Seroepidemiologic and Occupational Risk Survey for<i>Coxiella burnetii</i>Antibodies among US Veterinarians

Whitney, Ellen A. Spotts; Massung, Robert F.; Candee, Amanda J.; Ailes, Elizabeth C.; Myers, Lee M.; Patterson, Nicole E.; Berkelman, Ruth L.

doi:10.1086/596705

Cited by 103 publications

(106 citation statements)

References 24 publications

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“…6 For example, a recent study among U.S. veterinarians found a Q fever seroprevalence of 22.2% and an association to veterinarians working with cattle and wildlife. 17 Stable estimates by occupational exposure could not be produced in this study because data on agricultural occupations were limited.…”

Section: Discussionmentioning

confidence: 96%

Seroprevalence of Q Fever in the United States, 2003–2004

Anderson

Kruszon-Moran²,

Loftis³

et al. 2009

The American Journal of Tropical Medicine and Hygiene

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Abstract. We performed serum testing for IgG antibodies against Coxiella burnetii (phase I and phase II) and analyzed questionnaire data from 4,437 adults ≥ 20 years of age who participated in the National Health and Nutrition Examination Survey 2003-2004 survey cycle. National Q fever seroprevalence was determined by enzyme-linked immunosorbent assay and confirmed by using immunofluorescent antibody testing. Overall seroprevalence for Coxiella burnetii was 3.1% (95% confidence interval [CI] = 2.1-4.3%) among 4,437 adults ≥ 20 years of age. Coxiella burnetii age-adjusted antibody prevalence was higher for men than for women (3.8%, 95% CI = 2.7-5.2% versus 2.5%, 95% CI = 1.5-3.7%, respectively, P < 0.05). Mexican Americans had a significantly higher antibody prevalence (7.4%, 95% CI = 6.6-8.3%) than either nonHispanic whites (2.8%, 95% CI = 1.7-4.3%) or non-Hispanic blacks (1.3%, 95% CI = 0.6-2.5%) ( P < 0.001). Multivariate analysis showed that the risk for Q fever antibody positivity increased with age and was higher among persons who were foreign-born, male, and living in poverty. These findings indicate that the national seroprevalence of Q fever in the United States is higher than expected on the basis of case numbers reported to the Centers for Disease Control and Prevention from state health departments. Potential differences in risk for exposure by race/ethnicity warrant further study.

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Section: Discussionmentioning

confidence: 96%

Seroprevalence of Q Fever in the United States, 2003–2004

Anderson

Kruszon-Moran²,

Loftis³

et al. 2009

The American Journal of Tropical Medicine and Hygiene

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“…We may expect that most deer-livestock and deer-human transmission events would occur indirectly (52). Therefore, the risk of transmission from deer to livestock and humans depends on the exposure rate of deer, suggesting that extensively produced domestic ruminants and humans involved in hunting and wild ungulate management and conservation face a higher risk (9,53).…”

Section: Discussionmentioning

confidence: 99%

Host and Environmental Factors Modulate the Exposure of Free-Ranging and Farmed Red Deer (Cervus elaphus) to Coxiella burnetii

