A super-spreading ewe infects hundreds with Q fever at a farmers' market in Germany

Porten, Klaudia; Rissland, Jürgen; Tigges, Almira; Broll, Susanne; Hopp, Wilfried; Lunemann, Mechthild; Treeck, Ulrich van; Kimmig, Peter; Brockmann, Stefan; Wagner-Wiening, Christiane; Hellenbrand, Wiebke; Buchholz, Udo

doi:10.1186/1471-2334-6-147

Cited by 131 publications

(125 citation statements)

References 18 publications

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“…In Germany, 100-500 symptomatic human infections with C. burnetii are reported annually, the trend is increasing, mostly as cases related to outbreaks. The largest previously described outbreak occurred in 2003, associated with a farmers' market in Soest [5]. Infected sheep have been implicated as the source of infection in 24 out of 40 documented outbreaks reported in Germany between 1947 and 1999 [6].…”

Section: Discussionmentioning

confidence: 99%

Large Q fever outbreak due to sheep farming near residential areas, Germany, 2005

Gilsdorf¹,

Kroh²,

Grimm³

et al. 2007

Epidemiol. Infect.

109

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SUMMARYIn June 2005 Coxiella burnetii-infected sheep, grazing and lambing on a meadow bordering a residential area, caused a large Q fever outbreak (331 cases) in Germany. Our outbreak investigation provided attack rates (AR) by distance between residence and meadow, sex and age groups. The AR of people living within 50 m of the meadow was 11 . 8%. It decreased the further the residence was from the meadow, falling to 1 . 3% at 350-400 m distance (RR 8 . 7, 95 % CI 4 . 5-17 . 1). The AR was higher in men (RR 1 . 4, 95 % CI 1 . 1-1 . 8). In the 25-64 years age group, the AR was 2 . 3 times higher compared to other age groups (95 % CI 1 . 7-3 . 0). The distance-related AR showed a relationship between risk of infection and living close to the meadow. Ongoing urbanization will probably lead to further Q fever outbreaks, hence prevention activities undertaken by animal and public health practitioners should be aligned and strengthened.

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Section: Discussionmentioning

confidence: 99%

Large Q fever outbreak due to sheep farming near residential areas, Germany, 2005

Gilsdorf¹,

Kroh²,

Grimm³

et al. 2007

Epidemiol. Infect.

109

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“…Chronic Q fever usually presents as a culture-negative endocarditis. Recent outbreaks of Q fever have been associated with exposure to C. burnetii via inhalation of aerosolized bacteria from infected livestock (cows, sheep, or goats) (1,14,15). C. burnetii can replicate to high levels in the placentas of infected animals and is an established endemic abortifacient in goats and sheep (2,9).…”

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confidence: 99%

Coxiella burnetii Infection of a Steller Sea Lion ( Eumetopias jubatus ) Found in Washington State

et al. 2010

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A pregnant sea lion stranded in the State of Washington was found to have placentitis caused by a unique strain of Coxiella burnetii. This is the first description of coxiellosis in a sea lion and suggests that exposure to sea lions may be a risk factor for contracting Q fever. CASE REPORTA pregnant adult female Steller sea lion (Stranding number WDFW2008-058) was found dead on the beach at Westhaven State Park in Westport, WA (lat 46.8981, long 124.1307), on 9 June 2008. The adult female had an estimated weight of 250 to 300 kg and was in fair body condition. Based on the condition of the body and the frequency of beach surveys in the area, the time since death was estimated at approximately 3 days. The animal was in moderate postmortem condition. The abdominal cavity was distended by the enlarged uterus, a near-term fetus, and approximately 2 liters of creamy, brown-pink exudate. Fish bones were dispersed throughout the omentum, and there was pronounced thickening and opacification of the omentum and mesentery. The spleen was moderately enlarged, and there was pronounced injection of the meningeal vasculature, with scattered hemorrhage throughout the surface of the brain. Gross necropsy of the fetus disclosed a near-term male with a weight of 19 kg. The fetus was in good body condition. The liver was friable, with scattered hemorrhage noted randomly through the lobes. The meningeal vessels were congested. Samples of representative organs were fixed in 10% buffered formalin, embedded in wax, sectioned at 5 m, and stained with hematoxylin and eosin.The most significant histological findings of the adult female were moderate diffuse lymphoid hyperplasia of the lymph nodes, diffuse pulmonary edema, and mild encephalitis. The fetus showed edema, with aspirated squames through the pulmonary parenchyma. The placenta also showed aggregates of enlarged trophoblasts within the chorioallantoic villi that had vacuolated granular cytoplasm.Ancillary diagnostic testing was performed at the British Columbia Animal Health Center. Bacterial cultures on blood agar showed light growth of Enterococcus spp. within the fetus lung, brain, spleen, and small intestine and the adult uterus. This was attributed to postmortem overgrowth. Cultures from adult and fetal small intestines in selenite broth followed by plating on XLT4 and Hektoen enteric agar tested negative for Salmonella spp. Pooled tissue (lymph node, lung, spleen, brain, uterus, and thymus) for both the adult and fetus was negative by PCR for Brucella spp. and morbillivirus (3,5,8). Brain, heart, and skeletal muscle samples from the adult and the fetus were submitted to the Laboratory of Parasitic Diseases, NIAID, Bethesda,

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“…13 Outbreaks of Q fever in human beings are often linked to airborne spread of the disease from infected ruminants, particularly during parturition. 8,9,14,21,23 As a result of its high infectivity, the possibility of spread via aerosols, and the potentially fatal consequences of infection, C. burnetii is categorized as a biosafety level 3 agent.…”

mentioning

confidence: 99%

Interlaboratory Comparison of Real-Time Polymerase Chain Reaction Methods to Detect Coxiella Burnetii, The Causative Agent of Q Fever

Jones

Hertwig

Pitman³

et al. 2011

J VET Diagn Invest

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Abstract. The bacterium Coxiella burnetii, which has a wide host range, causes Q fever. Infection with C. burnetii can cause abortions, stillbirth, and the delivery of weak offspring in ruminants. Coxiella burnetii infection is zoonotic, and in human beings it can cause chronic, potentially fatal disease. Real-time polymerase chain reaction (PCR) is increasingly being used to detect the organism and to aid in diagnosis both in human and animal cases. Many different real-time PCR methods, which target different genes, have been described. To assess the comparability of the C. burnetii real-time PCR assays in use in different European laboratories, a panel of nucleic acid extracts was dispatched to 7 separate testing centers. The testing centers included laboratories from both human and animal health agencies. Each laboratory tested the samples using their inhouse real-time PCR methods. The results of this comparison show that the most common target gene for real-time PCR assays is the IS1111 repeat element that is present in multiple copies in the C. burnetii genome. Many laboratories also use additional real-time PCR tests that target single-copy genes. The results of the current study demonstrate that the assays in use in the different laboratories are comparable, with general agreement of results for the panel of samples.

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A super-spreading ewe infects hundreds with Q fever at a farmers' market in Germany

Abstract: Background: In May 2003 the Soest County Health Department was informed of an unusually large number of patients hospitalized with atypical pneumonia.

Cited by 131 publications

References 18 publications

Large Q fever outbreak due to sheep farming near residential areas, Germany, 2005

Large Q fever outbreak due to sheep farming near residential areas, Germany, 2005

Coxiella burnetii Infection of a Steller Sea Lion ( Eumetopias jubatus ) Found in Washington State

Interlaboratory Comparison of Real-Time Polymerase Chain Reaction Methods to Detect Coxiella Burnetii, The Causative Agent of Q Fever

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