Coxiella burnetii in periprosthetic joint infection: a case and systematic review / 中华骨科杂志

One case of periprosthetic infection after artificial joint replacement caused by Coxiella burnetii was reported. The patient was admitted to hospital due to joint pain and sinus formation after artificial knee replacement. Through medical history, physical examination, imaging examination and gene detection, it was confirmed that the infection around the prosthesis was caused by Coxiella burnetii. The patient was treated with two-stage revision surgery combined with sensitive antibiotics. Through literature review, a total of 9 cases of Coxiella burnetii infection after artificial joint replacement were reported, including 6 cases of hip joint and 3 cases of knee joint; 4 cases had clear pathogen exposure history; only one case was found protheses loosening on imaging; 7 cases with positive IgG antibody against Coxiella burnetii; 7 cases were positive for gene detection; 8 cases were negative in etiological examination, and 1 case was not cultured. All patients were treated with doxycycline and hydroxychloroquine. The serological index of 1 case without Q fever symptom turned negative after treatment. 1 case with multiple system organ dysfunction relieved symptoms after treatment, and serological antibody indicators and nuclear medicine results turned negative. All 7 patients were cured after secondary revision surgery. Coxiella burnetii infection after total joint arthroplasty is rare and lacks typical imaging manifestations and clinical features. The diagnosis of Coxiella burnetii infection after total joint arthroplasty mainly depends on gene detection and serological detection. Two-stage revision surgery combined with sufficient and long-term sensitive antibiotics is the main method of treatment.

Overview of Q fever in Brazil: an underestimated zoonosis

ABSTRACT This review aims to provide current information about Q fever, elucidating the etiological, epidemiological, pathogenic, clinical, diagnostic, therapeutic, and prophylactic aspects of the disease for the medical community. We discuss the main forms of presentation of the agent, its ability to persist in the body, the infinite possibilities of susceptible hosts, the main known forms of transmission, its importance in populations at occupational risk, and the role of arthropods in the natural history of the disease. Focusing on Brazil, we present the cases already described and studies developed since its first report, and how there is still much to unravel. We are aware of the possibilities of the persistence of the agent and the development of severe clinical pictures and the specific treatments currently instituted. We also wish to raise awareness about the future, the new genotypes that are emerging, the need to study the effects of vaccines, and the impact of Q fever on the population. Q fever is a poorly understood disease in Latin America, and recent studies, especially in Brazil, have revealed the importance of developing new studies.

Fiebre Q: revisión histórica de casos humanos en Uruguay. Abordaje desde la complementariedad entre las ciencias médicas y veterinarias / Q fever: historical review of human cases in Uruguay. A complementary approach from the medical and veterinarian sciences / Febre Q: revisão histórica de casos humanos no Uruguai. Abordagem a partir da complementaridade entre as ciências médicas e veterinárias

Resumen: La fiebre Q es una zoonosis distribuida mundialmente, causada por Coxiella burnetii. Los bovinos, ovinos y caprinos son la fuente más frecuente de infección en humanos, en los que la enfermedad es de notificación obligatoria ante el Ministerio de Salud Pública. Revisamos las publicaciones que describen casos de fiebre Q en humanos en Uruguay, con foco en sus características epidemiológicas, y discutimos las pruebas diagnósticas disponibles localmente. Se incluyeron nueve trabajos publicados e información del registro de enfermedades profesionales. Colectivamente fueron analizadas 2.715 personas con sospecha de fiebre Q entre 1956-2019, siendo 959 (35,3%) seropositivas. Los diagnósticos se basaron en serología, clínica y/o antecedentes de exposición laboral. Epidemiológicamente, el ganado o material proveniente del mismo fueron considerados las fuentes más probables de exposición en la mayoría de los casos. Según el ámbito de ocurrencia, no sistemáticamente reportado, los casos se registraron principalmente por exposición a ovinos y bovinos en frigoríficos o en la cadena cárnica (positivos/evaluados: 863/1540; seropositivos sintomáticos: 585); y en menor medida a bovinos lecheros (sector lácteo (positivos/evaluados:20/58; seropositivos sintomáticos: 17) y laboratorio diagnóstico (positivos/evaluados:2/4; seropositivos sintomáticos: 1)), o rumiantes silvestres (seropositivos/evaluados:25/117; seropositivos sintomáticos: 17). Hipertermia, cefaleas y sudoración fueron reportados. La inhalatoria fue asumida como la vía de infección en todos los casos. Actualmente no están disponibles localmente pruebas de PCR para detección de C. burnetii en humanos, siendo una limitante en el diagnóstico, particularmente en etapas tempranas. La colaboración interdisciplinaria de profesionales de salud humana y animal es esencial en el abordaje de esta zoonosis.

