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Stone NE, Ballard R, Bourgeois RM, Pemberton GL, McDonough RF, Ruby MC, Backus LH, López-Pérez AM, Lemmer D, Koch Z, Brophy M, Paddock CD, Kersh GJ, Nicholson WL, Sahl JW, Busch JD, Salzer JS, Foley JE, Wagner DM. A mutation associated with resistance to synthetic pyrethroids is widespread in US populations of the tropical lineage of Rhipicephalus sanguineus s.l. Ticks Tick Borne Dis 2024; 15:102344. [PMID: 38643721 DOI: 10.1016/j.ttbdis.2024.102344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 04/04/2024] [Accepted: 04/08/2024] [Indexed: 04/23/2024]
Abstract
The brown dog tick, Rhipicephalus sanguineus sensu lato (s.l.), is an important vector for Rickettsia rickettsii, causative agent of Rocky Mountain spotted fever. Current public health prevention and control efforts to protect people involve preventing tick infestations on domestic animals and in and around houses. Primary prevention tools rely on acaricides, often synthetic pyrethroids (SPs); resistance to this chemical class is widespread in ticks and other arthropods. Rhipicephalus sanguineus s.l. is a complex that likely contains multiple unique species and although the distribution of this complex is global, there are differences in morphology, ecology, and perhaps vector competence among these major lineages. Two major lineages within Rh. sanguineus s.l., commonly referred to as temperate and tropical, have been documented from multiple locations in North America, but are thought to occupy different ecological niches. To evaluate potential acaricide resistance and better define the distributions of the tropical and temperate lineages throughout the US and in northern Mexico, we employed a highly multiplexed amplicon sequencing approach to characterize sequence diversity at: 1) three loci within the voltage-gated sodium channel (VGSC) gene, which contains numerous genetic mutations associated with resistance to SPs; 2) a region of the gamma-aminobutyric acid-gated chloride channel gene (GABA-Cl) containing several mutations associated with dieldrin/fipronil resistance in other species; and 3) three mitochondrial genes (COI, 12S, and 16S). We utilized a geographically diverse set of Rh sanguineus s.l. collected from domestic pets in the US in 2013 and a smaller set of ticks collected from canines in Baja California, Mexico in 2021. We determined that a single nucleotide polymorphism (T2134C) in domain III segment 6 of the VGSC, which has previously been associated with SP resistance in Rh. sanguineus s.l., was widespread and abundant in tropical lineage ticks (>50 %) but absent from the temperate lineage, suggesting that resistance to SPs may be common in the tropical lineage. We found evidence of multiple copies of GABA-Cl in ticks from both lineages, with some copies containing mutations associated with fipronil resistance in other species, but the effects of these patterns on fipronil resistance in Rh. sanguineus s.l. are currently unknown. The tropical lineage was abundant and geographically widespread, accounting for 79 % of analyzed ticks and present at 13/14 collection sites. The temperate and tropical lineages co-occurred in four US states, and as far north as New York. None of the ticks we examined were positive for Rickettsia rickettsii or Rickettsia massiliae.
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Affiliation(s)
- Nathan E Stone
- Pathogen and Microbiome Institute, Northern Arizona University, PO Box 4073, Flagstaff, AZ 86011, United States
| | - Rebecca Ballard
- Pathogen and Microbiome Institute, Northern Arizona University, PO Box 4073, Flagstaff, AZ 86011, United States
| | - Reanna M Bourgeois
- Pathogen and Microbiome Institute, Northern Arizona University, PO Box 4073, Flagstaff, AZ 86011, United States
| | - Grant L Pemberton
- Pathogen and Microbiome Institute, Northern Arizona University, PO Box 4073, Flagstaff, AZ 86011, United States
| | - Ryelan F McDonough
- Pathogen and Microbiome Institute, Northern Arizona University, PO Box 4073, Flagstaff, AZ 86011, United States
| | - Megan C Ruby
- Pathogen and Microbiome Institute, Northern Arizona University, PO Box 4073, Flagstaff, AZ 86011, United States
| | - Laura H Backus
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616, United States
| | - Andrés M López-Pérez
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616, United States; Red de Biología y Conservación de Vertebrados, Instituto de Ecología, A.C., Xalapa 91073, Mexico
| | - Darrin Lemmer
- Translational Genomics Research Institute (TGen North), 3051 West Shamrell Boulevard, Suite 106, Flagstaff, AZ 86005, United States
| | - Zane Koch
- Translational Genomics Research Institute (TGen North), 3051 West Shamrell Boulevard, Suite 106, Flagstaff, AZ 86005, United States
| | - Maureen Brophy
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, United States
| | - Christopher D Paddock
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, United States
| | - Gilbert J Kersh
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, United States
| | - William L Nicholson
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, United States
| | - Jason W Sahl
- Pathogen and Microbiome Institute, Northern Arizona University, PO Box 4073, Flagstaff, AZ 86011, United States
| | - Joseph D Busch
- Pathogen and Microbiome Institute, Northern Arizona University, PO Box 4073, Flagstaff, AZ 86011, United States
| | - Johanna S Salzer
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, United States
| | - Janet E Foley
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616, United States
| | - David M Wagner
- Pathogen and Microbiome Institute, Northern Arizona University, PO Box 4073, Flagstaff, AZ 86011, United States.
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Moorthy GS, Rubach MP, Maze MJ, Refuerzo RP, Shirima GM, Lukambagire AS, Bodenham RF, Cash-Goldwasser S, Thomas KM, Sakasaka P, Mkenda N, Bowhay TR, Perniciaro JL, Nicholson WL, Kersh GJ, Kazwala RR, Mmbaga BT, Buza JJ, Maro VP, Haydon DT, Crump JA, Halliday JEB. Prevalence and risk factors for Q fever, spotted fever group rickettsioses, and typhus group rickettsioses in a pastoralist community of northern Tanzania, 2016-2017. Trop Med Int Health 2024. [PMID: 38480005 DOI: 10.1111/tmi.13980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
BACKGROUND In northern Tanzania, Q fever, spotted fever group (SFG) rickettsioses, and typhus group (TG) rickettsioses are common causes of febrile illness. We sought to describe the prevalence and risk factors for these zoonoses in a pastoralist community. METHODS Febrile patients ≥2 years old presenting to Endulen Hospital in the Ngorongoro Conservation Area were enrolled from August 2016 through October 2017. Acute and convalescent blood samples were collected, and a questionnaire was administered. Sera were tested by immunofluorescent antibody (IFA) IgG assays using Coxiella burnetii (Phase II), Rickettsia africae, and Rickettsia typhi antigens. Serologic evidence of exposure was defined by an IFA titre ≥1:64; probable cases by an acute IFA titre ≥1:128; and confirmed cases by a ≥4-fold rise in titre between samples. Risk factors for exposure and acute case status were evaluated. RESULTS Of 228 participants, 99 (43.4%) were male and the median (interquartile range) age was 27 (16-41) years. Among these, 117 (51.3%) had C. burnetii exposure, 74 (32.5%) had probable Q fever, 176 (77.2%) had SFG Rickettsia exposure, 134 (58.8%) had probable SFG rickettsioses, 11 (4.8%) had TG Rickettsia exposure, and 4 (1.8%) had probable TG rickettsioses. Of 146 participants with paired sera, 1 (0.5%) had confirmed Q fever, 8 (5.5%) had confirmed SFG rickettsioses, and none had confirmed TG rickettsioses. Livestock slaughter was associated with acute Q fever (adjusted odds ratio [OR] 2.54, 95% confidence interval [CI] 1.38-4.76) and sheep slaughter with SFG rickettsioses case (OR 4.63, 95% CI 1.08-23.50). DISCUSSION Acute Q fever and SFG rickettsioses were detected in participants with febrile illness. Exposures to C. burnetii and to SFG Rickettsia were highly prevalent, and interactions with livestock were associated with increased odds of illness with both pathogens. Further characterisation of the burden and risks for these diseases is warranted.
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Affiliation(s)
- Ganga S Moorthy
- Division of Pediatric Infectious Diseases, Duke University Medical Center, Durham, North Carolina, USA
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Matthew P Rubach
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
- Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, North Carolina, USA
- Programme in Emerging Infectious Diseases, Duke-National University of Singapore Medical School, Singapore, Singapore
- Kilimanjaro Christian Medical University College, Tumaini University, Moshi, Tanzania
| | - Michael J Maze
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Regina P Refuerzo
- School of Biodiversity, One Health and Veterinary Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Gabriel M Shirima
- School of Life Sciences and Bioengineering, Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania
| | - AbdulHamid S Lukambagire
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
- EcoHealth Alliance, New York, New York, USA
| | | | | | - Kate M Thomas
- Centre for International Health, University of Otago, Dunedin, New Zealand
| | | | - Nestory Mkenda
- Endulen Hospital, Ngorongoro Conservation Area, Endulen, Tanzania
| | - Thomas R Bowhay
- Centre for International Health, University of Otago, Dunedin, New Zealand
| | - Jamie L Perniciaro
- Rickettsial Zoonoses Branch, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - William L Nicholson
- Rickettsial Zoonoses Branch, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Gilbert J Kersh
- Rickettsial Zoonoses Branch, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Rudovick R Kazwala
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Blandina T Mmbaga
- Programme in Emerging Infectious Diseases, Duke-National University of Singapore Medical School, Singapore, Singapore
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Joram J Buza
- School of Life Sciences and Bioengineering, Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania
| | - Venance P Maro
- Programme in Emerging Infectious Diseases, Duke-National University of Singapore Medical School, Singapore, Singapore
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Daniel T Haydon
- School of Biodiversity, One Health and Veterinary Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - John A Crump
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
- Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, North Carolina, USA
- Programme in Emerging Infectious Diseases, Duke-National University of Singapore Medical School, Singapore, Singapore
- Centre for International Health, University of Otago, Dunedin, New Zealand
| | - Jo E B Halliday
- School of Biodiversity, One Health and Veterinary Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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Taylor ML, Kersh GJ, Salzer JS, Jones ES, Binder AM, Armstrong PA, Choudhary SK, Commins GK, Amelio CL, Biggerstaff BJ, Beard CB, Petersen LR, Commins SP. Intrinsic risk factors for alpha-gal syndrome in a case-control study, 2019 to 2020. Ann Allergy Asthma Immunol 2024:S1081-1206(24)00074-7. [PMID: 38341029 DOI: 10.1016/j.anai.2024.01.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 01/24/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Alpha-gal syndrome (AGS) is an allergy to galactose-α-1,3-galactose (alpha-gal), a carbohydrate found in most mammals. Evidence indicates that AGS develops after a tick bite, and in the United States, AGS is most associated with bites from Amblyomma americanum (lone star tick); however, not all persons bitten by ticks develop clinical AGS. OBJECTIVE To investigate intrinsic risk factors associated with the development of AGS. METHODS We performed a case-control study among adults presenting for diagnosis or management of AGS at an allergy clinic in North Carolina during 2019 to 2020 and compared them with controls enrolled from 2 nearby internal medicine clinics. A questionnaire gathered epidemiologic and tick exposure data, and blood was obtained for alpha-gal-specific IgE and other testing. RESULTS The 82 enrolled case patients and 191 controls did not differ significantly by age or sex. Case patients were more likely than controls to have A or O blood types (non B-antigen), have experienced childhood allergies, and have a family history of AGS and other food allergies. Case patients were also more likely to report experiencing long healing times for insect bites or stings and a family history of allergy to stinging or biting insects. CONCLUSION This study suggested that intrinsic factors contribute to risk of developing AGS. Some traits are genetic, but common behaviors among households and family units likely also contribute. Identification of these risk factors can inform personal risk, aid health care providers in understanding susceptible populations, and contribute to ongoing understanding of AGS epidemiology.
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Affiliation(s)
- Marissa L Taylor
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Gilbert J Kersh
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Johanna S Salzer
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Emma S Jones
- Office of the Director, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Alison M Binder
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Paige A Armstrong
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Shailesh K Choudhary
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Grace K Commins
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Claire L Amelio
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Brad J Biggerstaff
- Office of the Director, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Charles B Beard
- Office of the Director, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Lyle R Petersen
- Office of the Director, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Scott P Commins
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina
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Thompson JM, Carpenter A, Kersh GJ, Wachs T, Commins SP, Salzer JS. Geographic Distribution of Suspected Alpha-gal Syndrome Cases - United States, January 2017-December 2022. MMWR Morb Mortal Wkly Rep 2023; 72:815-820. [PMID: 37498787 PMCID: PMC10390090 DOI: 10.15585/mmwr.mm7230a2] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Alpha-gal syndrome (AGS) is an emerging, tick bite-associated allergic condition characterized by a potentially life-threatening immunoglobulin E (IgE)-mediated hypersensitivity to galactose-alpha-1,3-galactose (alpha-gal), an oligosaccharide found in most nonprimate mammalian meat and products derived from these mammals. Specific symptoms and severity of AGS vary among persons, and no treatment or cure is currently available. During 2010-2018, more than 34,000 suspected cases of AGS were identified in the United States, but current knowledge of where cases occur is limited. This study examined alpha-gal-specific IgE (sIgE) antibody testing results submitted to the commercial laboratory responsible for nearly all testing in the United States before 2022 to assess the geographic distribution and magnitude of this emerging condition. During January 1, 2017-December 31, 2022, a total of 357,119 tests were submitted from residences in the United States, corresponding to 295,400 persons. Overall, 90,018 (30.5%) persons received a positive test result in the study period, and the number of persons with positive test results increased from 13,371 in 2017 to 18,885 in 2021. Among 233,521 persons for whom geographic data were available, suspected cases predominantly occurred in counties within the southern, midwestern, and mid-Atlantic U.S. Census Bureau regions. These data highlight the evolving emergence of AGS and can be used to help state and local health agencies initiate surveillance and target public health outreach and health care provider education to high-risk localities.
