Association of Human Q Fever with Animal Husbandry, Taiwan, 2004-2012

Expanding the diagnostic scope of paleopathology: Identification of Q fever (Coxiella burnetii) using a One Paleopathology approach

OBJECTIVES

This project is an application of the One Paleopathology approach to the study of Q fever (C. burnetii infection), a disease which is underdiagnosed and largely unknown in paleopathology.

MATERIALS

Clinical and veterinary pathological case reports and reviews, bioarcheological and zooarchaeological data, veterinary and environmental studies of wild and domestic animal pathology, clinical molecular pathogen data METHODS: One Paleopathology approach which combines data from people, animals, and their environment to understand disease in the past.

RESULTS

Q fever in animals presents as reproductive failure, with no typical skeletal manifestations seen in animals. Persistent Q fever (C. burnetii) focalized infection affects the human skeleton in predictable ways, including spondylodiscitis and extravertebral osteomyelitis or osteitis which can occur more commonly in children. Evidence of skeletal involvement suggests C. burnetii infection in the past is underestimated and underdiagnosed in humans.

CONCLUSION

Using the One Paleopathology approach can improve the study of C. burnetii infection in the past, where both animal and human paleopathology and environmental factors are assessed in developing potential diagnoses.

SIGNIFICANCE

This project is the first paleopathological study to specifically focus awareness on identification of C. burnetii in past skeletal samples, both animal and human.

LIMITATIONS

Lack of paleopathological studies and existing reference literature identifying skeletal involvement associated with C. burnetii infection.

SUGGESTIONS FOR FUTURE RESEARCH

Future paleopathological genomic studies should focus on identification of C. burnetii genotypes.

Epidemiology of Q Fever in Southeast Europe for a 20-Year Period (2002-2021)

This study aimed to assess epidemiological trends of Q fever in six countries of Southeast Europe by analysing surveillance data for 2002-2021 period. In this descriptive analysis, we collected and analysed data on confirmed human Q fever cases, obtained from the national Public Health Institutes of Bosnia and Herzegovina, Croatia, Greece, Montenegro, North Macedonia and Serbia. Overall, 2714 Q fever cases were registered during the 20-year period. The crude average annual notification rate was 0.82 (± 2.06) (95% CI: 0.47-1.16) per 100,000 inhabitants, ranged from 0.06 (± 0.04) (95% CI: 0.04-0.08) /100,000 in Greece to 2.78 (± 4.80) (95% CI: 0.53-5.02) /100,000 in the Republic of Srpska (entity of Bosnia and Herzegovina). Significant declining trends of Q fever age standardized rates were registered in Croatia, the Federation of Bosnia and Herzegovina, North Macedonia and Serbia, with an average annual change of -30.15%; -17.13%; -28.33% and - 24.77%, respectively. An unequal spatial distribution was observed. The highest average age-specific notification rate was reported in the 20-59 age group (0.84 (± 0.40) (95% CI: 0.65-1.02) /100,000). Most cases (53.69%) were reported during the spring. Q fever remains a significant public health threat in this part of Europe. The findings of this study revealed the endemic maintenance of this disease in the including countries, with large regional and subnational disparities in notification rates. A downward trend was found in Q fever notification rates across the study countries with the average notification rate higher than in the EU/EEA, during the same period.

A 100-Year Review: Advances in goat milk research

In the century of research chronicled between 1917 and 2017, dairy goats have gone from simply serving as surrogates to cows to serving as transgenic carriers of human enzymes. Goat milk has been an important part of human nutrition for millennia, in part because of the greater similarity of goat milk to human milk, softer curd formation, higher proportion of small milk fat globules, and different allergenic properties compared with cow milk; however, key nutritional deficiencies limit its suitability for infants. Great attention has been given not only to protein differences between goat and cow milk, but also to fat and enzyme differences, and their effect on the physical and sensory properties of goat milk and milk products. Physiological differences between the species necessitate different techniques for analysis of somatic cell counts, which are naturally higher in goat milk. The high value of goat milk throughout the world has generated a need for a variety of techniques to detect adulteration of goat milk products with cow milk. Advances in all of these areas have been largely documented in the Journal of Dairy Science (JDS), and this review summarizes such advances.