Summary: Q fever is a globally distributed zoonosis caused by the bacteria Coxiella burnetii. Bovines, sheep and goats are the most frequent source of infection in humans, and it is mandatory for the latter to report the disease to the Ministry of Public Health. We reviewed the literature describing cases of Q fever in humans in Uruguay, focusing on epidemiological characteristics, and we discussed the diagnostic tests locally available. Nine published studies were included in the review, as well as the information in the professional diseases registry. 2.715 people with a suspicion of Q fever were collectively analyzed between 1956-2019, 959 (55.3%) of them being seropositive. Diagnosis were based on serology, clinical examination and/or a history of exposure while working. Epidemiologically, the cattle or material originating in it were considered as the most probable sources of exposure in most cases. Depending on the context cases arose, which were not systematically reported, they were mainly caused by exposure to sheep and cows in meat processing plants or in the meat chain (positive/evaluated: 863/1540; seropositive or symptomatic: 585); and to a lesser extent dairy cattle (milk sector (positive/evaluated: 20/58; symptomatic seropositive: 17) and diagnostic laboratory (positive/evaluated: 2/4; symptomatic seropositive: 1)) or wild ruminants (positive/evaluated: 25/117; symptomatic seropositive: 17). Hyperthermia, headaches and sweating were reported. In all cases inhalation was adopted as the source of infection. Today, there are no PCR tests to detect C. burnetii in humans available locally, what constitutes a limitation to diagnosis, in particular in early stages. Interdisciplinary collaboration between animal and human health professionals is key to approach this zoonosis.

Resumo: A febre Q é uma zoonose mundial causada por Coxiella burnetii. Bovinos, ovinos e caprinos são a fonte mais frequente de infecção em humanos, nos quais a doença é de notificação compulsória ao Ministério da Saúde Pública. Revisamos as publicações que descrevem casos de febre Q em humanos no Uruguai, enfocando em suas características epidemiológicas, e discutimos os testes diagnósticos disponíveis localmente. Foram incluídos nove trabalhos publicados e informações do registro de doenças ocupacionais. Foram analisadas 2.715 pessoas com suspeita de febre Q entre 1956-2019, das quais 959 (35,3%) eram soropositivas. Os diagnósticos foram baseados na sorologia, sintomas e/ou história de exposição ocupacional. Do ponto de vista epidemiológico, o gado ou material preveniente de gado foram considerados as fontes mais prováveis de exposição na maioria dos casos. De acordo com o lugar de ocorrência, não notificado sistematicamente, os casos foram registrados principalmente por exposição a ovinos e bovinos em matadouros ou na cadeia da carne (positivos/avaliados: 863/1540; soropositivos sintomáticos: 585); e em menor proporção gado leiteiro (setor leiteiro (positivo/avaliado: 20/58; soropositivo sintomático: 17) e laboratório de diagnóstico (positivo/avaliado: 2/4; soropositivo sintomático: 1)), ou ruminantes silvestres (soropositivo/avaliado: 25/117; soropositivos sintomáticos: 17). Hipertermia, dores de cabeça e sudorese foram relatados. A inalação foi assumida como via de infecção em todos os casos. Atualmente, os testes de PCR para detecção de C. burnetii em humanos não estão disponíveis localmente, sendo uma limitação no diagnóstico, principalmente em estágios iniciais. A colaboração interdisciplinar de profissionais de saúde humana e animal é essencial no enfrentamento dessa zoonose.