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Binder AM, Cherry-Brown D, Biggerstaff BJ, Jones ES, Amelio CL, Beard CB, Petersen LR, Kersh GJ, Commins SP, Armstrong PA. Clinical and laboratory features of patients diagnosed with alpha-gal syndrome-2010-2019. Allergy 2023; 78:477-487. [PMID: 36178236 PMCID: PMC10092820 DOI: 10.1111/all.15539] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 08/26/2022] [Accepted: 08/29/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Alpha-gal syndrome (AGS) is an IgE-mediated allergy to galactose-alpha-1,3-galactose. Clinical presentation ranges from hives to anaphylaxis; episodes typically occur 2-6 h after exposure to alpha-gal-containing products. In the United States, lone star tick bites are associated with the development of AGS. To characterize features of AGS, we evaluated a cohort of patients presenting for care at the University of North Carolina, focusing on symptoms, severity, and identifying features unique to specific alpha-gal-containing product exposures. METHODS We performed a chart review and descriptive analysis of 100 randomly selected patients with AGS during 2010-2019. RESULTS Median age at onset was 53 years, 56% were female, 95% reported White race, 86% reported a history of tick bite, and 75% met the criteria for anaphylaxis based on the involvement of ≥2 organ systems. Those reporting dairy reactions were significantly less likely to report isolated mucocutaneous symptoms (3% vs. 24%; ratio [95% CI]: 0.1 [0.1, 0.3]) than those who tolerated dairy, and were more likely to report gastrointestinal symptoms (79% vs. 59%; ratio [95% CI]: 1.3 [0.7, 2.6]), although this difference was not statistically significant. Dairy-tolerant patients demonstrated higher alpha-gal sIgE titers (as a percentage of total IgE) than dairy-reactive patients (GM 4.1 [95% CI: 2.7, 6.1] vs. GM 2.5 [95% CI: 1.3, 4.8], respectively; ratio -1.6 [95% CI: -1.0, 3.9]). CONCLUSION While tick exposure is common in the southern United States, nearly all AGS patients reported a tick bite. Gastrointestinal symptoms were prominent among those reporting reactions to dairy. Anaphylaxis was common, underscoring the severity and need to raise awareness of AGS among patients and providers.
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Affiliation(s)
- Alison M Binder
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Dena Cherry-Brown
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Brad J Biggerstaff
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Emma S Jones
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Claire L Amelio
- University of North Carolina, Chapel Hill, North Carolina, USA
| | - Charles B Beard
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Lyle R Petersen
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Gilbert J Kersh
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Scott P Commins
- University of North Carolina, Chapel Hill, North Carolina, USA
| | - Paige A Armstrong
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
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Kersh GJ, Salzer J, Jones ES, Binder AM, Armstrong PA, Choudhary SK, Commins GK, Amelio CL, Kato CY, Singleton J, Biggerstaff BJ, Beard CB, Petersen LR, Commins SP. Tick bite as a risk factor for alpha-gal specific IgE antibodies and development of alpha-gal syndrome. Ann Allergy Asthma Immunol 2022; 130:472-478. [PMID: 36574585 PMCID: PMC10148555 DOI: 10.1016/j.anai.2022.11.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND The disaccharide galactose-α-1,3-galactose (alpha-gal) is expressed in mammals other than humans, apes, and old-world monkeys. In humans, elevated immunoglobulin-E (IgE) antibodies specific for alpha-gal can result in allergic hypersensitivity known as alpha-gal syndrome (AGS). Case reports and series suggest that tick bites can induce alpha-gal specific IgE antibodies. OBJECTIVE Evaluate tick exposure as a risk factor for AGS and elevated alpha-gal specific IgE (sIgE). METHODS We conducted a case-control study comparing AGS patients from a North Carolina allergy clinic with controls who were patients at a nearby internal medicine clinic. Cases and controls were administered a questionnaire to obtain information about demographics, home environment, outdoor activities, and recollection of tick bite. Serum samples taken at the time of enrollment were tested for total IgE, alpha-gal sIgE, and antibodies to other tickborne pathogens. RESULTS AGS patients were more likely to recall finding a tick on themselves (OR=11.20, 95% CI 4.97-25.15), live near wooded forest (OR=2.27, 95% CI 0.92-5.55), and spend 17 or more hours per week outdoors in wooded areas (OR=5.58, 95% CI 2.56-12.19). AGS patients were also more likely to report 4 or more tick bites (OR=33.05, 95% CI 9.92-155.12) and reactions at the site of tick bites (OR=7.93, 95% CI 3.74-16.80). Elevated alpha-gal sIgE was also observed in 33% of controls and was also associated with tick exposure in the controls (OR=4.25, 95% CI 2.21-8.18). CONCLUSION The results define tick bite as a risk factor for AGS and elevated alpha-gal sIgE.
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Affiliation(s)
- Gilbert J Kersh
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329.
| | - Johanna Salzer
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329
| | - Emma S Jones
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, 80521
| | - Alison M Binder
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329
| | - Paige A Armstrong
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329
| | - Shailesh K Choudhary
- Division of Allergy, Immunology and Rheumatology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Grace K Commins
- Division of Allergy, Immunology and Rheumatology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Claire L Amelio
- Division of Allergy, Immunology and Rheumatology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Cecilia Y Kato
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329
| | - Joseph Singleton
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329
| | - Brad J Biggerstaff
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, 80521
| | - Charles B Beard
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, 80521
| | - Lyle R Petersen
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, 80521
| | - Scott P Commins
- Division of Allergy, Immunology and Rheumatology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC
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Kersh GJ. Tropical Q Fever. Am J Trop Med Hyg 2022; 107:219-220. [PMID: 35977719 PMCID: PMC9393446 DOI: 10.4269/ajtmh.22-0372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 06/01/2022] [Indexed: 11/07/2022] Open
Affiliation(s)
- Gilbert J. Kersh
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
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Miller HK, Priestley RA, Kersh GJ. Comparison of three Coxiella burnetii infectious routes in mice. Virulence 2021; 12:2562-2570. [PMID: 34569895 PMCID: PMC8477946 DOI: 10.1080/21505594.2021.1980179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/30/2021] [Accepted: 09/08/2021] [Indexed: 11/05/2022] Open
Abstract
Evidence suggests that Coxiella burnetii, which is shed in the milk, urine, feces, and birth products of infected domestic ruminants, can lead to Q fever disease following consumption of unpasteurized dairy products; however, C. burnetii is not believed to be a major gastrointestinal pathogen. Most infections are associated with inhalation of aerosols generated from the excreta of domestic ruminants. We recently demonstrated that C. burnetii delivered by oral gavage (OG) resulted in dissemination and an immune response; however, it is unclear how infection via the oral route compares to other well-established routes. Therefore, we delivered three strains of C. burnetii (representing three pertinent sequence types in the United States, such as ST16, ST20, and ST8) to immunocompetent mice in four doses via aerosol challenge (AC), intraperitoneal injection (IP), or OG. Low dose (10^5) of ST16 by OG was insufficient to cause infection, yet doses 1,000- or 100-fold lower by IP or AC, respectively, induced a robust immune response and dissemination. Despite being able to induce an immune response in a dose-dependent manner, administration of C. burnetii via OG is the least efficient route tested. Not only were the immune responses and bacterial loads diminished in mice exposed by OG relative to AC or IP, the efficiency of transmission was also inferior. High doses (10^8) were not sufficient to ensure transmission to 100% of the ST20 or ST8 cohorts. These results may provide some basis for why ingestion of C. burnetii as a mode of Q fever transmission is not often reported.
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Affiliation(s)
- Halie K. Miller
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Rachael A. Priestley
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Gilbert J. Kersh
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
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Cherry CC, Nichols Heitman K, Bestul NC, Kersh GJ. Acute and chronic Q fever national surveillance - United States, 2008-2017. Zoonoses Public Health 2021; 69:73-82. [PMID: 34626097 DOI: 10.1111/zph.12896] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 09/21/2021] [Accepted: 09/24/2021] [Indexed: 11/30/2022]
Abstract
Q fever is a zoonotic disease caused by the bacterium Coxiella burnetii and can manifest in an acute or chronic form. Many persons with acute Q fever are asymptomatic, but some develop a febrile illness, pneumonia or hepatitis. Chronic infections are rare and occur in less than 5% of persons exposed. Forms of chronic Q fever include endocarditis, infection of vascular grafts or aneurysms, osteomyelitis and osteoarthritis. Acute and chronic Q fever are nationally notifiable diseases, and presented here are the incidence, demographics and distribution of acute and chronic Q fever in the United States during 2008-2017. We summarized passive surveillance data from the Centers for Disease Control and Prevention's (CDC) National Notifiable Diseases Surveillance System (NNDSS) and supplemental case report forms (CRFs). Health departments reported 1,109 cases of acute Q fever and 272 chronic Q fever cases to NNDSS during this period. The 10-year average annual incidence for acute Q fever was 0.36 cases per million persons, and the average annual incidence for chronic Q fever was 0.09. Males accounted for nearly 75% of both acute and chronic Q fever cases. Average annual incidence was highest among persons aged 60-69 years for both acute and chronic Q fever (0.70 cases per million persons and 0.25, respectively). As reported through CRFs, many Q fever cases did not have a known exposure to C. burnetii; 60% (n = 380) of acute Q fever cases did not report exposure to animals in the 2 months before symptom onset. Almost 90% (n = 558) did not report exposure to unpasteurized milk. Only 40% (n = 247) of persons with reported Q fever were employed in high-risk occupations. Even though Q fever is a rare disease in the United States, incidence doubled from 2008 to 2017.
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Affiliation(s)
- Cara C Cherry
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kristen Nichols Heitman
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Nicolette C Bestul
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, Tennessee, USA
| | - Gilbert J Kersh
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Abstract
Coxiella burnetii is an obligate intracellular bacterium that causes the human disease Q fever, which can manifest as an acute flu-like illness or a long-term chronic illness, such as endocarditis. Three genotypes (ST8, ST16, and ST20) of Coxiella burnetii are commonly found in the contemporary US and are associated with specific animal hosts. Although all three genotypes have been isolated from humans with Q fever, studies comparing virulence between C. burnetii sequence types have been rare. Here, groups of mice were infected via aerosol inoculation with isolates derived from cow's milk, environmental, animal, and human samples. Mice were monitored for weight loss and blood samples were takenweekly. Animals were euthanized at 2- and 12-weeks post-infection, and bacterial burden was determined for tissues by real-time PCR. The levels of anti-Coxiella antibodies and selected inflammatory cytokines were determined for serum samples. Weight loss and splenomegaly were observed in mice infected with ST20 and ST16 isolates but were absent in the mice infected with ST8 isolates. Bacterial concentrations in the tissues were lower in the ST8 isolates at 2 weeks post-infection relative to all other isolates. ST16 and ST20 isolates induced robust antibody and cytokine responses, while ST8 isolates produced significantly lower anti-C. burnetii titers early in the infection but saw increased titers in some animals several weeks post-infection. The data suggest that the ST8 isolates are less virulent in this mouse model, as they produce less robust antibody responses that are slow to develop, relative to the ST16 and ST20 isolates.
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Affiliation(s)
- Rachael A Priestley
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, United States
| | - Cody B Smith
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, United States
| | - Halie K Miller
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, United States
| | - Gilbert J Kersh
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, United States
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11
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Abstract
Q fever is a disease caused by the bacterial pathogen Coxiella burnetii. This hardy organism can easily spread long distances in the wind, and only a few infectious aerosolized particles are necessary to cause serious illness. Presentations of Q fever disease can be wide-ranging, allowing it to masquerade as other illnesses and highlight the importance of laboratory testing for diagnosis and treatment. This review summarizes Q fever's epidemiology and clinical presentations and presents classical laboratory diagnostic assays and novel approaches to detecting this troubling disease.
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Affiliation(s)
- Halie K. Miller
- Centers for Disease Control and Prevention, Atlanta, Georgia
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12
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Binder AM, Commins SP, Altrich ML, Wachs T, Biggerstaff BJ, Beard CB, Petersen LR, Kersh GJ, Armstrong PA. Diagnostic testing for galactose-alpha-1,3-galactose, United States, 2010 to 2018. Ann Allergy Asthma Immunol 2021; 126:411-416.e1. [PMID: 33422649 PMCID: PMC10961706 DOI: 10.1016/j.anai.2020.12.019] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 12/13/2020] [Accepted: 12/28/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Alpha-gal syndrome (AGS) is an emerging immunoglobulin E (IgE)-mediated allergy to galactose-alpha-1,3-galactose (alpha-gal). The geographic distribution and burden of AGS in the United States are unknown. OBJECTIVE To characterize alpha-gal IgE testing patterns and describe the trends and distribution from 2010 to 2018 in the United States. METHODS This retrospective analysis included all persons tested for alpha-gal IgE antibodies by Viracor-IBT Laboratories (Lee's Summit, Missouri), the primary site of testing in the United States. Data included age and sex of person tested, specimen state of origin, collection date, and result value; persons with at least 1 positive test result (≥0.1 kU/L) were compared with negatives. Proportions tested and with positive test results were calculated using the US Census population estimates. RESULTS Overall, 122,068 specimens from 105,674 persons were tested for alpha-gal IgE during July 1, 2010, to December 31, 2018. Nearly one-third (34,256, 32.4%) had at least 1 positive result. The number of persons receiving positive test results increased 6-fold from 1110 in 2011 to 7798 in 2018. Of those receiving positive test results, mean [SD] age was 46.9 (19.8) years; men were more likely to test positive than women (43.3% vs 26.0%). Arkansas, Virginia, Kentucky, Oklahoma, and Missouri had the highest number of persons who were tested and had a positive result per 100,000 population. CONCLUSION More than 34,000 persons, most presumably symptomatic, have received positive test results for IgE antibodies to alpha-gal, suggesting AGS is an increasingly recognized public health problem. The geographic distribution of persons who tested positive is consistent with exposure to Amblyomma americanum ticks.