The Epidemiology and Characteristics of Q fever and Co-infections with Scrub Typhus, Murine Typhus or Leptospirosis in Taiwan: A Nationwide Database Study

Q fever (QF) is a worldwide zoonosis associated with outbreaks. Only a few nationwide studies regarding the surveillance and epidemiology of human QF have been reported. Although QF is endemic in Taiwan, a nationwide database investigation of the epidemiology and characteristics of QF and its associations with scrub typhus (ST), murine typhus (MT) and leptospirosis (LS) has never been reported. We analysed nationwide databases of suspected QF, ST, MT and LS cases from October 2007 to December 2014 obtained from the Centers for Disease Control, Taiwan. A total of 468 (4.2%) QF cases were identified among 11 109 suspected QF cases. QF cases were mainly distributed in the southern and Kaohsiung-Pingtung regions but rarely in the eastern region. Compared to non-QF cases, QF cases had significantly higher percentages of males (88.7 versus 66.2%) and high-risk occupations (farming, animal husbandry or veterinary medicine) (16.2 versus 10.5%). But the percentages of specific animal contact, including cattle (0.6 versus 0.8%) and goats (0.9 versus 1.0%), were low in both. The majority of suspected QF cases (89.4%) were simultaneously suspected with ST, MT or LS, and the combinations of suspected diseases differed between regions. The number of suspected QF cases from the eastern region decreased since 2009, which was not observed in other regions. A total of 1420 (12.8%) cases had confirmed diseases, including QF (453, 4.1%), QF+ST (7, 0.06%), QF+MT (4, 0.04%), QF+LS (4, 0.04%), MT (186, 1.7%), ST (545, 4.9%), ST+LS (11, 0.1%) and LS (210, 1.9%). Compared to cases of unknown disease, QF cases had larger percentages of high-risk occupations (16.2 versus 9.6%) but similar histories of animal contact (29.8 versus 25.1%). QF is an endemic disease in southern Taiwan. It is difficult to differentiate QF from ST, MT or LS only by high-risk occupations and history of animal contact, and co-infection of QF with these diseases should be considered.

Amphixenosic Aspects of Staphylococcus aureus Infection in Man and Animals

According to the mode of transmission, Staphylococcus aureus infection between hosts is classified as "direct zoonoses," or infection that is transmitted from an infected vertebrate host to a susceptible host (man) by direct contact, by contact with a fomite or by a mechanical vector. The agent itself undergoes little or no propagative or developmental changes during transmission. According to the reservoir host, staphylococcosis is most precisely defined as "zooanthroponoses" or infections transmitted from man to lower vertebrate animals (e.g., streptococci, diphtheria, Enterobacteriaceae, human tuberculosis in cattle and parrots), but also "anthropozoonoses" or infections transmitted to man from lower vertebrate animals. In particular, actually, the correct definition of S. aureus infections between humans and animals is "amphixenoses" or infections maintained in both man and lower vertebrate animals and transmitted in either direction. S. aureus exhibits tropisms to many distinct animal hosts. While spillover events can occur wherever there is an interface between host species, changes in host tropism only occur with the establishment of sustained transmission in the new host species, leading to clonal expansion. Although the genomic variation underpinning adaptation in S. aureus genotypes infecting bovids and poultry has been well characterized, the frequency of switches from one host to another remains obscure. In this review, we sought to identify the sustained switches in host tropism in the S. aureus population, both anthroponotic and zoonotic, and their distribution over the species phylogeny. S. aureus is an organism with the capacity to switch into and adapt to novel hosts, even after long periods of isolation in a single host species. Based on this evidence, animal-adapted S. aureus lineages exhibiting resistance to antibiotics must be considered a major threat to public health, as they can adapt to the human population.