Coxiella-like bacteria in Haemaphysalis wellingtoni ticks associated with Great Hornbill, Buceros bicornis

@#Birds are known to be the most mobile hosts and are therefore considered to be hosts with potential to contribute to the long-distance spread and transmission of tick-borne pathogens. In the present study, ticks were collected from a hornbill nest at Chaiyaphum Province, Thailand. They were screened for the presence of Coxiella bacteria using conventional PCR. The evolutionary relationships of positive Coxiella-like bacteria (CLB) were analysed based on the gene sequences of 16S rRNA, groEL and rpoB. Among all 22 tested ticks, CLB infections were found in 2 Haemaphysalis wellingtoni individuals. In a phylogenetic analysis, the Coxiella 16S rRNA gene detected in this study formed a separate clade from sequences found in ticks of the same genus. In contrast, the phylogenetic relationships based on groEL and rpoB revealed that these two genes from H. wellingtoni ticks grouped with CLB from the same tick genus (Haemaphysalis). This study is the first to report the presence of CLB in H. wellingtoni ticks associated with the Great Hornbill, Buceros bicornis in Thailand. Three genes of CLB studied herein were grouped separately with Coxiella burnetii (pathogenic strain). The effects of CLB in the ticks and Buceros bicornis require further investigation.

Analysis on the prokaryotic microbiome in females and embryonic cell cultures of Rhipicephalus sanguineus tropical and temperate lineages from two specific localities in Brazil / Análise do microbioma procarionte de fêmeas e cultura celular embrionária de Rhipicephalus sanguineus linhagens tropical e temperada de duas localidades no Brasil

Abstract Two lineages of Rhipicephalus sanguineus are known in Brazil: the temperate or southern and the tropical or northern populations. The distribution patterns of both lineages of R. sanguineus have epidemiological implications that can affect vectorial competence concerning Ehrlichia canis, the agent of canine monocytic ehrlichiosis. Intending to identify the microbiomes of both lineages and compare microorganisms in R. sanguineus, we used the 16S rRNA (V4-V5 region) gene-based metataxonomic approach, through NGS sequencing on the MiSeq Illumina platform. We selected specimens of females from the environment and samples of primary embryonic cell cultures, from both lineages, and this was the first study to investigate the prokaryotic microbiome in tick cell cultures. The results showed that many bacterial taxa detected in the samples were typical members of the host environment. A significant diversity of microorganisms in R. sanguineus females and in embryonic cell cultures from both lineages was found, with emphasis on the presence of Coxiella in all samples, albeit in different proportions. The Coxiella species present in the two lineages of ticks may be different and may have co-evolved with them, thus driving different patterns of interactions between ticks and the pathogens that they can harbor or transmit to vertebrate hosts.

Resumo Duas linhagens de Rhipicephalus sanguineus são conhecidas no Brasil: populações da linhagem temperada ou do sul, e tropical ou do norte. Os padrões de distribuição de ambas as linhagens de R. sanguineus têm implicações epidemiológicas, podendo afetar a competência vetorial de Ehrlichia canis, o agente etiológico da erliquiose monocítica canina. Com a intenção de identificar os microbiomas de ambas as linhagens e comparar microrganismos de R. sanguineus, foi utilizada a metataxonomia, baseada no gene 16S rRNA (região V4-V5), por meio do sequenciamento de nova geração na plataforma MiSeq Illumina. Foram selecionadas amostras de fêmeas do ambiente e cultivo primário de células embrionárias, considerando-se as duas linhagens conhecidas do Brasil. Este é o primeiro estudo que investiga o microbioma procariótico de células de cultura de carrapato. Os resultados mostram que muitos grupos de bactérias detectadas nas amostras são membros típicos do ambiente do hospedeiro. Uma diversidade significativa de microrganismos em fêmeas e cultura de células embrionárias nas duas linhagens de R. sanguineus foi encontrada, com ênfase na presença de Coxiella em todas as amostras, ainda que em diferentes proporções. Possivelmente, as espécies de Coxiella presentes nas duas linhagens de carrapatos são diferentes e co-evoluíram com essas linhagens, conduzindo a diferentes padrões de interação entre carrapatos e patógenos que podem abrigar ou transmitir aos hospedeiros vertebrados.