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Affiliation(s)
- Alison M Binder
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado.
| | - Scott P Commins
- Division of Rheumatology, Allergy, and Immunology, University of North Carolina, Chapel Hill, North Carolina
| | | | | | - Brad J Biggerstaff
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Charles B Beard
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Lyle R Petersen
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Gilbert J Kersh
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Paige A Armstrong
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
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13
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Abstract
Serology is essential for Q fever diagnostics, a disease caused by the bacterial pathogen Coxiella burnetii. The gold standard test is an immunofluorescence assay utilizing whole cell antigens, which are both dangerous and laborious to produce. Complexities of the antigen coupled with the subjective nature of the assay lead to decreased uniformity of test results and underscore the need for improved methodologies. Thirty-three C. burnetii proteins, previously identified as immunoreactive, were screened for reactivity to naturally infected goat serum. Based on reactivity, 10 proteins were analyzed in a secondary screen against human serum from healthy donors. Assay sensitivity and specificity ranged from 21 to 71% and 90 to 100%, respectively. Three promising antigens were identified based on receiver operating characteristic curve analysis (CBU_1718, CBU_0307, and CBU_1398). Five multiplex assays failed to outperform the individual proteins, with sensitivities and specificities ranging from 29 to 57% and 90 to 100%, respectively. Truncating the top antigen, CBU_1718, had no effect on specificity (90%); yet sensitivity decreased dramatically (71% to 21%). Through this study, we have expanded the subset of C. burnetii immunoreactive proteins validated by enzyme-linked immunosorbent assay and demonstrate the effect of novel antigen combinations and protein truncations on assay performance.
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Affiliation(s)
- Halie K Miller
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Gilbert J Kersh
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
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14
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Miller HK, Stoddard RA, Dawsey SM, Nasrollahzadeh D, Abnet CC, Etemadi A, Kamangar F, Murphy G, Sotoudeh M, Kersh GJ, Malekzadeh R, Camargo MC. Association Between Serological Responses to Two Zoonotic Ruminant Pathogens and Esophageal Squamous Cell Carcinoma. Vector Borne Zoonotic Dis 2020; 21:125-127. [PMID: 33121389 DOI: 10.1089/vbz.2020.2668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Questionnaire data have linked contact with ruminants to the risk of esophageal squamous cell carcinoma (ESCC) in high-risk Asian populations. To better understand this observed association, we investigated exposure to two major zoonotic ruminant pathogens relative to ESCC risk. Using enzyme-linked immunosorbent assay, immunofluorescence assay, and Brucella microagglutination test assays, we measured immunoglobulin G anti-Coxiella burnetii and anti-Brucella spp. antibodies in patients with ESCC (n = 177) and population-based controls (n = 177) matched by age, gender, and residence area from the Golestan case-control study in Iran. We found a similarly high seroprevalence of C. burnetii in ESCC cases and controls (75% and 80%, respectively), and a similarly low seroprevalence of Brucella spp. (0% and 0.6%, respectively). While documenting a high exposure to one of two zoonotic ruminant infections, this exposure failed to explain the observed association of ruminant contact and ESCC risk in this high-risk population.
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Affiliation(s)
- Halie K Miller
- Rickettsial Zoonoses Branch and Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Robyn A Stoddard
- Bacterial Special Pathogens Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sanford M Dawsey
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Dariush Nasrollahzadeh
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Christian C Abnet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Arash Etemadi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA.,Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farin Kamangar
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Department of Biology, School of Computer, Mathematical, and Natural Sciences, Morgan State University, Baltimore, Maryland, USA
| | - Gwen Murphy
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Masoud Sotoudeh
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Gilbert J Kersh
- Rickettsial Zoonoses Branch and Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Reza Malekzadeh
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - M Constanza Camargo
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
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15
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Kersh GJ, Fitzpatrick K, Pletnikoff K, Brubaker M, Bruce M, Parkinson A. Prevalence of serum antibodies to Coxiella burnetii in Alaska Native Persons from the Pribilof Islands. Zoonoses Public Health 2020; 67:89-92. [PMID: 31705592 PMCID: PMC6996239 DOI: 10.1111/zph.12661] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 07/30/2019] [Accepted: 10/12/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Q fever is a febrile illness caused by infection with the bacterium Coxiella burnetii. It is most often transmitted by inhalation of the bacteria after it is shed by infected livestock. Recent studies have found very high C. burnetii infection rates among marine mammals, but it is not known if shedding by marine mammals creates a risk of Q fever among humans. To better understand infection of humans with exposure to marine mammals, the prevalence of antibodies against C. burnetii in serum samples taken from Alaskan Native persons residing on the Pribilof Islands was evaluated. The Pribilof Islands support large populations of northern fur seals infected with C. burnetii that may increase the risk of exposure for island residents. METHODS Serum testing for IgG antibodies against C. burnetii (phase I and phase II) was performed, and demographic data were analysed utilizing banked serum specimens drawn from island residents from 1980 to 2000. RESULTS The overall seroprevalence rate was 11.6% (95% CI = 9.3%-14.4%; 72/621). This is higher than the previously reported 3.1% (95% CI = 2.1%-4.3%) seroprevalence for the U.S. POPULATION CONCLUSIONS These results suggest that Alaskan Native persons may be at higher risk for exposure to C. burnetii than the general US. population, possibly due to proximity to large populations of infected marine mammals.
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Affiliation(s)
- Gilbert J. Kersh
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Kelly Fitzpatrick
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | | | - Michael Brubaker
- Center for Climate and Health, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - Michael Bruce
- Arctic Investigation Program, CDC, Anchorage, AK, USA
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16
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Heitman KN, Drexler NA, Cherry-Brown D, Peterson AE, Armstrong PA, Kersh GJ. National Surveillance Data Show Increase in Spotted Fever Rickettsiosis: United States, 2016-2017. Am J Public Health 2019; 109:719-721. [PMID: 30969821 DOI: 10.2105/ajph.2019.305038] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Kristen Nichols Heitman
- All of the authors are with the National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | - Naomi A Drexler
- All of the authors are with the National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | - Dena Cherry-Brown
- All of the authors are with the National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | - Amy E Peterson
- All of the authors are with the National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | - Paige A Armstrong
- All of the authors are with the National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | - Gilbert J Kersh
- All of the authors are with the National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA
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17
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Miernyk KM, Bruden D, Parkinson AJ, Hurlburt D, Klejka J, Berner J, Stoddard RA, Handali S, Wilkins PP, Kersh GJ, Fitzpatrick K, Drebot MA, Priest JW, Pappert R, Petersen JM, Teshale E, Hennessy TW, Bruce MG. Human Seroprevalence to 11 Zoonotic Pathogens in the U.S. Arctic, Alaska. Vector Borne Zoonotic Dis 2019; 19:563-575. [PMID: 30789314 PMCID: PMC10874833 DOI: 10.1089/vbz.2018.2390] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Background: Due to their close relationship with the environment, Alaskans are at risk for zoonotic pathogen infection. One way to assess a population's disease burden is to determine the seroprevalence of pathogens of interest. The objective of this study was to determine the seroprevalence of 11 zoonotic pathogens in people living in Alaska. Methods: In a 2007 avian influenza exposure study, we recruited persons with varying wild bird exposures. Using sera from this study, we tested for antibodies to Cryptosporidium spp., Echinococcus spp., Giardia intestinalis, Toxoplasma gondii, Trichinella spp., Brucella spp., Coxiella burnetii, Francisella tularensis, California serogroup bunyaviruses, and hepatitis E virus (HEV). Results: Eight hundred eighty-seven persons had sera tested, including 454 subsistence bird hunters and family members, 160 sport bird hunters, 77 avian wildlife biologists, and 196 persons with no wild bird exposure. A subset (n = 481) of sera was tested for California serogroup bunyaviruses. We detected antibodies to 10/11 pathogens. Seropositivity to Cryptosporidium spp. (29%), California serotype bunyaviruses (27%), and G. intestinalis (19%) was the most common; 63% (301/481) of sera had antibodies to at least one pathogen. Using a multivariable logistic regression model, Cryptosporidium spp. seropositivity was higher in females (35.7% vs. 25.0%; p = 0.01) and G. intestinalis seropositivity was higher in males (21.8% vs. 15.5%; p = 0.02). Alaska Native persons were more likely than non-Native persons to be seropositive to C. burnetii (11.7% vs. 3.8%; p = 0.005) and less likely to be seropositive to HEV (0.4% vs. 4.1%; p = 0.01). Seropositivity to Cryptosporidium spp., C. burnetii, HEV, and Echinococcus granulosus was associated with increasing age (p ≤ 0.01 for all) as was seropositivity to ≥1 pathogen (p < 0.0001). Conclusion: Seropositivity to zoonotic pathogens is common among Alaskans with the highest to Cryptosporidium spp., California serogroup bunyaviruses, and G. intestinalis. This study provides a baseline for use in assessing seroprevalence changes over time.
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Affiliation(s)
- Karen M. Miernyk
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska
| | - Dana Bruden
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska
| | - Alan J. Parkinson
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska
| | - Debby Hurlburt
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska
| | | | - James Berner
- Alaska Native Tribal Health Consortium, Anchorage, Alaska
| | - Robyn A. Stoddard
- Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sukwan Handali
- Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Patricia P. Wilkins
- Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Gilbert J. Kersh
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kelly Fitzpatrick
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mike A. Drebot
- Zoonotic Diseases and Special Pathogens, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada
| | - Jeffrey W. Priest
- Waterborne Diseases Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ryan Pappert
- Bacterial Diseases Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Ft. Collins, Colorado
| | - Jeannine M. Petersen
- Bacterial Diseases Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Ft. Collins, Colorado
| | - Eyasu Teshale
- Epidemiology and Surveillance Branch, Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Thomas W. Hennessy
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska
| | - Michael G. Bruce
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska
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Rosenberg R, Lindsey NP, Fischer M, Gregory CJ, Hinckley AF, Mead PS, Paz-Bailey G, Waterman SH, Drexler NA, Kersh GJ, Hooks H, Partridge SK, Visser SN, Beard CB, Petersen LR. Vital Signs: Trends in Reported Vectorborne Disease Cases - United States and Territories, 2004-2016. MMWR Morb Mortal Wkly Rep 2018; 67:496-501. [PMID: 29723166 PMCID: PMC5933869 DOI: 10.15585/mmwr.mm6717e1] [Citation(s) in RCA: 478] [Impact Index Per Article: 79.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Introduction Vectorborne diseases are major causes of death and illness worldwide. In the United States, the most common vectorborne pathogens are transmitted by ticks or mosquitoes, including those causing Lyme disease; Rocky Mountain spotted fever; and West Nile, dengue, and Zika virus diseases. This report examines trends in occurrence of nationally reportable vectorborne diseases during 2004–2016. Methods Data reported to the National Notifiable Diseases Surveillance System for 16 notifiable vectorborne diseases during 2004–2016 were analyzed; findings were tabulated by disease, vector type, location, and year. Results A total 642,602 cases were reported. The number of annual reports of tickborne bacterial and protozoan diseases more than doubled during this period, from >22,000 in 2004 to >48,000 in 2016. Lyme disease accounted for 82% of all tickborne disease reports during 2004–2016. The occurrence of mosquitoborne diseases was marked by virus epidemics. Transmission in Puerto Rico, the U.S. Virgin Islands, and American Samoa accounted for most reports of dengue, chikungunya, and Zika virus diseases; West Nile virus was endemic, and periodically epidemic, in the continental United States. Conclusions and Implications for Public Health Practice Vectorborne diseases are a large and growing public health problem in the United States, characterized by geographic specificity and frequent pathogen emergence and introduction. Differences in distribution and transmission dynamics of tickborne and mosquitoborne diseases are often rooted in biologic differences of the vectors. To effectively reduce transmission and respond to outbreaks will require major national improvement of surveillance, diagnostics, reporting, and vector control, as well as new tools, including vaccines.
