Vaccine prophylaxis of abattoir-associated Q fever: eight years' experience in Australian abattoirs

Marmion, B. P.; Ormsbee, R. A.; Kyrkou, M.; Wright, John; Worswick, D. A.; Izzo, Angelo A.; Esterman, Adrian; Feery, Brian J.; Shapiro, R. A.

doi:10.1017/s0950268800059458

Cited by 135 publications

(158 citation statements)

References 14 publications

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“…• Chronic fatigue syndrome characterized by an inappropriate fatigue, myalgia, arthralgia, night sweats and changes in moods and sleep patterns has been particularly described in Australia [9,93]. It may persist after an acute episode of Q fever and last several months or years.…”

Section: In Humansmentioning

confidence: 99%

“…Current vaccines used in humans and animals include formalin-killed whole-cell vaccine preparations (WCV) [93] and chloroform methanol-extracted bacterial residue (CMR) [47,175,183]. The two types of vaccines (WCV and CMR) protect monkeys (Macaca fascicularis) against fever and bacteremia (especially in the lungs) after challenge with an aerosol [176].…”

Section: Vaccinesmentioning

confidence: 99%

“…Pre-vaccination serological test and skin test with 0.02 mg of the vaccine are recommended in order to avoid reactions at the inoculation site. This vaccine has provided a full and lasting protection by preventing severe cases of Q fever [93]. It could be very useful in the protection of exposed populations and particularly in female veterinarians.…”

Section: Vaccinesmentioning

confidence: 99%

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Is Q Fever an emerging or re-emerging zoonosis?

2005

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-Q fever is a zoonotic disease considered as emerging or re-emerging in many countries. It is caused by Coxiella burnetii, a bacterium developing spore-like forms that are highly resistant to the environment. The most common animal reservoirs are livestock and the main source of infection is by inhalation of contaminated aerosols. Although the culture process for Coxiella is laborious, advances on the knowledge of the life cycle of the bacterium have been made. New tools have been developed to (i) improve the diagnosis of Q fever in humans and animals, and especially animal shedders, (ii) perform epidemiological studies, and (iii) prevent the disease through the use of vaccines. This review summarizes the state of the knowledge on the bacteriology and clinical manifestations of Q fever as well as its diagnosis, epidemiology, treatment and prevention in order to understand what factors are responsible for its emergence or re-emergence. Coxiella burnetii / epidemiology / bacteriology / diagnostic / control

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Section: In Humansmentioning

confidence: 99%

Section: Vaccinesmentioning

confidence: 99%

Section: Vaccinesmentioning

confidence: 99%

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Is Q Fever an emerging or re-emerging zoonosis?

2005

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“…In 1984, 924 abattoir workers were given Q-Vax, with no evidence of Q fever at 18 months post-vaccination (Marmion et al, 1984). This was supported by a review of 4000 patients trialled with Q-Vax; all eight cases of endocarditis developed prior to the expected timing of vaccinemediated immunity, suggesting that vaccination occurred during the incubation period of natural Q fever infection (Marmion et al, 1990). Furthermore, a 5 year follow-up study demonstrated that only two patients from a cohort of 2553 vaccinated patients developed breakthrough Q fever infection.…”

Section: Discussionmentioning

confidence: 96%

“…This further confirms that disease seldom exists if vaccination occurs correctly. Routine postvaccine serology is not recommended due to resultant longterm cell-mediated immunity and successful vaccine efficacy (Ackland et al, 1994;Marmion et al, 1990;Gefenaite et al, 2011). Moreover, most cases of Q fever endocarditis occur in patients with previous valvulopathies (Houpikian & Raoult, 2005), highlighting the importance of vaccination and increased vigilance in those with underlying valvular pathology.…”

Section: Discussionmentioning

confidence: 99%

Coxiella burnetii endocarditis after Q fever vaccination

Trubiano

Holmes

Williams

et al. 2012

Journal of Medical Microbiology

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Coxiella burnetii is the causative bacterium of Q fever, a vaccine-preventable infection. C. burnetii is an unusual cause of culture-negative endocarditis. Here, we present a case of Q fever native valve endocarditis that developed in a young man despite prior vaccination. Definitive diagnosis was difficult and required C. burnetii-specific PCR testing. Case reportA 29-year-old Australian man was admitted in April 2012 for elective aortic and mitral valve replacement for progressive severe aortic and mitral regurgitation with mild aortic root dilatation from Marfan's syndrome. His past medical history included a meticillin-susceptible Staphylococcus aureus-colonized chronic left leg ulcer requiring oral flucloxacillin 500 mg four-times daily, chronic fatigue syndrome and recent partial dental clearance. He denied intravenous drug use. He lived in a country town where he worked as a house painter.A St Jude mitral and aortic valve replacement was performed with preservation of the aortic root. An intraoperative diagnosis of native valve infective endocarditis was suspected due to the appearance of concurrent healed aortic and mitral valve vegetations. Interestingly, his preoperative transoesophageal echocardiogram was normal.Post-operatively, further history of occupational and environmental exposures relevant to endocarditis was obtained. Cat scratches, farm animal exposure, ingestion of unpasteurized milk and abattoir work raised the possibility of Bartonella spp., Brucella spp. and Coxiella burnetii (Q fever) as infectious aetiologies. Twelve years earlier (late March 2000), he commenced work at a local abattoir. At commencement of employment, he underwent a medical review and was screened for Q fever on 28 March 2000: baseline serology was negative (immunofluorescence phase II antibody ,10, complement fixation test against phase II antigen ,2.5), and a skin test using 0.5 ml purified killed suspension of C. burnetii was also negative. Documentation illustrates that he was subsequently vaccinated 7 days later with Q-Vax (CSL Biotherapies Q fever vaccine 0.5 ml containing 25 mg purified killed suspension of C. burnetii). He worked at the abattoir for 8 months. Approximately 9 months later, he reported to his local medical officer with unexplained loss of weight (30 kg) and fatigue. In the intervening years prior to cardiac surgery, he also reported intermittent drenching night sweats; however, C. burnetii serology was not performed nor did he receive any antibiotic treatment other than flucloxacillin for his leg ulcer.Physical examination was remarkable for marfanoid features and chronic venous insufficiency of his left leg without active infection. An orthopantomogram excluded an odontogenic source of infection. Blood cultures performed intraand post-operatively revealed Staphylococcus hominis in 1 of 12 bottles; this was judged to represent contamination, and other culture bottles remained negative with extended incubation to 21 days. There were polymorphonuclear leukocytes on aortic and mitral valve tissue, b...

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