First molecular detection of Coxiella burnetii in Brazilian artisanal cheese: a neglected food safety hazard in ready-to-eat raw-milk product

ABSTRACT Background: Global publications on Q fever have increased after the 2007 epidemic in the Netherlands. However, the epidemiology of Q fever/coxiellosis in Brazil is still poorly understood. Accordingly, there have been few studies investigating the presence of Coxiella burnetii in dairy products around the world, especially in Brazil, where consumption of fresh cheese made from raw-milk is very high. Objective: This study was a random survey to assess the prevalence of C. burnetii by PCR in traditional Minas artisanal cheese from the Serro microregion, Brazil, which is manufactured from bovine raw-milk. Methods: DNA extracted from 53 cheese samples were analyzed by nested PCR with C. burnetii-specific primers and the products confirmed by DNA sequencing. Results: Out of the 53 cheese samples five (9.43%) were C. burnetii DNA-positive, each coming from one of the respective randomly selected manufacturing agroindustries.Based on our results, it is estimated that 1.62 tons/day of ready-to-eat cheese made from raw-milk from a total of 16.2 tons produced daily in the study region are contaminated with C. burnetii. Conclusion: To our knowledge, this is the first report of highly heat-resistant zoonotic pathogen in raw-milk Brazilian artisanal cheese. This food safety hazard has been completely neglected in ready-to-eat raw-milk Brazilian artisanal cheese and could imply potential threats to consumers, since C. burnetii survives in artisanal cheese submitted to long ripening periods. Thus, this work established random and representative baseline prevalence of C. burnetii in this food product in Brazil. Further epidemiological studies, monitoring trends and setting control targets are warranted. Finally, these results point out the importance of including C. burnetii in animal and public health surveillance programs.

Causes of abortion in dairy cows in Uruguay / Causas de aborto em bovinos de leite no Uruguai

A case series study was conducted to determine the frequency of causes of abortion in dairy cattle in Uruguay. The sample size of 102 cases was composed of 53 fetuses, 35 fetuses with placentas, and 14 placentas without an associated fetus. All cases underwent gross and microscopic pathologic examinations as well as microbiological and serological testing. The etiology was determined in 54 (53%) of cases, 51 of which were caused by infectious agents. Within the observed 102 cases, 30 (29%) were caused by Neospora caninum, six (6%) by Coxiella burnetii and two (2%) by Campylobacter fetus subsp. venerealis. Bovine Parainfluenza-3 virus and Salmonella enterica serovar Newport caused one abortion each. Opportunistic bacteria (Escherichia coli, Streptococcus sp., Staphylococcus sp., Mannheimia sp., Trueperella pyogenes, and Providencia stuartii) were associated with 11 abortions. In two cases the fetal death was attributed to dystocia, and in one case the fetus had a congenital mesothelioma. Bovine viral diarrhea virus (BVDV) infection was identified in three fetuses; two of which were co-infected with and had typical lesions of N. caninum. No lesions were observed in the other fetus infected by BVDV. Leptospira interrogans was identified in one fetus without lesions. Despite the relatively low overall success rate in establishing an etiological diagnosis in cases of abortion in cattle, a systemic workup of bovine abortion is necessary to establish prevention and control strategies. This also facilitates monitoring and surveillance of reproductive diseases in dairy cattle, some of which represent a risk to public health.(AU)

Uma série de casos foi estudada para determinar a frequência de causas do aborto em bovinos leiteiros no Uruguai. A amostra, de 102 casos, foi composta por 53 fetos, 35 fetos com placentas e 14 placentas sem feto associado. Todos os casos foram submetidos a exames patológicos macroscópicos e microscópicos, além de testes microbiológicos e sorológicos. A etiologia foi determinada em 54 (53%) dos casos, 51 dos quais foram causados por agentes infecciosos. Nos 102 casos observados, 30 (29%) foram causados por Neospora caninum, seis (6%) por Coxiella burnetii e dois (2%) por Campylobacter fetus subsp. venerealis. O vírus da Parainfluenza-3 e Salmonella enterica serovar Newport causaram um aborto cada. Bactérias oportunistas (Escherichia coli, Streptococcus sp., Staphylococcus sp., Mannheimia sp., Trueperella pyogenes e Providencia stuartii) foram associadas a 11 abortos. Em dois casos, a morte fetal foi atribuída a distocia e, em um caso, o feto apresentava mesotelioma congênito. A infecção pelo vírus da diarreia viral bovina (BVDV) foi identificada em três fetos; dois dos quais foram co-infectados e apresentavam lesões típicas de N. caninum. Não foram observadas lesões no outro feto infectado pelo BVDV. Leptospira interrogans foi identificada em um feto sem lesões. Apesar da relativamente baixa taxa de sucesso no diagnóstico etiológico nos casos de aborto em bovinos, é necessário o diagnóstico sistemático dos abortos para estabelecer estratégias de prevenção e controle. Isso também facilita o monitoramento e a vigilância de doenças reprodutivas em bovinos leiteiros, algumas das quais representam um risco para a saúde pública.(AU)