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Affiliation(s)
- Ronald Rosenberg
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Fort Collins, Colorado
| | - Nicole P Lindsey
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Fort Collins, Colorado
| | - Marc Fischer
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Fort Collins, Colorado
| | - Christopher J Gregory
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Fort Collins, Colorado
| | - Alison F Hinckley
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Fort Collins, Colorado
| | - Paul S Mead
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Fort Collins, Colorado
| | - Gabriela Paz-Bailey
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Fort Collins, Colorado
| | - Stephen H Waterman
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Fort Collins, Colorado
| | - Naomi A Drexler
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Fort Collins, Colorado
| | - Gilbert J Kersh
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Fort Collins, Colorado
| | - Holley Hooks
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Fort Collins, Colorado
| | - Susanna K Partridge
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Fort Collins, Colorado
| | - Susanna N Visser
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Fort Collins, Colorado
| | - Charles B Beard
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Fort Collins, Colorado
| | - Lyle R Petersen
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Fort Collins, Colorado
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19
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Duncan CG, Tiller R, Mathis D, Stoddard R, Kersh GJ, Dickerson B, Gelatt T. Brucella placentitis and seroprevalence in northern fur seals ( Callorhinus ursinus) of the Pribilof Islands, Alaska. J Vet Diagn Invest 2018; 26:507-512. [PMID: 24803576 DOI: 10.1177/1040638714532647] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Brucella species infect a wide range of hosts with a broad spectrum of clinical manifestations. In mammals, one of the most significant consequences of Brucella infection is reproductive failure. There is evidence of Brucella exposure in many species of marine mammals, but the outcome of infection is often challenging to determine. The eastern Pacific stock of northern fur seals (NFSs, Callorhinus ursinus) has declined significantly, spawning research into potential causes for this trend, including investigation into reproductive health. The objective of the current study was to determine if NFSs on St. Paul Island, Alaska have evidence of Brucella exposure or infection. Archived DNA extracted from placentas ( n = 119) and serum ( n = 40) samples were available for testing by insertion sequence (IS) 711 polymerase chain reaction (PCR) and the Brucella microagglutination test (BMAT), respectively. As well, placental tissue was available for histologic examination. Six (5%) placentas were positive by PCR, and a single animal had severe placentitis. Multilocus variable number tandem repeat analysis profiles were highly clustered and closely related to other Brucella pinnipedialis isolates. A single animal was positive on BMAT, and 12 animals had titers within the borderline range; 1 borderline animal was positive by PCR on serum. The findings suggest that NFSs on the Pribilof Islands are exposed to Brucella and that the organism has the ability to cause severe placental disease. Given the population trend of the NFS, and the zoonotic nature of this pathogen, further investigation into the epidemiology of this disease is recommended.
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Affiliation(s)
- Colleen G Duncan
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO (Duncan).,Bacterial Special Pathogens (Tiller, Mathis, Stoddard) Branches of the Centers for Disease Control and Prevention, Atlanta, GA.,Rickettsial Zoonoses (Kersh) Branches of the Centers for Disease Control and Prevention, Atlanta, GA.,National Marine Fisheries Service, Alaska Fisheries Science Center, National Marine Mammal Lab, Seattle, WA (Dickerson, Gelatt)
| | - Rebekah Tiller
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO (Duncan).,Bacterial Special Pathogens (Tiller, Mathis, Stoddard) Branches of the Centers for Disease Control and Prevention, Atlanta, GA.,Rickettsial Zoonoses (Kersh) Branches of the Centers for Disease Control and Prevention, Atlanta, GA.,National Marine Fisheries Service, Alaska Fisheries Science Center, National Marine Mammal Lab, Seattle, WA (Dickerson, Gelatt)
| | - Demetrius Mathis
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO (Duncan).,Bacterial Special Pathogens (Tiller, Mathis, Stoddard) Branches of the Centers for Disease Control and Prevention, Atlanta, GA.,Rickettsial Zoonoses (Kersh) Branches of the Centers for Disease Control and Prevention, Atlanta, GA.,National Marine Fisheries Service, Alaska Fisheries Science Center, National Marine Mammal Lab, Seattle, WA (Dickerson, Gelatt)
| | - Robyn Stoddard
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO (Duncan).,Bacterial Special Pathogens (Tiller, Mathis, Stoddard) Branches of the Centers for Disease Control and Prevention, Atlanta, GA.,Rickettsial Zoonoses (Kersh) Branches of the Centers for Disease Control and Prevention, Atlanta, GA.,National Marine Fisheries Service, Alaska Fisheries Science Center, National Marine Mammal Lab, Seattle, WA (Dickerson, Gelatt)
| | - Gilbert J Kersh
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO (Duncan).,Bacterial Special Pathogens (Tiller, Mathis, Stoddard) Branches of the Centers for Disease Control and Prevention, Atlanta, GA.,Rickettsial Zoonoses (Kersh) Branches of the Centers for Disease Control and Prevention, Atlanta, GA.,National Marine Fisheries Service, Alaska Fisheries Science Center, National Marine Mammal Lab, Seattle, WA (Dickerson, Gelatt)
| | - Bobette Dickerson
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO (Duncan).,Bacterial Special Pathogens (Tiller, Mathis, Stoddard) Branches of the Centers for Disease Control and Prevention, Atlanta, GA.,Rickettsial Zoonoses (Kersh) Branches of the Centers for Disease Control and Prevention, Atlanta, GA.,National Marine Fisheries Service, Alaska Fisheries Science Center, National Marine Mammal Lab, Seattle, WA (Dickerson, Gelatt)
| | - Tom Gelatt
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO (Duncan).,Bacterial Special Pathogens (Tiller, Mathis, Stoddard) Branches of the Centers for Disease Control and Prevention, Atlanta, GA.,Rickettsial Zoonoses (Kersh) Branches of the Centers for Disease Control and Prevention, Atlanta, GA.,National Marine Fisheries Service, Alaska Fisheries Science Center, National Marine Mammal Lab, Seattle, WA (Dickerson, Gelatt)
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20
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Greiner AL, Bhengsri S, Million M, Edouard S, Thamthitiwat S, Clarke K, Kersh GJ, Gregory CJ, Raoult D, Parola P. Acute Q Fever Case Detection among Acute Febrile Illness Patients, Thailand, 2002-2005. Am J Trop Med Hyg 2018; 98:252-257. [PMID: 29141767 PMCID: PMC5928714 DOI: 10.4269/ajtmh.17-0413] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 09/29/2017] [Indexed: 12/21/2022] Open
Abstract
Acute Q fever cases were identified from a hospital-based acute febrile illness study conducted in six community hospitals in rural north and northeast Thailand from 2002 to 2005. Of 1,784 participants that underwent Coxiella burnetii testing, nine (0.5%) participants were identified in this case-series as acute Q fever cases. Eight case-patients were located in one province. Four case-patients were hospitalized. Median age was 13 years (range: 7-69); five were male. The proportion of children with acute Q fever infection was similar to adults (P = 0.17). This previously unrecognized at-risk group, school-age children, indicates that future studies and prevention interventions should target this population. The heterogeneity of disease burden across Thailand and milder clinical presentations found in this case-series should be considered in future studies. As diagnosis based on serology is limited during the acute phase of the disease, other diagnostic options, such as polymerase chain reaction, should be explored to improve acute case detection.
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Affiliation(s)
- Ashley L. Greiner
- Division of Global Health Protection, Center for Global Health, United States Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Saithip Bhengsri
- Division of Global Health Protection, Center for Global Health, United States Centers for Disease Control and Prevention, Nonthaburi, Thailand
| | - Matthieu Million
- Aix Marseille Université, AP-HM, URMITE, IHU-Méditerranée Infection, Marseille, France
| | - Sophie Edouard
- Aix Marseille Université, AP-HM, URMITE, IHU-Méditerranée Infection, Marseille, France
| | - Somsak Thamthitiwat
- Division of Global Health Protection, Center for Global Health, United States Centers for Disease Control and Prevention, Nonthaburi, Thailand
| | - Kevin Clarke
- Division of Global Health Protection, Center for Global Health, United States Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Gilbert J. Kersh
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, United States Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Christopher J. Gregory
- Division of Global Health Protection, Center for Global Health, United States Centers for Disease Control and Prevention, Nonthaburi, Thailand
| | - Didier Raoult
- Aix Marseille Université, AP-HM, URMITE, IHU-Méditerranée Infection, Marseille, France
| | - Philippe Parola
- Aix Marseille Université, AP-HM, URMITE, IHU-Méditerranée Infection, Marseille, France
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21
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McLaughlin HP, Cherney B, Hakovirta JR, Priestley RA, Conley A, Carter A, Hodge D, Pillai SP, Weigel LM, Kersh GJ, Sue D. Phylogenetic inference of Coxiella burnetii by 16S rRNA gene sequencing. PLoS One 2017; 12:e0189910. [PMID: 29287100 PMCID: PMC5747434 DOI: 10.1371/journal.pone.0189910] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 12/05/2017] [Indexed: 11/18/2022] Open
Abstract
Coxiella burnetii is a human pathogen that causes the serious zoonotic disease Q fever. It is ubiquitous in the environment and due to its wide host range, long-range dispersal potential and classification as a bioterrorism agent, this microorganism is considered an HHS Select Agent. In the event of an outbreak or intentional release, laboratory strain typing methods can contribute to epidemiological investigations, law enforcement investigation and the public health response by providing critical information about the relatedness between C. burnetii isolates collected from different sources. Laboratory cultivation of C. burnetii is both time-consuming and challenging. Availability of strain collections is often limited and while several strain typing methods have been described over the years, a true gold-standard method is still elusive. Building upon epidemiological knowledge from limited, historical strain collections and typing data is essential to more accurately infer C. burnetii phylogeny. Harmonization of auspicious high-resolution laboratory typing techniques is critical to support epidemiological and law enforcement investigation. The single nucleotide polymorphism (SNP) -based genotyping approach offers simplicity, rapidity and robustness. Herein, we demonstrate SNPs identified within 16S rRNA gene sequences can differentiate C. burnetii strains. Using this method, 55 isolates were assigned to six groups based on six polymorphisms. These 16S rRNA SNP-based genotyping results were largely congruent with those obtained by analyzing restriction-endonuclease (RE)-digested DNA separated by SDS-PAGE and by the high-resolution approach based on SNPs within multispacer sequence typing (MST) loci. The SNPs identified within the 16S rRNA gene can be used as targets for the development of additional SNP-based genotyping assays for C. burnetii.
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Affiliation(s)
- Heather P. McLaughlin
- Laboratory Preparedness and Response Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Blake Cherney
- Laboratory Preparedness and Response Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Janetta R. Hakovirta
- Laboratory Preparedness and Response Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Rachael A. Priestley
- Rickettsial Zoonoses Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Andrew Conley
- Laboratory Preparedness and Response Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Andrew Carter
- Laboratory Preparedness and Response Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - David Hodge
- Science and Technology Directorate, U.S. Department of Homeland Security, Washington, D.C., United States of America
| | - Segaran P. Pillai
- Office of Laboratory Science and Safety, Office of the Commissioner, U.S. Food and Drug Administration, Silver Spring, MD, United States of America
| | - Linda M. Weigel
- Laboratory Preparedness and Response Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Gilbert J. Kersh
- Rickettsial Zoonoses Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - David Sue
- Laboratory Preparedness and Response Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
- * E-mail:
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22
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Abstract
This large-scale cross-sectional study was conducted to determine the prevalence, geographical distribution, and risk factors for the presence of antibodies against Coxiella burnetii in bulk tank milk derived from dairy cattle, sheep, and goats in Jordan. Bulk milk samples were collected from 78 dairy cattle, 48 sheep, and 23 goat farms from various places in Jordan according to the density of these animal species in each region of the country. The samples were tested for C. burnetii antibodies using the CHEKIT Q-Fever Antibody ELISA kit. A standardized questionnaire was also used to collect data from each farm to identify and rank the risk factors for the presence of C. burnetii antibodies. The results revealed that 62.9% (95% confidence interval: 55.1 to 70.0%) of the tested ruminant farms were positive for C. burnetii antibodies. Positive results were obtained from 70.9% (60.6 to 79.5%) of dairy cattle farms, 52.1% (38.3 to 65.5%) of sheep farms, and 56.0% (37.1 to 73.3%) of goat farms. Six factors were associated with the presence of these antibodies on cattle farms, and five factors were associated with these antibodies on sheep and goat farms (chi-square test). The multivariate logistic regression model revealed that large dairy cattle farms, farms that add new animals to the herd, farms that infrequently clean the feeders, and farms in particular areas are 28.6, 19.9, 8.0, and 6.4 times more likely, respectively, to have animals with C. burnetii antibodies. Sheep and goat farms that mix their animals with those from other farms, graze more than 5 km, and infrequently sanitize the feeders were 8.0, 0.06, and 13.6 times more likely, respectively, to have animals with C. burnetii antibodies. These data reveal the widespread exposure of Jordanian ruminants to C. burnetii and suggest a high risk for public health.
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Affiliation(s)
- Mohammad M Obaidat
- Department of Veterinary Pathology and Public Health, Faculty of Veterinary Medicine, Jordan University of Science and Technology, Al Ramtha, Irbid, Jordan
| | - Gilbert J Kersh
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30329, USA
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23
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Doung-Ngern P, Chuxnum T, Pangjai D, Opaschaitat P, Kittiwan N, Rodtian P, Buameetoop N, Kersh GJ, Padungtod P. Seroprevalence of Coxiella burnetii Antibodies Among Ruminants and Occupationally Exposed People in Thailand, 2012-2013. Am J Trop Med Hyg 2017; 96:786-790. [PMID: 28115661 DOI: 10.4269/ajtmh.16-0336] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
AbstractLittle is known about the burden of Q fever in Thailand. We conducted a serological study to describe the prevalence of anti-Coxiella burnetii antibodies among ruminants and occupationally exposed persons in response to the report of the first two Q fever endocarditis patients in Thailand in 2012. We randomly selected ruminant sera from brucellosis surveillance and examined sera of 661 occupationally exposed subjects from two provinces of Thailand: Chiangmai and Nakornratchasima. Animal and human sera were tested using commercial enzyme-linked immunosorbent assay (ELISA). Environmental samples, vaginal swab, and milk from cows in Chiangmai farms with detectable anti-C. burnetii serum antibodies were tested using polymerase chain reaction (PCR). Among the 1,632 animal sera tested, 64 (3.9%) were seropositive. The prevalence was highest in dairy cattle (4.6%, 45/988), followed by goats (3.5%, 18/516) and sheep (2.1%, 1/48). The prevalence of anti-C. burnetii antibodies in each species varied significantly by province: the prevalence in cattle was higher in Chiangmai (5.5% versus 0%), however, the prevalence in sheep and goats was higher in Nakornratchasima (5.9% versus 1.0%). Four out of 60 milk samples were positive by PCR (6.7%). No environmental samples were positive. Among 661 human samples, 83 (12.6%) were ELISA positive. Seroprevalence was statistically higher in Chiangmai compare with Nakornratchasima (42.8% versus 3.0%). Coxiella burnetii infection exists in Thailand, but the prevalence varies by geographic distribution and animal reservoirs. Further studies focusing on the burden and risk factors of C. burnetii infection among high-risk groups should be conducted.
