada
| | - J Jansen
- Veterinary Science and Policy, Ontario Ministry of Agriculture and Food, and Rural Affairs, 6484 Wellington Rd 7, Unit 10, Elora, Ontario, N0B 1S0, Canada
| | - P Menzies
- Department of Population Medicine, University of Guelph, 50 Stone Road East, Guelph, Ontario N1G2W1, Canada
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de Lange MMA, Hukkelhoven CWPM, Munster JM, Schneeberger PM, van der Hoek W. Nationwide registry-based ecological analysis of Q fever incidence and pregnancy outcome during an outbreak in the Netherlands. BMJ Open 2015; 5:e006821. [PMID: 25862010 PMCID: PMC4401861 DOI: 10.1136/bmjopen-2014-006821] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE Whether areas affected by Q fever during a large outbreak (2008-2010) had higher rates of adverse pregnancy outcomes than areas not affected by Q fever. DESIGN Nationwide registry-based ecological study. SETTING Pregnant women in areas affected and not affected by Q fever in the Netherlands, 2003-2004 and 2008-2010. PARTICIPANTS Index group (N=58,737): pregnant women in 307 areas with more than two Q fever notifications. Reference group (N=310,635): pregnant women in 921 areas without Q fever notifications. As a baseline, pregnant women in index and reference areas in the years 2003-2004 were also included in the reference group to estimate the effect of Q fever in 2008-2010, and not the already existing differences before the outbreak. MAIN OUTCOME MEASURES Preterm delivery, small for gestational age, perinatal mortality. RESULTS In 2008-2010, there was no association between residing in a Q fever-affected area and both preterm delivery (adjusted OR 1.01 (95% CI 0.94 to 1.08)), and perinatal mortality (adjusted OR 0.87 (95% CI 0.72 to 1.05)). In contrast, we found a weak significant association between residing in a Q fever-affected area in 2008-2010 and small for gestational age (adjusted OR 1.06 (95% CI 1.01 to 1.12)), with a population-attributable fraction of 0.70% (95% CI 0.07% to 1.34%). We observed no dose-response relation for this outcome with increasing Q fever notifications, and we did not find a stronger association for women who were in their first trimester of pregnancy during the months of high human Q fever incidence. CONCLUSIONS This study found a weak association between residing in a Q fever-affected area and the pregnancy outcome small for gestational age. Early detection of infection would require mass screening of pregnant women; this does not seem to be justified considering these results, and the uncertainties about its efficacy and the adverse effects of antibiotic treatment.
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Affiliation(s)
- Marit M A de Lange
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | - Janna M Munster
- Department of Obstetrics and Gynaecology, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - Peter M Schneeberger
- Department of Medical Microbiology and Infection Control, Jeroen Bosch Hospital, ‘s-Hertogenbosch, the Netherlands
| | - Wim van der Hoek
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
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Commandeur M, Jeurissen L, van der Hoek W, Roest HJ, Hermans TCML. Spatial relationships in the Q fever outbreaks 2007-2010 in the Netherlands. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2014; 24:137-157. [PMID: 23802588 DOI: 10.1080/09603123.2013.800963] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
We analyzed the Q fever epidemic in the Netherlands on a national scale from a spatial point of view. Data on dairy goat farms and Dutch population, whether or not infected, were geo-referenced. Human cases were counted in GIS at different distance classes for all dairy goat farms, farms with Q fever based on BTM analysis, and farms with clinical symptoms. In all selections, human incidence decreased with increasing distances from dairy goat farms. Incidence was highest around farms with clinical symptoms. Depending on the acceptable incidence value, a dairy goat-free zone around residential areas could be defined. Cluster analyses were performed to identify local clusters of both infected farms and human cases and to identify focused clusters of human cases. Focused clusters were detected for only 14 out of 29 farms with clinical symptoms, giving rise to a new hypothesis on the transmission of Q fever.
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Environmental attributes to respiratory diseases of small ruminants. Vet Med Int 2014; 2014:853627. [PMID: 24782941 PMCID: PMC3981018 DOI: 10.1155/2014/853627] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2013] [Revised: 02/13/2014] [Accepted: 02/15/2014] [Indexed: 02/06/2023] Open
Abstract
Respiratory diseases are the major disease crisis in small ruminants. A number of pathogenic microorganisms have been implicated in the development of respiratory disease but the importance of environmental factors in the initiation and progress of disease can never be overemphasized. They irritate the respiratory tree producing stress in the microenvironment causing a decline in the immune status of the small ruminants and thereby assisting bacterial, viral, and parasitic infections to break down the tissue defense barriers. Environmental pollutants cause acute or chronic reactions as they deposit on the alveolar surface which are characterized by inflammation or fibrosis and the formation of transitory or persistent tissue manifestation. Some of the effects of exposures may be immediate, whereas others may not be evident for many decades. Although the disease development can be portrayed as three sets of two-way communications (pathogen-environment, host-environment, and host-pathogen), the interactions are highly variable. Moreover, the environmental scenario is never static; new compounds are introduced daily making a precise evaluation of the disease burden almost impossible. The present review presents a detailed overview of these interactions and the ultimate effect on the respiratory health of sheep and goat.