Endocarditis por bartonella asociada a glomerulonefritis y neurorretinitis / Bartonella endocarditis associated with glomerulonephritis and neuroretinitis

La endocarditis bacteriana con hemocultivo negativo constituye un dilema diagnóstico. Tanto Bartonella como Coxiella pueden causarla, con presentaciones clínicas similares que pueden simular una vasculitis sistémica no infecciosa. Sin embargo, difieren en el tipo y la duración del tratamiento, por lo que es fundamental identificar el agente etiológico. Presentamos un caso de endocarditis por Bartonella henselae asociada a glomerulonefritis y neurorretinitis, con hemocultivo negativo, anticuerpos anticitoplasma de neutrófilos y antiproteinasa 3 positivos, y serología positiva para Bartonella con reacción cruzada para Coxiella burnetti. El diagnóstico etiológico fue confirmado a posteriori mediante amplificación y secuenciación parcial del gen ribC a partir de tejido de la válvula cardíaca. El paciente recibió tratamiento antibiótico e inmunosupresor seguido de recambio valvular aórtico y presentó evolución favorable.

Blood-culture negative endocarditis is a diagnostic challenge. Both Bartonella and Coxiella can cause it with similar clinical presentations mimicking a systemic vasculitis. The identification of the etiologic agent is essential because they differ in treatment type and duration. We present a case of blood-culture negative endocarditis caused by Bartonella henselae, associated with glomerulonephritis and neuroretinitis, with negative blood culture, positive anti-neutrophil cytoplasmic and antiproteinase 3 antibodies. The serology was positive for Bartonella with cross-reactivity to Coxiella burnetti. The etiological diagnosis was achieved by polymerase chain reaction amplification and sequencing of a ribC gene fragment. The patient received antibiotic and immunosuppressive treatment followed by replacement of the aortic valve with favorable medium-term evolution.

Coxiella burnetii associated with BVDV (Bovine Viral Diarrhea Virus), BoHV (Bovine Herpesvirus), Leptospira spp, Neospora caninum, Toxoplasma gondii and Trypanosoma vivax in reproductive disorders in cattle / Coxiella burnetii associada ao BVDV (Vírus da Diarreia Viral Bovina), BoHV (Vírus do Herpes Bovino), Leptospira spp, Neospora caninum, Toxoplasma gondii e Trypanosoma vivax em distúrbios reprodutivos em bovinos

Abstract This is a cross-sectional study to assess the presence of antibodies in ruminants against selected pathogens associated with reproductive disorders in cattle in four Brazilian states, including the zoonotic agent Coxiella burnetii. The used tests were Virus Neutralization Assay for IBR and BVD, Microscopic Agglutination Test for Leptospira spp., Indirect Fluorescent Antibody Test (IFAT) for C. burnetii and Toxoplasma gondii, and Enzyme-Linked Immunosorbent Assay for Neospora caninum and Trypanosoma vivax. Seropositivity for C. burnetii was 13.7% with titers from 128 to 131,072; 57.8% for BoHV-1, with titers between 2 and 1,024; 47.1% for BVDV-1a, with titers from 10 to 5,120; 89.2% for N. caninum; 50% for T. vivax; and 52.0% for Leptospira spp., with titers between 100 to 800 (the following serovars were found: Tarassovi, Grippotyphosa, Canicola, Copenhageni, Wolffi, Hardjo, Pomona and Icterohaemorrhagiae); 19.6% for T. gondii with titer of 40. This is the first study that has identified C. burnetii in cattle associated with BoHV and BVDV, N. caninum, Leptospira spp., T. gondii and T. vivax. Thus, future studies should be conducted to investigate how widespread this pathogen is in Brazilian cattle herds.