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Affiliation(s)
- Pawinee Doung-Ngern
- Bureau of Epidemiology, Department of Diseases Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Teerasak Chuxnum
- Bureau of Epidemiology, Department of Diseases Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Decha Pangjai
- National Institute of Health, Department of Medical Science, Ministry of Public Health, Nonthaburi, Thailand
| | - Pattarin Opaschaitat
- National Institute of Animal Health, Department of Livestock Development, Bangkok, Thailand
| | - Nattinee Kittiwan
- National Institute of Animal Health, Department of Livestock Development, Bangkok, Thailand
| | - Pranee Rodtian
- The Fifth Regional Livestock Office, Department of Livestock Development, Chiangmai, Thailand
| | - Noppawan Buameetoop
- Bureau of Disease Control and Veterinary Services, Department of Livestock Development, Bangkok, Thailand
| | - Gilbert J Kersh
- Rickettsial Zoonoses Branch, National Center for Emerging Zoonoses and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Pawin Padungtod
- Global Disease Detection Regional Center, Thai MOPH - U.S. CDC Collaboration, Ministry of Public Health, Thailand and Global Disease Detection Branch, Division of Global Health Protection, Center for Global Health, Nonthaburi, Thailand
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24
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Olivas S, Hornstra H, Priestley RA, Kaufman E, Hepp C, Sonderegger DL, Handady K, Massung RF, Keim P, Kersh GJ, Pearson T. Massive dispersal of Coxiella burnetii among cattle across the United States. Microb Genom 2016; 2:e000068. [PMID: 28348863 PMCID: PMC5320587 DOI: 10.1099/mgen.0.000068] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 05/19/2016] [Indexed: 11/18/2022] Open
Abstract
Q-fever is an underreported disease caused by the bacterium Coxiella burnetii, which is highly infectious and has the ability to disperse great distances. It is a completely clonal pathogen with low genetic diversity and requires whole-genome analysis to identify discriminating features among closely related isolates. C. burnetii, and in particular one genotype (ST20), is commonly found in cow's milk across the entire dairy industry of the USA. This single genotype dominance is suggestive of host-specific adaptation, rapid dispersal and persistence within cattle. We used a comparative genomic approach to identify SNPs for high-resolution and high-throughput genotyping assays to better describe the dispersal of ST20 across the USA. We genotyped 507 ST20 cow milk samples and discovered three subgenotypes, all of which were present across the entire country and over the complete time period studied. Only one of these sub-genotypes was observed in a single dairy herd. The temporal and geographic distribution of these sub-genotypes is consistent with a model of large-scale, rapid, frequent and continuous dissemination on a continental scale. The distribution of subgenotypes is not consistent with wind-based dispersal alone, and it is likely that animal husbandry and transportation practices, including pooling of milk from multiple herds, have also shaped the patterns. On the scale of an entire country, there appear to be few barriers to rapid, frequent and large-scale dissemination of the ST20 subgenotypes.
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Affiliation(s)
- Sonora Olivas
- Center for Microbial Genetics and Genomics, Northern Arizona University, PO Box 4073, Flagstaff, AZ 86011, USA
| | - Heidie Hornstra
- Center for Microbial Genetics and Genomics, Northern Arizona University, PO Box 4073, Flagstaff, AZ 86011, USA
| | - Rachael A. Priestley
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, USA
| | - Emily Kaufman
- Center for Microbial Genetics and Genomics, Northern Arizona University, PO Box 4073, Flagstaff, AZ 86011, USA
| | - Crystal Hepp
- Center for Microbial Genetics and Genomics, Northern Arizona University, PO Box 4073, Flagstaff, AZ 86011, USA
- Informatics and Computing Program, Northern Arizona University, PO Box 5717, Flagstaff, AZ 86011, USA
| | - Derek L. Sonderegger
- Department of Mathematics and Statistics, Northern Arizona University, PO Box 5717, Flagstaff, AZ 86011, USA
| | - Karthik Handady
- Center for Microbial Genetics and Genomics, Northern Arizona University, PO Box 4073, Flagstaff, AZ 86011, USA
| | - Robert F. Massung
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, USA
| | - Paul Keim
- Center for Microbial Genetics and Genomics, Northern Arizona University, PO Box 4073, Flagstaff, AZ 86011, USA
- Pathogen Genomics Division, Translational Genomics Research Institute, Phoenix, Arizona, USA
| | - Gilbert J. Kersh
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, USA
| | - Talima Pearson
- Center for Microbial Genetics and Genomics, Northern Arizona University, PO Box 4073, Flagstaff, AZ 86011, USA
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25
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Kersh GJ, Priestley RA, Hornstra HM, Self JS, Fitzpatrick KA, Biggerstaff BJ, Keim P, Pearson T, Massung RF. Genotyping and Axenic Growth of Coxiella burnetii Isolates Found in the United States Environment. Vector Borne Zoonotic Dis 2016; 16:588-94. [PMID: 27304166 DOI: 10.1089/vbz.2016.1972] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Coxiella burnetii is a gram-negative bacterium that is the etiologic agent of the zoonotic disease Q fever. Common reservoirs of C. burnetii include sheep, goats, and cattle. These animals shed C. burnetii into the environment, and humans are infected by inhalation of aerosols. A survey of 1622 environmental samples taken across the United States in 2006-2008 found that 23.8% of the samples contained C. burnetii DNA. To identify the strains circulating in the U.S. environment, DNA from these environmental samples was genotyped using an SNP-based approach to derive sequence types (ST) that are also compatible with multispacer sequence typing methods. Three different sequence types were observed in 31 samples taken from 19 locations. ST8 was associated with goats and ST20 with dairy cattle. ST16/26 was detected in locations with exposure to various animals and also in locations with no direct animal contact. Viable isolates were obtained for all three sequence types, but only the ST20 and ST16/26 isolates grew in acidified citrate cysteine medium (ACCM)-2 axenic media. Examination of a variety of isolates with different sequence types showed that ST8 and closely related isolates did not grow in ACCM-2. These results suggest that a limited number of C. burnetii sequence types are circulating in the U.S. environment and these strains have close associations with specific reservoir species. Growth in ACCM-2 may not be suitable for isolation of many C. burnetii strains.
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Affiliation(s)
- Gilbert J Kersh
- 1 Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Rachael A Priestley
- 1 Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Heidie M Hornstra
- 2 Center for Microbial Genetics and Genomics, Northern Arizona University , Flagstaff, Arizona
| | - Joshua S Self
- 1 Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Kelly A Fitzpatrick
- 1 Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Brad J Biggerstaff
- 3 Division of Vector-Borne Diseases, Centers for Disease Control and Prevention , Ft. Collins, Colorado
| | - Paul Keim
- 2 Center for Microbial Genetics and Genomics, Northern Arizona University , Flagstaff, Arizona
| | - Talima Pearson
- 2 Center for Microbial Genetics and Genomics, Northern Arizona University , Flagstaff, Arizona
| | - Robert F Massung
- 1 Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention , Atlanta, Georgia
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26
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Biggs HM, Turabelidze G, Pratt D, Todd SR, Jacobs-Slifka K, Drexler NA, McCurdy G, Lloyd J, Evavold CL, Fitzpatrick KA, Priestley RA, Singleton J, Sun D, Tang M, Kato C, Kersh GJ, Anderson A. Coxiella burnetii Infection in a Community Operating a Large-Scale Cow and Goat Dairy, Missouri, 2013. Am J Trop Med Hyg 2016; 94:525-31. [PMID: 26811433 DOI: 10.4269/ajtmh.15-0726] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 12/06/2015] [Indexed: 11/07/2022] Open
Abstract
Coxiella burnetii is a zoonotic pathogen that causes Q fever in humans and is transmitted primarily from infected goats, sheep, or cows. Q fever typically presents as an acute febrile illness; however, individuals with certain predisposing conditions, including cardiac valvulopathy, are at risk for chronic Q fever, a serious manifestation that may present as endocarditis. In response to a cluster of Q fever cases detected by public health surveillance, we evaluated C. burnetii infection in a community that operates a large-scale cow and goat dairy. A case was defined as an individual linked to the community with a C. burnetii phase II IgG titer ≥ 128. Of 135 participants, 47 (35%) cases were identified. Contact with or close proximity to cows, goats, and their excreta was associated with being a case (relative risk 2.7, 95% confidence interval 1.3-5.3). Cases were also identified among individuals without cow or goat contact and could be related to windborne spread or tracking of C. burnetii on fomites within the community. A history of injection drug use was reported by 26/130 (20%) participants; follow-up for the presence of valvulopathy and monitoring for development of chronic Q fever may be especially important among this population.
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Affiliation(s)
- Holly M Biggs
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Missouri Department of Health and Senior Services, Jefferson City, Missouri
| | - George Turabelidze
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Missouri Department of Health and Senior Services, Jefferson City, Missouri
| | - Drew Pratt
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Missouri Department of Health and Senior Services, Jefferson City, Missouri
| | - Suzanne R Todd
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Missouri Department of Health and Senior Services, Jefferson City, Missouri
| | - Kara Jacobs-Slifka
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Missouri Department of Health and Senior Services, Jefferson City, Missouri
| | - Naomi A Drexler
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Missouri Department of Health and Senior Services, Jefferson City, Missouri
| | - Gail McCurdy
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Missouri Department of Health and Senior Services, Jefferson City, Missouri
| | - Jennifer Lloyd
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Missouri Department of Health and Senior Services, Jefferson City, Missouri
| | - Charles L Evavold
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Missouri Department of Health and Senior Services, Jefferson City, Missouri
| | - Kelly A Fitzpatrick
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Missouri Department of Health and Senior Services, Jefferson City, Missouri
| | - Rachael A Priestley
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Missouri Department of Health and Senior Services, Jefferson City, Missouri
| | - Joseph Singleton
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Missouri Department of Health and Senior Services, Jefferson City, Missouri
| | - David Sun
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Missouri Department of Health and Senior Services, Jefferson City, Missouri
| | - Minh Tang
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Missouri Department of Health and Senior Services, Jefferson City, Missouri
| | - Cecilia Kato
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Missouri Department of Health and Senior Services, Jefferson City, Missouri
| | - Gilbert J Kersh
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Missouri Department of Health and Senior Services, Jefferson City, Missouri
| | - Alicia Anderson
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Missouri Department of Health and Senior Services, Jefferson City, Missouri
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Anderson AD, Szymanski TJ, Emery MP, Kohrs PH, Bjork AC, Marsden-Haug N, Nett RJ, Woodhall DM, Self JS, Fitzpatrick KA, Priestley RA, Kersh GJ. Epizootiological investigation of a Q fever outbreak and implications for future control strategies. J Am Vet Med Assoc 2015; 247:1379-86. [DOI: 10.2460/javma.247.12.1379] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Haider N, Rahman MS, Khan SU, Mikolon A, Osmani MG, Gurley ES, Shanta IS, Paul SK, Macfarlane-Berry L, Islam A, Islam A, Desmond J, Epstein JH, Priestley RA, Kersh GJ, Rahman MZ, Daszak P, Luby SP, Massung RF, Zeidner N. Serological Evidence of Coxiella burnetii Infection in Cattle and Goats in Bangladesh. Ecohealth 2015; 12:354-358. [PMID: 25649716 DOI: 10.1007/s10393-015-1011-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 12/24/2014] [Accepted: 01/09/2015] [Indexed: 06/04/2023]
Abstract
We tested 1149 ruminant sera conveniently collected from three districts of Bangladesh to identify the serological evidence of Coxiella burnetii infection in cattle and goats by enzyme-linked immunosorbent assay. We found that 0.7% (8/1149) of ruminants had detectable immunoglobulin G for C. burnetii: 0.65% (4/620) in cattle and 0.76% (4/529) in goats. A sub-set of ruminant samples was retested and confirmed by immunofluorescence assay (18/112). Although we cannot rule out false-positive reactions, our study suggests the presence of C. burnetii in cattle and goats in Bangladesh. Further studies are required to estimate disease burden at the population level and identify risk factors for Q fever in ruminants in Bangladesh.
