Who is at risk of occupational Q fever: new insights from a multi-profession cross-sectional study

Abstract

ObjectivesQ fever is a zoonosis caused by the bacteriumCoxiella burnetii. It is recognised as an occupational hazard for individuals who are in regular contact with animal birth products. Data from the literature are not comparable because different serological assays perform very differently in detecting past infections. It is therefore essential to choose the right assay for obtaining reliable data of seroprevalence. Obstetricians are another profession potentially at risk of Q fever. They can be infected from birth products of women with Q fever during pregnancy. There is little data, however, for Q fever in this occupational group. Our study therefore had two purposes. The first was to obtain reliable seroprevalence data for occupational groups in regular contact with animal birth products by using an assay with proven excellent sensitivity and specificity for detecting past infections. The second purpose was to obtain primary data for obstetricians.DesignWe carried out a cross-sectional study.SettingThe study included shepherds, cattle farmers, veterinarians and obstetricians from Thuringia.Participants77 shepherds, 74 veterinarians, 14 cattle farmers, 17 office employees and 68 obstetricians participated. The control group consisted of 92 blood donors.Primary outcome measureThe primary outcome measure wasC. burnetiiphase II specific IgG. The assay used was evaluated for this purpose in a previous study.ResultsOf the 250 blood samples we analysed, the very highest seroprevalences (64%–77%) occurred in individuals with frequent animal contact. There were no significant differences between shepherds, cattle farmers and veterinarians. The seroprevalence in people working in administration was lower but still significantly greater than the control. No obstetricians or midwives tested positive.ConclusionsShepherds, cattle farmers and veterinarians have a high risk ofC. burnetiiinfection. However, our study clearly proves that there was no increased risk for people working in an obstetric department.

The Prevalence of Coxiella burnetii in Hard Ticks in Europe and Their Role in Q Fever Transmission Revisited—A Systematic Review

“…In their birth products, large amounts of infectious agents can be detected ( 7 , 8 ). As the infective dose by inhalation is <10 bacteria, farmers, and veterinarians are especially at high risk of acquiring this disease through contact with infected animals and their products ( 9 , 10 ). Coxiella burnetii develops spore-like forms, which are resistant to environmental stressors such as desiccation or sunlight.…”

Q fever prevention and vaccination: Australian livestock farmers' knowledge and attitudes to inform a One Health approach

“…Clinical manifestations span asymptomatic infections, acute disease, chronic Q fever and post Q fever fatigue syndrome [ 3 , 4 ]. Livestock farmers bear substantial burden of Q fever zoonosis [ 3 , 5 ].…”

Evaluation of the Diagnostic Potential of Recombinant Coxiella burnetii Com1 in an ELISA for the Diagnosis of Q Fever in Sheep, Goats and Cattle

“…As reproductive disorders can have different etiologies, Q fever is often not considered and the spread of C. burnetii via aerosols proceeds [ 9 ]. C. burnetii is highly contagious also for humans and is an occupational hazard for people in close contact with infected ruminants like farmers, shepherds and veterinarians as well as abattoir workers [ 5 , 6 , 10 ]. The typical course of disease is an acute, often self-limiting flu-like illness.…”