Resumo Este é um estudo transversal para avaliar a presença de anticorpos em ruminantes contra patógenos selecionados e associados a distúrbios reprodutivos em bovinos de quatro estados brasileiros, incluindo o agente zoonótico Coxiella burnetii. Os testes utilizados foram Teste de Vírus-Neutralização para BoHV e BVDV, teste de Aglutinação Microscópica para Leptospira spp., Reação de Imunofluorescência Indireta for C. burnetii e Toxoplasma gondii, e Ensaio de Imunoabsorção Enzimática para Neospora caninum e Trypanosoma vivax. A soropositividade para C. burnetii foi de 13,7% com títulos de 128 a 131.072; 57,8% para BoHV-1, com títulos entre 2 a 1.024; 47,1% para BVDV-1a, com títulos de 10 a 5.120; 89,2% para N. caninum; 50% para T. vivax; e 52,0% para Leptospira spp., com títulos entre 100 a 800 (sorovares encontrados: Tarassovi, Grippotyphosa, Canicola, Copenhageni, Wolffi, Hardjo, Pomona e Icterohaemorrhagiae) 19,6% para T. gondii com título de 40. Este é o primeiro estudo que evidencia a participação de C. burnetii em bovinos associada ao Vírus da Rinotraqueíte bovina infecciosa e da diarreia viral bovina, N. caninum, Leptospira spp., T. gondii e T. vivax em bovinos. Desta forma, futuros estudos devem ser conduzidos a fim de investigar o quão disseminado se encontra este patógeno em rebanhos bovinos brasileiros.

Genotyping of Coxiella burnetii strains detected in cattle from a nationwide survey in Korea

A total of 123 Coxiella burnetii strains detected in cattle from a nationwide survey in Korea were classified into five genomic groups: I (0.8%), II (14.6%), III (12.2%), IV (66.7%), and V (5.7%). Acute Q-fever strains (Groups I, II, and III) comprised 27.6% and chronic strains (Groups IV and V) comprised 72.4%. At a dairy farm where both types were present, the detection rate was 6.7-times higher than that of another farm where only chronic strains were detected. Both acute and chronic Q-fever strains are widespread in Korea, and their presence could represent an active transmission to livestock and humans.

Molecular Detection of Coxiella burnetii in Cattle on Ulleung Island, Korea: A Population-based Study with Four Years of Follow Up

In a population-based study with 4 years of follow up, we evaluated the prevalence of Coxiella burnetii in cattle on Ulleung Island, Korea. In this study, the rates of C. burnetii infection in cattle on Ulleung Island were determined by PCR and were found to be 0.3–1.0% in the period 2011–2014. All 17 C. burnetii partial 16S rRNA gene sequences from PCR-positive cattle were identical and 2 geographic representatives were included in our analysis. The nucleotide sequences of the 2 samples showed high (98.4–100%) identity with C. burnetii sequences obtained from the GenBank. In this long-term tracking study, the number of cattle positive for C. burnetii on Ulleung Island was low. To prevent the transmission of C. burnetii on Ulleung Island, control strategy should include biosecurity improvement in surveillance, livestock management, administering suitable tests before purchasing animals to detect C. burnetii shedders, and restricting movements between herds.

“Hairiness” is a Facsimile of Reorganized Cytoskeletons: A Cytopathic Effect of Coxiella burnetii

In 1993, I reported that Coxiella burnetii transforms human B cells into hairy cells (cbHCs), the first hairy cell reported outside of hairy cell leukemia (HCL). Over last few decades, advances in molecular biology have provided evidence supporting that C. burnetii induces hairiness and inhibits the apoptosis of host cells. The present review summarizes new information in support of cbHC. C. burnetii was shown to induce reorganization of the cytoskeleton and to inhibit apoptosis in host cells. Peritoneal B1a cells were found to be permissive for virulent C. burnetii Nine Mile phase I (NMI) strains in mice. C. burnetii severely impaired E-cad expression in circulating cells of Q fever patients. B-cell non-Hodgkin lymphoma was linked to C. burnetii. Mutation of BRAF V600E was pronounced in HCL, but “hairiness” was not linked to the mutation. Risk factors shared among coxiellosis and HCL in humans and animals were reported in patients with Q-fever. Accordingly, I propose that C. burnetii induces reorganization of the cytoskeleton and inhibits apoptosis as cytopathic effects that are not target cell specific. The observed hairiness in cbHC appears to be a fixed image of dynamic nature, and hairy cells in HCL are distinct among lymphoid cells in circulation. As the cytoskeleton plays key roles in maintaining cell structural integrity in health and disease, the pathophysiology of similar cytopathic effects should be addressed in other diseases, such as myopathies, B-cell dyscrasias, and autoimmune syndromes.