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Affiliation(s)
- Najmul Haider
- Zoonotic Diseases Research Group, Centre for Communicable Diseases, International Centre for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
| | - Md Shafiqur Rahman
- Zoonotic Diseases Research Group, Centre for Communicable Diseases, International Centre for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Salah Uddin Khan
- Zoonotic Diseases Research Group, Centre for Communicable Diseases, International Centre for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Andrea Mikolon
- United States Department of Agriculture, La Cienega, Hawthorne, CA, USA
| | - Muzaffor G Osmani
- Department of Livestock Services, Ministries of Fisheries and Livestock, Dhaka, Bangladesh
| | - Emily S Gurley
- Zoonotic Diseases Research Group, Centre for Communicable Diseases, International Centre for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Ireen Sultana Shanta
- Zoonotic Diseases Research Group, Centre for Communicable Diseases, International Centre for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Suman Kumer Paul
- Zoonotic Diseases Research Group, Centre for Communicable Diseases, International Centre for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Laura Macfarlane-Berry
- Zoonotic Diseases Research Group, Centre for Communicable Diseases, International Centre for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | - Ausraful Islam
- Zoonotic Diseases Research Group, Centre for Communicable Diseases, International Centre for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | | | | | - Gilbert J Kersh
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mohammed Ziaur Rahman
- Zoonotic Diseases Research Group, Centre for Communicable Diseases, International Centre for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | - Stephen P Luby
- Zoonotic Diseases Research Group, Centre for Communicable Diseases, International Centre for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- Woods Institute of the Environment, Stanford University, Stanford, CA, USA
| | | | - Nord Zeidner
- Zoonotic Diseases Research Group, Centre for Communicable Diseases, International Centre for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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Duncan C, Gill VA, Worman K, Burek-Huntington K, Pabilonia KL, Johnson S, Fitzpatrick KA, Weller C, Kersh GJ. Coxiella burnetii exposure in northern sea otters Enhydra lutris kenyoni. Dis Aquat Organ 2015; 114:83-87. [PMID: 25958809 DOI: 10.3354/dao02857] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Valvular endocarditis has been well described in northern sea otters Enhydra lutris kenyoni of Alaska and in many cases no cause has been identified. It is also one of the most common conditions observed in people with chronic Coxiella burnetii infection. Given the high levels of C. burnetii exposure in marine mammals distributed throughout the same geographic range as the northern sea otter, and the presence of valvular lesions seen in otters, the objective of this study was to determine the level of C. burnetii exposure in otters and investigate any association between exposure, infection and valvular disease in this species. Archived serum from 75 live captured, apparently healthy otters (25 from each of 3 stocks) and 30 dead otters were tested for C. burnetii antibodies by indirect florescent antibody assay (IFA). Archived bone marrow and heart valves were tested for C. burnetii DNA by real-time PCR (qPCR). Overall, the seroprevalence in live otters was 17%, with significantly more exposed animals in the south central (40%) stock relative to the southwest (8%) and southeast (4%). The seroprevalence of animals sampled post mortem was 27%, although none of the bone marrow or heart valve samples were positive by qPCR. Results of this study failed to demonstrate a significant association between C. burnetii infection and valvular endocarditis in sea otters; however, the differing seroprevalence suggests that exposure opportunities vary geographically.
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Affiliation(s)
- Colleen Duncan
- Department of Microbiology, Immunology and Pathology, Colorado State University, Diagnostic Medicine Center, 300 West Drake Avenue, Fort Collins, Colorado 80523, USA
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Schoffelen T, Self JS, Fitzpatrick KA, Netea MG, van Deuren M, Joosten LAB, Kersh GJ. Early cytokine and antibody responses against Coxiella burnetii in aerosol infection of BALB/c mice. Diagn Microbiol Infect Dis 2014; 81:234-9. [PMID: 25618420 DOI: 10.1016/j.diagmicrobio.2014.12.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 12/19/2014] [Accepted: 12/21/2014] [Indexed: 12/28/2022]
Abstract
Coxiella burnetii, a Gram-negative intracellular bacterium, can give rise to Q fever in humans and is transmitted mainly by inhalation of infected aerosols from animal reservoirs. Serology is commonly used to diagnose Q fever, but the early cellular immune response-i.e., C. burnetii-specific interferon γ (IFN-γ) production in response to antigen challenge-might be an additional diagnostic. Detection of IFN-γ responses has been used to identify past and chronic Q fever infections, but the IFN-γ response in acute Q fever has not been described. By challenging immunocompetent BALB/c mice with aerosols containing phase I C. burnetii, the timing and extent of IFN-γ recall responses were evaluated in an acute C. burnetii infection. Other cytokines were also measured in an effort to identify other potential diagnostic markers. The data show that after initial expansion of bacteria first in lungs and then in other tissues, the infection was cleared from day 10 onwards as reflected by the decreasing number of bacteria. The antigen-induced IFN-γ production by splenocytes coincided with emergence of IgM phase II antibodies at day 10 postinfection and preceded appearance of IgG antibodies. This was accompanied by the production of proinflammatory cytokines including interleukin (IL) 6, keratinocyte-derived cytokine, and IFN-γ-induced protein 10, followed by monocyte chemotactic protein 1, but not by IL-1β and tumor necrosis factor α, and only very low production of the anti-inflammatory cytokine IL-10. These data suggest that analysis of antigen-specific IFN-γ responses could be a useful tool for diagnosis of acute Q fever. Moreover, the current model of C. burnetii infection could be used to give new insights into immunological factors that predispose to development of persistent infection.
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Affiliation(s)
- Teske Schoffelen
- Radboud University Medical Center, Department of Internal Medicine, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - Joshua S Self
- Centers for Disease Control and Prevention, Rickettsial Zoonoses Branch, 1600 Clifton Rd, MS G13, Atlanta, GA 30333, USA
| | - Kelly A Fitzpatrick
- Centers for Disease Control and Prevention, Rickettsial Zoonoses Branch, 1600 Clifton Rd, MS G13, Atlanta, GA 30333, USA
| | - Mihai G Netea
- Radboud University Medical Center, Department of Internal Medicine, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - Marcel van Deuren
- Radboud University Medical Center, Department of Internal Medicine, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - Leo A B Joosten
- Radboud University Medical Center, Department of Internal Medicine, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - Gilbert J Kersh
- Centers for Disease Control and Prevention, Rickettsial Zoonoses Branch, 1600 Clifton Rd, MS G13, Atlanta, GA 30333, USA.
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Pearson T, Hornstra HM, Hilsabeck R, Gates LT, Olivas SM, Birdsell DM, Hall CM, German S, Cook JM, Seymour ML, Priestley RA, Kondas AV, Clark Friedman CL, Price EP, Schupp JM, Liu CM, Price LB, Massung RF, Kersh GJ, Keim P. High prevalence and two dominant host-specific genotypes of Coxiella burnetii in U.S. milk. BMC Microbiol 2014; 14:41. [PMID: 24533573 PMCID: PMC3936997 DOI: 10.1186/1471-2180-14-41] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Accepted: 02/10/2014] [Indexed: 11/11/2022] Open
Abstract
Background Coxiella burnetii causes Q fever in humans and Coxiellosis in animals; symptoms range from general malaise to fever, pneumonia, endocarditis and death. Livestock are a significant source of human infection as they shed C. burnetii cells in birth tissues, milk, urine and feces. Although prevalence of C. burnetii is high, few Q fever cases are reported in the U.S. and we have a limited understanding of their connectedness due to difficulties in genotyping. Here, we develop canonical SNP genotyping assays to evaluate spatial and temporal relationships among C. burnetii environmental samples and compare them across studies. Given the genotypic diversity of historical collections, we hypothesized that the current enzootic of Coxiellosis is caused by multiple circulating genotypes. We collected A) 23 milk samples from a single bovine herd, B) 134 commercial bovine and caprine milk samples from across the U.S., and C) 400 bovine and caprine samples from six milk processing plants over three years. Results We detected C. burnetii DNA in 96% of samples with no variance over time. We genotyped 88.5% of positive samples; bovine milk contained only a single genotype (ST20) and caprine milk was dominated by a second type (mostly ST8). Conclusions The high prevalence and lack of genotypic diversity is consistent with a model of rapid spread and persistence. The segregation of genotypes between host species is indicative of species-specific adaptations or dissemination barriers and may offer insights into the relative lack of human cases and characterizing genotypes.
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Affiliation(s)
- Talima Pearson
- Center for Microbial Genetics and Genomics, Northern Arizona University, Flagstaff, AZ 86011-4073, USA.
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Bjork A, Marsden-Haug N, Nett RJ, Kersh GJ, Nicholson W, Gibson D, Szymanski T, Emery M, Kohrs P, Woodhall D, Anderson AD. First Reported Multistate Human Q Fever Outbreak in the United States, 2011. Vector Borne Zoonotic Dis 2014; 14:111-7. [DOI: 10.1089/vbz.2012.1202] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Adam Bjork
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
- Epidemic Intelligence Service, CDC, Atlanta, Georgia
- Present address: Division of Global HIV/AIDS, Center for Global Health; CDC, Atlanta, Georgia
| | | | - Randall J. Nett
- Career Epidemiology Field Officer Program, Office of Public Health and Preparedness, CDC, Atlanta, Georgia
- Public Health and Safety Division, Montana Department of Public Health and Human Services, Helena, Montana
| | - Gilbert J. Kersh
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - William Nicholson
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Deborah Gibson
- Public Health Laboratory, Montana Department of Public Health and Human Services, Helena, Montana
| | | | - Michelle Emery
- United States Department of Agriculture, National Veterinary Services Laboratories, Ames, Iowa
| | - Paul Kohrs
- Washington State Department of Agriculture, Olympia, Washington
| | - Dana Woodhall
- Parastitic Diseases Branch, Division of Parasitic Diseases and Malaria, CDC, Atlanta, Georgia
- Epidemic Intelligence Service, CDC, Atlanta, Georgia
| | - Alicia D. Anderson
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
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Whitney EAS, Massung RF, Kersh GJ, Fitzpatrick KA, Mook DM, Taylor DK, Huerkamp MJ, Vakili JC, Sullivan PJ, Berkelman RL. Survey of laboratory animal technicians in the United States for Coxiella burnetii antibodies and exploration of risk factors for exposure. J Am Assoc Lab Anim Sci 2013; 52:725-731. [PMID: 24351760 PMCID: PMC3838606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 02/25/2013] [Accepted: 05/28/2013] [Indexed: 06/03/2023]
Abstract
Little is known about the prevalence of zoonotic infections among laboratory animal care technicians (LAT). Q fever, a disease caused by Coxiella burnetii, is a known occupational hazard for persons caring for livestock. We sought to determine the seroprevalence of C. burnetii antibodies among LAT and to identify risk factors associated with C. burnetii seropositivity. A survey was administered and serum samples collected from a convenience sample of 97 LAT. Samples were screened by using a Q fever IgG ELISA. Immunofluorescent antibody assays for phase I and phase II IgG were used to confirm the status of samples that were positive or equivocal by ELISA; positive samples were titered to endpoint. Antibodies against C. burnetii were detected in 6 (6%) of the 97 respondents. In our sample of LAT, seropositivity to C. burnetii was therefore twice as high in LAT as compared with the general population. Age, sex, and working with sheep regularly were not associated with seropositivity. Risk factors associated with seropositivity included breeding cattle within respondent's research facility, any current job contact with waste from beef cattle or goats, and exposure to animal waste during previous jobs or outside of current job duties. Only 15% of responding LAT reported being aware that sheep, goats, and cattle can transmit Q fever. Research facilities that use cattle or goats should evaluate their waste-management practices and educational programs in light of these findings. Additional efforts are needed to increase awareness among LAT regarding Q fever and heightened risk of exposure to infectious materials. Physicians should consider the risk of infection with C. burnetii when treating LAT with potential occupational exposures.
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Affiliation(s)
- Ellen A Spotts Whitney
- Center for Public Health Preparedness and Research and Department of Epidemiology, Rollins School of Public Health, Atlanta, Georgia, USA.
| | - Robert F Massung
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Gilbert J Kersh
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kelly A Fitzpatrick
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Deborah M Mook
- Division of Animal Resources, Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia, USA
| | - Douglas K Taylor
- Division of Animal Resources, Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia, USA
| | - Michael J Huerkamp
- Division of Animal Resources, Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia, USA
| | - Jessica C Vakili
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Atlanta, Georgia, USA
| | - Patrick J Sullivan
- Department of Epidemiology, Rollins School of Public Health, Atlanta, Georgia, USA
| | - Ruth L Berkelman
- Center for Public Health Preparedness and Research and Department of Epidemiology, Rollins School of Public Health, Atlanta, Georgia, USA
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Abstract
Q fever is caused by the bacterium Coxiella burnetii and has both acute and chronic forms. The acute disease is a febrile illness often with headache and myalgia that can be self-limiting, whereas the chronic disease typically presents as endocarditis and can be life threatening. The normal therapy for the acute disease is a 2 week course of doxycycline, whereas chronic disease requires 18-24 months of doxycycline in combination with hydroxychloroquine. Alternative treatments are used for pregnant women, young children and those who cannot tolerate doxycycline. Doxycycline resistance is rare, but has been reported. Co-trimoxazole is a currently recommended alternative treatment, but quinolones, rifampin and newer macrolides may also provide some benefit.