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van Leuken JPG, Havelaar AH, van der Hoek W, Ladbury GAF, Hackert VH, Swart AN. A model for the early identification of sources of airborne pathogens in an outdoor environment. PLoS One 2013; 8:e80412. [PMID: 24324598 PMCID: PMC3850919 DOI: 10.1371/journal.pone.0080412] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Accepted: 10/03/2013] [Indexed: 11/19/2022] Open
Abstract
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.
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Affiliation(s)
- Jeroen P. G. van Leuken
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- * E-mail:
| | - Arie H. Havelaar
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Wim van der Hoek
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | | | - Volker H. Hackert
- Municipal Health Service Zuid-Limburg, Sittard-Geleen, The Netherlands
| | - Arno N. Swart
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
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van den Berg EJ, Wielders CCH, Schneeberger PM, Wegdam-Blans MC, van der Hoek W. Spatial analysis of positive and negative Q fever laboratory results for identifying high- and low-risk areas of infection in the Netherlands. Infect Ecol Epidemiol 2013; 3:20432. [PMID: 24298327 PMCID: PMC3843769 DOI: 10.3402/iee.v3i0.20432] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Revised: 10/16/2013] [Accepted: 10/25/2013] [Indexed: 12/03/2022] Open
Abstract
Background The Netherlands faced a large Q fever epidemic from 2007 to 2010, in which thousands of people were tested for the presence of antibodies against Coxiella burnetii as part of individual patient diagnosis. So far, only data of notified cases were used for the identification of high-risk areas, which can lead to misclassification of risk. Therefore, we identified high- and low-risk areas based on laboratory test results to make control measures more efficient. Methods Data on diagnostic Q fever laboratory tests were obtained from two regional laboratories of medical microbiology in the high-incidence area in the south of the Netherlands. The proportion of patients testing positive was mapped per postal code area. Patients testing positive were compared to patients testing negative based on the distance between residential address and the nearest infected goat farm with adjustment for age and sex. Results and conclusion Of 11,035 patients tested, 4,011 (36.4%) had a positive laboratory test result for Q fever. Maps showing the spatial pattern of tests performed and proportion of positive tests allowed for the identification of high- and low-risk Q fever areas. The proportion of patients testing positive was higher in areas close to infected goat farms compared to areas further away. Patients living <1 km from an infected goat farm had a substantially higher risk of testing positive for antibodies to C. burnetii than those living >10 km away (OR 21.70, 95% CI 16.28–28.92). Laboratory test results have the potential to make control measures more efficient by identifying high-risk areas as well as low-risk areas.
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Affiliation(s)
- Elsa J van den Berg
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
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Screening for Coxiella burnetii seroprevalence in chronic Q fever high-risk groups reveals the magnitude of the Dutch Q fever outbreak. Epidemiol Infect 2012; 141:847-51. [DOI: 10.1017/s0950268812001203] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
SUMMARYThe Netherlands experienced an unprecedented outbreak of Q fever between 2007 and 2010. The Jeroen Bosch Hospital (JBH) in 's-Hertogenbosch is located in the centre of the epidemic area. Based on Q fever screening programmes, seroprevalence of IgG phase II antibodies to Coxiella burnetii in the JBH catchment area was 10·7% [785 tested, 84 seropositive, 95% confidence interval (CI) 8·5–12·9]. Seroprevalence appeared not to be influenced by age, gender or area of residence. Extrapolating these data, an estimated 40 600 persons (95% CI 32 200–48 900) in the JBH catchment area have been infected by C. burnetii and are, therefore, potentially at risk for chronic Q fever. This figure by far exceeds the nationwide number of notified symptomatic acute Q fever patients and illustrates the magnitude of the Dutch Q fever outbreak. Clinicians in epidemic Q fever areas should be alert for chronic Q fever, even if no acute Q fever is reported.
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Experimental inoculation of male rats with Coxiella burnetii: successful infection but no transmission to cage mates. Appl Environ Microbiol 2012; 78:5661-5. [PMID: 22685149 DOI: 10.1128/aem.01169-12] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Beginning in 2007, the largest human Q fever outbreak ever described occurred in the Netherlands. Dairy goats from intensive farms were identified as the source, amplifying Coxiella burnetii during gestation and shedding large quantities during abortions. It has been postulated that wild rodents are reservoir hosts from which C. burnetii can be transmitted to domestic animals and humans. However, little is known about the infection dynamics of C. burnetii in wild rodents. The aim of this study was to investigate whether brown rats (Rattus norvegicus) can be experimentally infected with C. burnetii and whether transmission to a cage mates occurs. Fourteen male brown rats (wild type) were intratracheally or intranasally inoculated with a Dutch C. burnetii isolate obtained from a goat. At 3 days postinoculation, a contact rat was placed with each inoculated rat. The pairs were monitored using blood samples and rectal and throat swabs for 8 weeks, and after euthanasia the spleens were collected. Rats became infected by both inoculation routes, and detection of C. burnetii DNA in swabs suggests that excretion occurred. However, based on the negative spleens in PCR and the lack of seroconversion, none of the contact animals was considered infected; thus, no transmission was observed. The reproduction ratio R(0) was estimated to be 0 (95% confidence interval = 0 to 0.6), indicating that it is unlikely that rats act as reservoir host of C. burnetii through sustained transmission between male rats. Future research should focus on other transmission routes, such as vertical transmission or bacterial shedding during parturition.
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