González‐Barrio

Ávila

Boadella³

et al. 2015

Appl Environ Microbiol

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fThe control of multihost pathogens, such as Coxiella burnetii, should rely on accurate information about the roles played by the main hosts. We aimed to determine the involvement of the red deer (Cervus elaphus) in the ecology of C. burnetii. We predicted that red deer populations from broad geographic areas within a European context would be exposed to C. burnetii, and therefore, we hypothesized that a series of factors would modulate the exposure of red deer to C. burnetii. To test this hypothesis, we designed a retrospective survey of 47 Iberian red deer populations from which 1,751 serum samples and 489 spleen samples were collected. Sera were analyzed by enzyme-linked immunosorbent assays (ELISA) in order to estimate exposure to C. burnetii, and spleen samples were analyzed by PCR in order to estimate the prevalence of systemic infections. Thereafter, we gathered 23 variables-within environmental, host, and management factors-potentially modulating the risk of exposure of deer to C. burnetii, and we performed multivariate statistical analyses to identify the main risk factors. Twenty-three populations were seropositive (48.9%), and C. burnetii DNA in the spleen was detected in 50% of the populations analyzed. The statistical analyses reflect the complexity of C. burnetii ecology and suggest that although red deer may maintain the circulation of C. burnetii without third species, the most frequent scenario probably includes other wild and domestic host species. These findings, taken together with previous evidence of C. burnetii shedding by naturally infected red deer, point at this wild ungulate as a true reservoir for C. burnetii and an important node in the life cycle of C. burnetii, at least in the Iberian Peninsula.C oxiella burnetii is a Gram-negative intracellular bacterium that causes Q fever, a disease that affects both humans and animals. Whereas the epidemiological status of C. burnetii in European domestic ruminants is well known (1), information for wildlife is mostly local and scattered (2, 3). Although the majority of human Q fever outbreaks are linked to the transmission of C. burnetii from domestic ruminants (4, 5), the ability of C. burnetii to infect wild hosts (3, 6) and its high environmental resistance (1) make wildlife species potential reservoirs of C. burnetii. Based on this hypothesis, wildlife could maintain C. burnetii and transmit it to wildlife (7), domestic animals (8), or humans (9). It is therefore of paramount relevance (i) to identify those potential wild reservoir species that could, through direct and indirect interactions, transmit C. burnetii to target species (domestic animals and humans) and (ii) to determine which environmental factors are the main drivers of C. burnetii within the most relevant wild reservoirs. Efficient prevention of C. burnetii transmission at the wildlifedomestic-animal-human interface can be approached only once the main reservoirs have been identified and the driving risk factors are known (10).Several wild ruminant species are present and wel...

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“…Q fever is also recognized as an occupational risk for people who work with animals or animal products, including veterinarians, sheep and dairy workers, meat processing plant workers, laboratory workers, hide handlers, wool spinners, taxidermists and butchers [8]. Few occupational health studies have been conducted to examine occupational exposure and rates of infection among exposed workers [9]. In Italy, a seroprevalence of Q fever in sheep, goats, cows and buffaloes has been reported, and the presence of DNA of C. burnetii in dogs was 31.5% in Sicilian area and 7% in Southern Italy [10,11].…”

Section: Introductionmentioning

confidence: 99%

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

Fenga¹,

Gangemi²,

Luca³

et al. 2015

Int J Occup Med Environ Health

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International Journal of Occupational Medicine and EnvironmentalThe aim of this survey was to assess the seroprevalence of antibodies against Coxiella burnetii (C. burnetii) in subjects at risk of exposure in Sicily, Southern Italy. Material and Methods: Prevalence of IgG antibodies to C. burnetii phase II antigens was evaluated by ELISA in a group of 140 workers at risk of exposure (38 veterinarians, 38 slaughterhouse workers, 44 livestock handlers, 20 laboratory and technical personnel) included in a medical surveillance program and in 42 control subjects. Positive samples were classified as suggestive of prior exposure to C. burnetii. Results: Antibodies against C. burnetii were detected in 88 out of 140 (62.9%) exposed workers and in 6 out of 42 (14.3%) subjects of the control group. The variables evaluated did not seem to have a significant effect on seropositivity to Coxiella with the exception of symptoms in the last 6 months preceding the survey. Conclusions: Our study demonstrated a high seroprevalence of C. burnetii in the group of exposed workers in comparison to non-exposed subjects of the control group. 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. As aerosols represent the main route of infection in animals and humans, these workers are strongly advised to wear respiratory masks. In addition, occupational physicians should consider routine serologic evaluation and vaccination of occupationally exposed workers.

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Seroepidemiologic and Occupational Risk Survey forCoxiella burnetiiAntibodies among US Veterinarians

Cited by 103 publications

References 24 publications

Seroprevalence of Q Fever in the United States, 2003–2004

Seroprevalence of Q Fever in the United States, 2003–2004

Host and Environmental Factors Modulate the Exposure of Free-Ranging and Farmed Red Deer (Cervus elaphus) to Coxiella burnetii

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

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