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Affiliation(s)
- Gilbert J Kersh
- Centers for Disease Control and Prevention, Mailstop G13, 1600 Clifton Rd. Atlanta, GA 30333, USA +1 404 639 1028 +1 404 718 2116
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35
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Pearson T, Hornstra HM, Sahl JW, Schaack S, Schupp JM, Beckstrom-Sternberg SM, O'Neill MW, Priestley RA, Champion MD, Beckstrom-Sternberg JS, Kersh GJ, Samuel JE, Massung RF, Keim P. When outgroups fail; phylogenomics of rooting the emerging pathogen, Coxiella burnetii. Syst Biol 2013; 62:752-62. [PMID: 23736103 PMCID: PMC3739886 DOI: 10.1093/sysbio/syt038] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Revised: 02/19/2013] [Accepted: 05/28/2013] [Indexed: 11/20/2022] Open
Abstract
Rooting phylogenies is critical for understanding evolution, yet the importance, intricacies and difficulties of rooting are often overlooked. For rooting, polymorphic characters among the group of interest (ingroup) must be compared to those of a relative (outgroup) that diverged before the last common ancestor (LCA) of the ingroup. Problems arise if an outgroup does not exist, is unknown, or is so distant that few characters are shared, in which case duplicated genes originating before the LCA can be used as proxy outgroups to root diverse phylogenies. Here, we describe a genome-wide expansion of this technique that can be used to solve problems at the other end of the evolutionary scale: where ingroup individuals are all very closely related to each other, but the next closest relative is very distant. We used shared orthologous single nucleotide polymorphisms (SNPs) from 10 whole genome sequences of Coxiella burnetii, the causative agent of Q fever in humans, to create a robust, but unrooted phylogeny. To maximize the number of characters informative about the rooting, we searched entire genomes for polymorphic duplicated regions where orthologs of each paralog could be identified so that the paralogs could be used to root the tree. Recent radiations, such as those of emerging pathogens, often pose rooting challenges due to a lack of ingroup variation and large genomic differences with known outgroups. Using a phylogenomic approach, we created a robust, rooted phylogeny for C. burnetii. [Coxiella burnetii; paralog SNPs; pathogen evolution; phylogeny; recent radiation; root; rooting using duplicated genes.].
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Affiliation(s)
- Talima Pearson
- Center for Microbial Genetics and Genomics, Northern Arizona University, Flagstaff, AZ, USA
| | - Heidie M. Hornstra
- Center for Microbial Genetics and Genomics, Northern Arizona University, Flagstaff, AZ, USA
| | - Jason W. Sahl
- Center for Microbial Genetics and Genomics, Northern Arizona University, Flagstaff, AZ, USA
- Department of Biology, Reed College, Portland, OR, USA
| | - Sarah Schaack
- Pathogen Genomics Division, Translational Genomics Research Institute, Flagstaff, AZ, USA
| | | | - Stephen M. Beckstrom-Sternberg
- Center for Microbial Genetics and Genomics, Northern Arizona University, Flagstaff, AZ, USA
- Department of Biology, Reed College, Portland, OR, USA
| | - Matthew W. O'Neill
- Center for Microbial Genetics and Genomics, Northern Arizona University, Flagstaff, AZ, USA
| | - Rachael A. Priestley
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mia D. Champion
- Center for Microbial Genetics and Genomics, Northern Arizona University, Flagstaff, AZ, USA
- Department of Biology, Reed College, Portland, OR, USA
| | | | - Gilbert J. Kersh
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - James E. Samuel
- Department of Microbial and Molecular Pathogenesis, Texas A&M Health Science Center, College Station, TX, USA
| | - Robert F. Massung
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Paul Keim
- Center for Microbial Genetics and Genomics, Northern Arizona University, Flagstaff, AZ, USA
- Department of Biology, Reed College, Portland, OR, USA
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Anderson A, Bijlmer H, Fournier PE, Graves S, Hartzell J, Kersh GJ, Limonard G, Marrie TJ, Massung RF, McQuiston JH, Nicholson WL, Paddock CD, Sexton DJ. Diagnosis and management of Q fever--United States, 2013: recommendations from CDC and the Q Fever Working Group. MMWR Recomm Rep 2013; 62:1-30. [PMID: 23535757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
Q fever, a zoonotic disease caused by the bacterium Coxiella burnetii, can cause acute or chronic illness in humans. Transmission occurs primarily through inhalation of aerosols from contaminated soil or animal waste. No licensed vaccine is available in the United States. Because many human infections result in nonspecific or benign constitutional symptoms, establishing a diagnosis of Q fever often is challenging for clinicians. This report provides the first national recommendations issued by CDC for Q fever recognition, clinical and laboratory diagnosis, treatment, management, and reporting for health-care personnel and public health professionals. The guidelines address treatment of acute and chronic phases of Q fever illness in children, adults, and pregnant women, as well as management of occupational exposures. These recommendations will be reviewed approximately every 5 years and updated to include new published evidence.
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Affiliation(s)
- Alicia Anderson
- National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, Georgia, USA
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Kersh GJ, Priestley R, Massung RF. Stability of Coxiella burnetii in stored human blood. Transfusion 2012; 53:1493-6. [PMID: 23034070 DOI: 10.1111/j.1537-2995.2012.03912.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Revised: 08/10/2012] [Accepted: 08/14/2012] [Indexed: 01/15/2023]
Abstract
BACKGROUND Coxiella burnetii, an obligate intracellular organism, is the causative agent of the zoonotic disease Q fever. The seroprevalence rate for Q fever in the United States is 3.1%, suggesting a high number of infections each year. However, fewer than 200 cases of Q fever are reported to the CDC annually. This discrepancy is likely the result of underutilized diagnostics and a high percentage (>50%) of asymptomatic infections. The detection of C. burnetii in patient blood during the first 2 to 3 weeks of infection raises the possibility that the organism could be present in donated human blood. The purpose of this study was to determine if extracellular C. burnetii would be stable in blood under normal storage conditions. STUDY DESIGN AND METHODS Donated human blood was separated into whole blood, leukoreduced whole blood, red blood cells, and plasma. Each component was spiked with purified, extracellular C. burnetii strain Nine Mile Phase 1, and the viability and infectivity of the organisms were tested weekly. RESULTS C. burnetii did not decrease in viability or the ability to infect cells after storage in any of the blood products, even after 6 weeks of storage at 1 to 6 °C. CONCLUSIONS Extracellular C. burnetii can survive and remain infectious in donated blood products.
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Affiliation(s)
- Gilbert J Kersh
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
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38
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Duncan C, Savage K, Williams M, Dickerson B, Kondas AV, Fitzpatrick KA, Guerrero JL, Spraker T, Kersh GJ. Multiple strains of Coxiella burnetii are present in the environment of St. Paul Island, Alaska. Transbound Emerg Dis 2012; 60:345-50. [PMID: 22747976 DOI: 10.1111/j.1865-1682.2012.01353.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In 2010, Coxiella burnetii was identified at a high prevalence in the placentas of Northern fur seals (Callorhinus ursinus) collected at a single rookery on St. Paul Island Alaska; an area of the United States where the agent was not known to be present. As contamination was hypothesized as a potential cause of false positives, but nothing was known about environmental C. burnetii in the region, an environmental survey was conducted to look for the prevalence and distribution of the organism on the island. While environmental prevalence was low, two strains of the organism were identified using PCR targeting the COM1 and IS1111 genes. The two strains are consistent with the organism that has been increasingly identified in marine mammals as well as a strain type more commonly found in terrestrial environments and associated with disease in humans and terrestrial animals. Further work is needed to elucidate information regarding the ecology of this organism in this region, particularly in association with the coastal environment.
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Affiliation(s)
- C Duncan
- Veterinary Diagnostic Lab, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO 80523, USA.
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39
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Prabhu M, Nicholson WL, Roche AJ, Kersh GJ, Fitzpatrick KA, Oliver LD, Massung RF, Morrissey AB, Bartlett JA, Onyango JJ, Maro VP, Kinabo GD, Saganda W, Crump JA. Q fever, spotted fever group, and typhus group rickettsioses among hospitalized febrile patients in northern Tanzania. Clin Infect Dis 2012; 53:e8-15. [PMID: 21810740 DOI: 10.1093/cid/cir411] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The importance of Q fever, spotted fever group rickettsiosis (SFGR), and typhus group rickettsiosis (TGR) as causes of febrile illness in sub-Saharan Africa is unknown; the putative role of Q fever as a human immunodeficiency virus (HIV) coinfection is unclear. METHODS We identified febrile inpatients in Moshi, Tanzania, from September 2007 through August 2008 and collected acute- and convalescent-phase serum samples. A ≥4-fold increase in immunoglobulin (Ig) G immunfluorescence assay (IFA) titer to Coxiella burnetii phase II antigen defined acute Q fever. A ≥4-fold increase in IgG IFA titer to Rickettsia conorii or Rickettsia typhi antigen defined SFGR and TGR, respectively. RESULTS Among 870 patients, 483 (55.5%) were tested for acute Q fever, and 450 (51.7%) were tested for acute SFGR and TGR. Results suggested acute Q fever in 24 (5.0%) patients and SFGR and TGR in 36 (8.0%) and 2 (0.5%) patients, respectively. Acute Q fever was associated with hepato- or splenomegaly (odds ratio [OR], 3.1; P = .028), anemia (OR, 3.0; P = .009), leukopenia (OR, 3.9; P = .013), jaundice (OR, 7.1; P = .007), and onset during the dry season (OR, 2.7; P = .021). HIV infection was not associated with acute Q fever (OR, 1.7; P = .231). Acute SFGR was associated with leukopenia (OR, 4.1; P = .003) and with evidence of other zoonoses (OR, 2.2; P = .045). CONCLUSIONS Despite being common causes of febrile illness in northern Tanzania, Q fever and SFGR are not diagnosed or managed with targeted antimicrobials. C. burnetii does not appear to be an HIV-associated co-infection.
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Affiliation(s)
- Malavika Prabhu
- Department of Medicine, Division of Infectious Diseases and International Health, Duke University Medical Center, Duke University, Durham, North Carolina 27710, USA
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40
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Duncan C, Kersh GJ, Spraker T, Patyk KA, Fitzpatrick KA, Massung RF, Gelatt T. Coxiella burnetii in northern fur seal (Callorhinus ursinus) placentas from St. Paul Island, Alaska. Vector Borne Zoonotic Dis 2011; 12:192-5. [PMID: 22017469 DOI: 10.1089/vbz.2011.0715] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The decline in the number of northern fur seal (NFS; Callorhinus ursinus) pups on St. Paul Island, Alaska, has led to multidisciplinary research, including investigation into issues of reproductive health and success. Given the recent identification of Coxiella burnetii in the placenta of two other marine mammal species, NFS placentas were collected from Reef rookery on St. Paul Island, Alaska, during the 2010 pupping season, examined histologically, and tested for C. burnetii using polymerase chain reaction (PCR). Of 146 placentas examined, gram-negative intratrophoblastic bacteria that were positive for C. burnetii on immunohistochemistry were observed in 5 (3%) placentas. Placental infection was usually devoid of associated inflammation or significant ancillary pathology. One hundred nine (75%) of the placentas were positive for C. burnetii on PCR. C. burnetii is globally distributed and persists for long periods in the environment, providing ample opportunity for exposure of many species. The significance of this finding for the declining fur seal population, potential human exposure and infection, and impact on other sympatric marine mammal or terrestrial species is unclear; further investigation into the epidemiology of Coxiella in the marine ecosystem is warranted.
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Affiliation(s)
- Colleen Duncan
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado 80524, USA.
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Kersh GJ, Oliver LD, Self JS, Fitzpatrick KA, Massung RF. Virulence of pathogenic Coxiella burnetii strains after growth in the absence of host cells. Vector Borne Zoonotic Dis 2011; 11:1433-8. [PMID: 21867419 DOI: 10.1089/vbz.2011.0670] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Coxiella burnetii is a gram-negative bacterium that causes the zoonotic disease Q fever. Traditionally considered an obligate intracellular agent, the requirement to be grown in tissue culture cells, embryonated eggs, or animal hosts has made it difficult to isolate strains and perform genetic studies on C. burnetii. However, it was recently demonstrated that the attenuated Nine Mile Phase 2 (NM2) C. burnetii strain will grow axenically in acidified citrate cysteine medium (ACCM) in a 2.5% oxygen environment. The current study was undertaken to determine whether more virulent C. burnetii strains could be grown in ACCM, and whether virulence would be maintained after passage. The ACCM medium supported an ?1000-fold expansion of Nine Mile Phase 1 (NM1), NM2, M44, and Henzerling strains of C. burnetii, whereas the Priscilla (Q177) strain expanded only 100-fold, and the K strain (Q154) grew poorly in ACCM. To determine if passage in ACCM would maintain the virulence of C. burnetii, the NM1 strain was grown for up to 26 weekly passages in ACCM. C. burnetii maintained in ACCM for 5 or 8 passages maintained full virulence in a mouse model, but NM1 passaged for 23 or 26 times was somewhat attenuated. These data demonstrate that virulent strains of C. burnetii can be successfully passaged in ACCM; however, some strains can lose virulence after extended passage, and other strains grow poorly in this medium. The loss of virulence in axenic culture was associated with some truncation of lipopolysaccharide chains, suggesting a possible mechanism for attenuation.
