High prevalence of Coxiella burnetii infection in humans and livestock in Assiut, Egypt: A serological and molecular survey

Abstract

Background and Aim: Q fever is considered a neglected zoonotic disease and is caused by Coxiella burnetii. Very little information is available on C. burnetii infections in cattle, sheep, and goat populations in Egypt. The aim of this study was to identify the seroprevalence of C. burnetii in humans and livestock and to test for the presence of C. burnetii DNA in sera from seropositive animals and humans. Materials and Methods: Blood samples were collected from 160 apparently healthy farm animals and 120 patients from three hospitals of the Assiut Governorate throughout 2017/2018. These populations were tested for antibodies against C. burnetii phase II antigen by immunofluorescence assay [IFA]) and enzyme-linked immunosorbent assay (ELISA). Seropositive samples were subjected to real-time quantitative polymerase chain reaction (RT-qPCR). Results: The results of the IFA revealed C. burnetii seroprevalence rates of 45.3%, 56.0%, 45.7%, and 53.3% in cattle, sheep, goats, and humans, respectively. In humans, the seroprevalence rates were 52.1%, 30.4%, 37.5%, 74.1%, and 62.5% in patients with fever of unknown origin, influenza, kidney dialysis, hepatitis C virus, and hepatitis B virus, respectively. Likewise, by ELISA, the seroprevalence in bovine was 50.7%; sheep, 60.0%; goats, 51.4%; and humans, 55.0% (54.3%, 30.4%, 37.5%, 77.8%, and 62.5% in patients with fever of unknown origin, influenza, kidney dialysis, hepatitis C virus, and hepatitis B virus, respectively). RT-qPCR targeting the repetitive element IS1111 confirmed the presence of C. burnetii DNA. Conclusion: These results proved that apparently healthy cattle, sheep, and goats may be very important reservoirs of C. burnetii infection. In light of these data, the effect of Q fever on the replication of hepatitis virus remains unclear. Although hepatitis is one of the main aspects of acute Q fever, the influence of hepatitis on Q fever remains to be investigated. Q fever is not a reportable disease in Egypt, and clinical cases may rarely be recognized by the health-care system. Additional information on the epidemiology of C. burnetii in Egypt is warranted, including other associated problems such as the distribution of infections, pathologic hallmarks, and molecular typing.

Seroprevalence of Coxiella burnetii (Q fever) in Cows and Buffaloes in Egypt

“…These results confirm that IgM results provide subsidiary evidence to IgG titers (CDC 2013). The overall seroprevalence of C. burnetii Abs in this study was 31.5% which is nearly the same (30.7%) as reported by Jarelnabi et al (2018) in Saudi Arabia while disagree with the findings of Abbass et al (2020) who reported 45.3% seroprevalence in cattle may be due to different period. Also disagree with Johnson et al (2019) who reported 21.7% seroprevalence in cattle in Ghana.…”

“…Clinical signs of coxiellosis in animals vary, usually asymptomatic with subclinical presentation except in ruminants, where it is usually characterized by reproductive problems such as abortion, premature birth, stillbirth, weak offspring, endometritis and infertility (Agerholm 2013;Carbonero et al 2015;OIE 2015;Chochlakis et al 2018). Q fever is a neglected zoonosis in Egypt, and limited data on coxiellosis in human, and animals are available (Abbass et al 2020). The accurate diagnosis of coxiellosis in animals is of great importance to identify the infected flocks and to determine the public health significance of the disease in human (OIE 2016).…”

The prevalence of Q fever in the Eastern Mediterranean region: a systematic review and meta-analysis

“…Therefore, this disease can be classified as an occupational disease. 40 Also, the frequency of livestock breeding and the infrastructure of microbiological diagnostic tests, specific epidemiological care, and awareness of the disease affect the spread or control of this disease 36 . Although the prevalence of this disease may lead to underestimation of this infection, as the symptoms are nonspecific and similar to those of other infectious diseases 33 , several studies on human antibodies to C. burnetii antigens show that Q fever is a major challenge in many countries.…”

The first report of seroprevalence of Q fever in water buffaloes (Bubalus bubalis) in Phatthalung, Thailand

“…Q fever is an example of a "One Health" approach. There are several studies also describing the occurrence of this infection in people working with ruminants, such as farmers, veterinarians, and animal health officers [3,6,20,21]. Unfortunately, we did not collect human samples for analysis in the present study.…”