High Seroprevalence ofCoxiella burnetiiAntibodies in Veterinarians Associated with Cattle Obstetrics, Bavaria, 2009

Abstract

Q fever is a zoonosis caused by Coxiella burnetii. Infection can result in severe disease. However, little is known about the risk of infection in veterinarians. In a cross-sectional study among German veterinarians, participants provided sera and completed an exposure questionnaire. We investigated predictors for seropositivity using multivariable logistic regression modelling. The 424 participants' median age was 40 (18-74) years, and 276 (65%) were female. Sera of 162 (38%) were positive for Coxiella burnetii phase II IgG antibodies (by ELISA and IFAT). Predictors for seropositivity were occupational exposure to cattle (aOR 2.83, 95% CI 1.64-4.87), occupational exposure to sheep (2.09, 1.22-3.58), male sex (1.9, 1.15-3.13), and increasing age (30-39 years: 4.91, 2.00-12.04; 40-49 years: 5.32, 2.12-13.33; >50 years: 6.70, 2.60-17.25; compared with <30 years). When investigating occupational exposure to cattle and sheep in detail in a separate model, the seroprevalence increased with increasing numbers of cattle obstetrics procedures performed per month, and with increasing numbers of individual cattle treated per week. The high antibody prevalence implies a high lifetime-risk of Q fever in veterinarians. Cattle veterinarians, especially those frequently performing obstetrics, should be counseled early in their career on the clinical picture of Q fever, and on specific risks.

Coxiella burnetiiSeroprevalence and Risk for Humans on Dairy Cattle Farms, the Netherlands, 2010–2011

“…As determined on the basis of phase II IgM, 1.2% of DCF residents and 11.0% of small-ruminant dairy farm residents had a relatively recent C. burnetii infection ( 12 , 13 ), indicating that the infection among DCF residents was generally in the more distant past. Physicians diagnosed Q fever in 0.5% of DCF residents in our study compared with 4.1% in Dutch goat farm residents ( 12 ); nevertheless, to ensure a timely diagnosis and treatment, physicians should consider Q fever in patients with compatible symptoms and occupational exposure to cattle ( 20 , 21 ). In general, clinical illness from C. burnetii infection appears to be rare among DCF residents, which fits the suggestion in the literature that cattle-acquired C. burnetii infection has a milder clinical course ( 20 ).…”

Seroprevalence and occupational risk survey for Coxiella burnetii among exposed workers in Sicily, Southern Italy

“…In general, clinical illness appears to be rare; nevertheless, physicians should consider Q fever in patients with compatible symptoms and occupational exposure to animals and their products [24]. The infection by C. burnetii in the population studied was not significantly affected by drinking unpasteurized milk, age and sex.…”

“…International prevalence rates vary greatly. For example, published prevalence rates for cattle workers in Sweden, Austria, Bavaria and Spain vary from 10% to 30% [21][22][23][24][25]. Such variation may reflect either geographical differences and/or variable sensitivity of the available testing techniques (e.g., complement fixation test -CFT, ELISA, immunofluorescence assay, skin prick testing) [8].…”

<b><i>Coxiella burnetii</i></b> - Pathogenic Agent of Q (Query) Fever

“…At the center of the epidemic (Hertogenbosch), 10.7% (84 of 785) of the persons tested in the screening program had Phase II IgG antibodies, resulting in an estimate of around 40,600 exposed persons for the entire region [58]. In Europe, outbreaks of Q fever in sheep herds occurred in the German Federal states of Baden-Württemberg [59], Bavaria [60] and Thuringia [61], as well as in France [62], Cheltenham in England [63], and Bosnia [64]. C. burnetii infected individuals were also identified among soldiers returning from Kuwait [65], Iraq [66], and Afghanistan [67].…”

“…Around 12% of the population of Montana, USA, have C. burnetii antibodies [140]. A Coxiella antibody prevalence of 38% (162/424) was found among veterinarians in Germany [60]. …”