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Affiliation(s)
- Gilbert J Kersh
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Abstract
TCR-induced NF-AT activation leads to the up-regulation of multiple genes involved in T cell anergy. Since NF-AT is also involved in T cell activation, we have endeavored to dissect TCR-induced activating and inhibitory genetic programs. This approach revealed roles for the early growth response (Egr) family of transcription factors and the Egr coactivator/corepressor NGFI-A-binding protein (NAB)2 in regulating T cell function. TCR-induced Egr-1 and NAB2 enhance T cell function, while Egr-2 and Egr-3 inhibit T cell function. In this report, we demonstrate that Egr-2 and Egr-3 are induced by NF-AT in the absence of AP-1, while Egr-1 and NAB2 both require AP-1-mediated transcription. Our data suggest that Egr-3 is upstream of Egr-2, and that mechanistically Egr-2 and Egr-3 suppress Egr-1 and NAB2 expression. Functionally, T cells from Egr-2 and Egr-3 null mice are hyperresponsive while T cells from Egr-3 transgenic, overexpressing mice are hyporesponsive. Furthermore, an in vivo model of autoimmune pneumonitis reveals that T cells from Egr-3 null mice hasten death while Egr-3-overexpressing T cells cause less disease. Overall, our data suggest that just as the Egr/NAB network of genes control cell fate in other systems, TCR-induced Egr-1, 2, 3 and NAB2 control the fate of antigen recognition in T cells.
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Affiliation(s)
- Sam Collins
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA
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43
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Kersh GJ. E proteins enforce security checkpoints in the thymus. Immunity 2008; 27:827-9. [PMID: 18093534 DOI: 10.1016/j.immuni.2007.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In this issue of Immunity, two studies define new roles for E proteins in thymocyte development. Agata et al. (2007) show a new role in beta selection; Jones and Zhuang (2007) demonstrate a role in positive selection.
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Affiliation(s)
- Gilbert J Kersh
- Department of Pathology and Laboratory Medicine, Emory University, 7311 Woodruff Memorial Building, 101 Woodruff Circle, Atlanta, GA 30322, USA.
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Abstract
Phosphorylation of MAP kinases is important for proper translation of T cell antigen receptor (TCR) signals into thymocyte cell fates, but the role of MAP kinase phosphatase (MKP) activity in thymocyte development has not been characterized. To explore the role of MKP in thymocytes, we constructed a double mutant MKP-3 (DM-MKP3) that acts as a dominant-negative inhibitor of ERK- and JNK-specific MKP. Thymocytes developing in the presence of DM-MKP3 have enhanced frequencies of both CD4 and CD8 mature, single-positive cells and no increase in apoptosis. Expression of DM-MKP3 also results in an increased proportion of thymocytes with high levels of both CD69 and TCRbeta, suggesting that the increased proportion of mature thymocytes is the result of an increased probability that CD4(+)CD8(+) cells will be positively selected. Thus, MKP activity controls thymocyte cell fate by regulating the threshold of TCR signaling that is able to induce positive selection.
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Affiliation(s)
- Matthew L. Bettini
- Department of Pathology and Laboratory Medicine, 101 Woodruff Circle, Emory University School of Medicine, Atlanta, GA 30322
| | - Gilbert J. Kersh
- Department of Pathology and Laboratory Medicine, 101 Woodruff Circle, Emory University School of Medicine, Atlanta, GA 30322
- *To whom correspondence should be addressed. E-mail:
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Kersh GJ, Xi H. Negative regulation of RORgt by direct binding to Egr3 (35.41). The Journal of Immunology 2007. [DOI: 10.4049/jimmunol.178.supp.35.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Abstract
The orphan hormone receptor RORgt is a transcription factor that is expressed in lymphoid tissue inducer cells, double positive thymocytes, and Th17 cells. Analysis of RORg-deficient mice has revealed that this factor is critical for normal function of all three of these cell types. It is therefore of interest to understand how RORgt function is regulated. We have found that RORgt function can be negatively regulated by Egr3, a zinc finger transcription factor that is induced by a variety of stimuli, including TCR signaling. Ectopic expression of both RORgt and Egr3 in a thymocyte cell line prevents RORgt from binding to target gene promoters, and blocks target gene expression. We have employed multiple strategies to demonstrate that the inhibition of RORgt function is due to direct binding of RORgt by Egr3. Immunoprecipitation of either Egr3 or RORgt brings down the other protein, even when both proteins are obtained by in vitro translation. A mammalian two-hybrid system also indicates that the two proteins physically interact. Mutational analysis of RORgt indicates that the domain responsible for steroid receptor coactivator recruitment is required for binding to Egr3. These studies demonstrate a novel function for Egr3, and suggest a mechanism for regulation of thymocyte and Th17 cell differentiation.
This work is funded by a grant from the American Cancer Society.
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Affiliation(s)
- Gilbert J Kersh
- 1Pathology, Emory University, 7311 WMB, 101 Woodruff Circle, Atlanta, GA, 30322,
| | - Hongkang Xi
- 2Genentech, Inc., 1 DNA Way, South San Francisco, CA, 94080
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Bettini ML, Kersh GJ. Dual Specificity Phosphatase (DUSP) activity regulates ERK activation and positive selection of thymocytes (87.16). The Journal of Immunology 2007. [DOI: 10.4049/jimmunol.178.supp.87.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Abstract
Regulation of MAP Kinase phosphorylation is thought to be important for proper translation of TCR signals into thymocyte cell fates. However, the role of phosphatase activity in thymic development has not been extensively characterized. DUSP-6, also known as Map Kinase Phosphatase-3 (MKP-3), is expressed in the thymus and can bind and dephosphorylate ERK. To explore the role of MKP in thymocytes, we expressed MKP-3 or a catalytically inactive form of MKP-3 (DM-MKP3) in an immature thymocyte cell line, 16610 D9. Lower amounts of phosphorylated ERK (p-ERK) were found in D9 cells that over express MKP-3, while D9 cells that over express DM-MKP3 exhibited higher amounts of p-ERK after TCR stimulation in comparison to vector control cells. Thus, over expression of a catalytically inactive ERK phosphatase results in inhibition of all ERK specific MKP activity, and acts as a dominant negative MKP. Utilizing real time PCR, we also observed elevated Egr-1 mRNA levels after TCR stimulation in D9 cells expressing DM-MKP3 compared to control D9 cells. Egr-1 is an ERK dependent immediate early gene known to support positive selection of thymocytes. Finally, we over expressed DM-MKP3 in vivo, and observed enhanced positive selection. Together these results indicate that MKP control of ERK activation after TCR stimulation is critical in regulation of thymocyte cell fate decisions.
This work is funded by grants from the NIH and the ACS.
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Affiliation(s)
- Matthew L. Bettini
- Pathology, Emory University School of Medicine, 101 Woodruff Circle, Atlanta, GA, 30322
| | - Gilbert J. Kersh
- Pathology, Emory University School of Medicine, 101 Woodruff Circle, Atlanta, GA, 30322
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47
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Abstract
During mammalian pregnancy the maternal thymus undergoes significant involution, and then recovers in size after birth. The mechanism behind this involution is not known, but it has been suggested that elevated levels of hormones during pregnancy induce the involution. We have recently shown that injection of 17beta-oestradiol into mice causes loss of early thymocyte precursors and inhibits proliferation of developing thymocytes. This suggests that elevated oestrogen in pregnancy may contribute to thymic involution. We have investigated this idea by examining the fate of thymocytes during mouse pregnancy in much greater detail than has been previously reported. Looking over a broad time-course, we find that pregnancy does not affect thymocyte precursor populations in the bone marrow, but induces a profound loss of early thymic progenitors in the thymus as early as day 12 x 5 of pregnancy. This loss is accompanied by decreased thymocyte proliferation, which returns to normal 2-4 days postpartum. No enhancement of apoptosis is detectable at any stage of pregnancy. We also find that there is a reduction in recent thymic emigrants after oestrogen treatment and at day 17 x 5 of pregnancy, suggesting that thymic involution during pregnancy influences the peripheral T-cell repertoire. The similarities between oestrogen-mediated involution and pregnancy-mediated involution suggest that oestrogen is a significant contributor to loss of thymocyte cellularity during pregnancy, and probably functions primarily by reducing thymocyte proliferation.
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Affiliation(s)
- Allison L Zoller
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA
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48
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Xi H, Schwartz R, Engel I, Murre C, Kersh GJ. Interplay between RORgammat, Egr3, and E proteins controls proliferation in response to pre-TCR signals. Immunity 2006; 24:813-826. [PMID: 16782036 DOI: 10.1016/j.immuni.2006.03.023] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2005] [Revised: 12/20/2005] [Accepted: 03/21/2006] [Indexed: 10/24/2022]
Abstract
The response of thymocytes to pre-T cell receptor (pre-TCR) signaling includes proliferation and gene rearrangement, two cellular processes that are incompatible. The control of proliferation by pre-TCR signals depends on the activities of the transcription factors RORgammat, Egr3, E12, and E47. Here, we describe a regulatory network in which interplay between these factors ensures transient proliferation that is temporally distinct from gene rearrangement. RORgammat expression was elevated after pre-TCR signaling, and RORgammat promoted gene rearrangement in CD4+, CD8+ cells by inhibiting cell division, promoting survival via Bcl-X(L), and inducing Rag2. Egr3 was transiently induced by pre-TCR signals and promoted a distinct proliferative phase by reducing E protein-dependent RORgammat expression and interacting with RORgammat to prevent induction of target genes. After Egr3 subsided, the expression and function of RORgammat increased. Thus, transient induction of Egr3 delays the effects of RORgammat and enables pre-TCR signaling to induce both proliferation and gene rearrangement.
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MESH Headings
- Animals
- E-Box Elements
- Early Growth Response Protein 3/genetics
- Early Growth Response Protein 3/metabolism
- Gene Rearrangement, T-Lymphocyte
- Inhibitor of Differentiation Proteins/metabolism
- Lymphocyte Activation/genetics
- Mice
- Mice, Mutant Strains
- Nuclear Receptor Subfamily 1, Group F, Member 3
- Promoter Regions, Genetic
- RNA-Binding Proteins/genetics
- Rats
- Receptors, Antigen, T-Cell, alpha-beta/metabolism
- Receptors, Retinoic Acid/genetics
- Receptors, Retinoic Acid/metabolism
- Receptors, Thyroid Hormone/genetics
- Receptors, Thyroid Hormone/metabolism
- Signal Transduction
- T-Lymphocytes/immunology
- TCF Transcription Factors/metabolism
- Transcription Factor 7-Like 1 Protein
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Affiliation(s)
- Hongkang Xi
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, 101 Woodruff Circle, Atlanta, Georgia 30322
| | - Ruth Schwartz
- Division of Biological Sciences, University of California, San Diego, La Jolla, California 92903
| | - Isaac Engel
- La Jolla Institute for Allergy and Immunology, San Diego, California 92121
| | - Cornelis Murre
- Division of Biological Sciences, University of California, San Diego, La Jolla, California 92903
| | - Gilbert J Kersh
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, 101 Woodruff Circle, Atlanta, Georgia 30322.
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49
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Zoller AL, Kersh GJ. Estrogen Induces Thymic Atrophy by Eliminating Early Thymic Progenitors and Inhibiting Proliferation of β-Selected Thymocytes. J Immunol 2006; 176:7371-8. [PMID: 16751381 DOI: 10.4049/jimmunol.176.12.7371] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Although it has been established that high levels of estrogen can induce thymic involution, the mechanism by which this happens is not known. We have found that daily i.p. injections of the synthetic estrogen 17-beta-estradiol reduce thymus cellularity by 80% over a period of 4-6 days. Although the atrophy is most strikingly observed in the CD4/CD8 double-positive (DP) thymic subset, the loss of thymocytes is not accompanied by a significant increase in thymocyte apoptosis, suggesting that direct killing of cells may not be the dominant means by which estrogens induce thymic atrophy. Instead, we find that estradiol drastically reduces the lineage-negative, Flt3(+)Sca-1(+)c-Kit(+) population in the bone marrow, a population that contains thymic homing progenitors. Within the thymus, we observe that estradiol treatment results in a preferential depletion of early thymic progenitors. In addition, we find that estradiol leads to a significant reduction in the proliferation of thymocytes responding to pre-TCR signals. Reduced proliferation of DN3 and DN4 cell subsets is likely the major contributor to the reduction in DP thymocytes that is observed. The reduction in early thymic progenitors is also likely to contribute to thymic atrophy, as we show that estradiol treatment can reduce the size of Rag1-deficient thymuses, which lack pre-TCR signals and DP thymocytes.
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Affiliation(s)
- Allison L Zoller
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA
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50
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Schnell FJ, Zoller AL, Patel SR, Williams IR, Kersh GJ. Early growth response gene 1 provides negative feedback to inhibit entry of progenitor cells into the thymus. J Immunol 2006; 176:4740-7. [PMID: 16585567 DOI: 10.4049/jimmunol.176.8.4740] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The size of the thymus can be greatly influenced by changes in the small number of early progenitors in the thymus. However, it is not known whether thymic cellularity feeds back to regulate the recruitment, survival, and expansion of progenitors. The transcription factor early growth response gene 1 (Egr1) has been implicated in controlling proliferation and survival in many cell types. We have previously shown that mice deficient in Egr1 have increased thymic cellularity. We now show that Egr1 regulates a negative feedback signal that controls the entry of cells into the thymus. Egr1-deficient mice have higher percentages of early T lineage progenitors in the thymus, yet Egr1-deficient mice have normal numbers of myelolymphoid progenitors in the bone marrow, and Egr1-deficient thymocytes show normal rates of apoptosis and proliferation at all stages of development. Evidence from mixed bone marrow chimeras shows that the ability of Egr1 to control progenitor recruitment is mediated by bone marrow-derived cells, but is not cell autonomous. Furthermore, Egr1-deficient thymuses have increased P-selectin expression. The data suggest that Egr1 mediates a feedback mechanism whereby the number of resident double negative thymocytes controls the entry of new progenitors into the thymus by regulating P-selectin expression on thymic endothelial cells.
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Affiliation(s)
- Frederick J Schnell
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA
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