Coxiella burnetii e a febre Q no Brasil, uma questão de saúde pública / Coxiella burnetii and Q fever in Brazil: a public health issue

Resumo A Febre Q é uma zoonose de ampla distribuição mundial, apesar dos poucos relatos associados a sua ocorrência no Brasil. "Coxiella burnetii", agente etiológico da Febre Q, é um cocobacilo gram-negativo, parasita intracelular obrigatório da ordem Legionellales. O microrganismo geralmente está presente na urina e fezes de animais infectados, podendo ser encontrado em grande quantidade nos restos placentários de animais nascidos a termo ou produtos de aborto. A inalação de células bacterianas suspensas no ar ou aerossóis contaminados é a forma mais comum de entrar em contato com a bactéria. A febre Q é uma doença autolimitada e, geralmente, evolui de forma benigna. Nos casos onde a doença evolui de forma crônica, a endocardite é a manifestação mais frequente. O diagnóstico clínico é difícil, visto que os sintomas assemelham-se a várias outras doenças. Nos casos confirmados a antibioticoterapia é o tratamento indicado. Diante da sintomatologia pouco específica e dificuldade de diagnóstico, acredita-se que no Brasil a doença seja mais comum do que se pensa.

Abstract Q fever is a zoonosis that is broadly distributed worldwide, despite few reports associated with its occurrence in Brazil. Coxiella burnetii, namely the causative agent of Q fever is a gram-negative coccobacillus and an obligate intracellular bacterial parasite of the order of Legionellales. The microorganism is generally present in the urine and feces of infected animals and can be found in large quantities in placental membranes of at-term or aborted animals. The inhalation of particles suspended in the air or contaminated aerosols is the most common form of bacterial contact. Q Fever is a self-limited disease, and often progresses in a benign way. In cases where the disease progresses to the chronic form, endocarditis is the most prevalent manifestation. Clinical diagnosis is difficult since the symptoms are similar to many other diseases. In confirmed cases, antibiotic therapy is the treatment indicated. Given the lack of knowledge about the disease and the difficulty of diagnosis, it is believed that Q fever is more common than generally believed in Brazil.

Clinical and epidemiological use of nested PCR targeting the repetitive element IS1111 associated with the transposase gene from Coxiella burnetii

ABSTRACT Q fever is a worldwide zoonosis caused by Coxiella burnetii—a small obligate intracellular Gram-negative bacterium found in a variety of animals. It is transmitted to humans by inhalation of contaminated aerosols from urine, feces, milk, amniotic fluid, placenta, abortion products, wool, and rarely by ingestion of raw milk from infected animals. Nested PCR can improve the sensitivity and specificity of testing while offering a suitable amplicon size for sequencing. Serial dilutions were performed tenfold to test the limit of detection, and the result was 10× detection of C. burnetti DNA with internal nested PCR primers relative to trans-PCR. Different biological samples were tested and identified only in nested PCR. This demonstrates the efficiency and effectiveness of the primers. Of the 19 samples, which amplify the partial sequence of C. burnetii, 12 were positive by conventional PCR and nested PCR. Seven samples—five spleen tissue samples from rodents and two tick samples—were only positive in nested PCR. With these new internal primers for trans-PCR, we demonstrate that our nested PCR assay for C. burnetii can achieve better results than conventional PCR.

Seroprevalence of Coxiella burnetii infection in cattle on Ulleung Island, Korea / 대한수의학회지

We assessed the seroprevalence of Coxiella burnetii (C. burnetii) in cattle on Ulleung Island, Korea in a population-based follow up study for 4 years and determined the spatial distribution and risk factors associated with C. burnetii. The seroprevalence of C. burnetii was determined to be 1.4–2.0% during 2011–2014. Overall, nine cattle from three farms that tested seropositive showed C. burnetii antibody seroconversions between 2011 and 2014. The number of seropositive cattle was low, suggesting that movement of and contact between animals was possible risk factors for the transmission of C. burnetii.

Serologic Survey and Risk Factors for Coxiella burnetii Infection among Dairy Cattle Farmers in Korea

BACKGROUND: The zoonotic disease Q fever is caused by Coxiella burnetii and usually affects high-risk human populations. We conducted a serological survey of dairy cattle farmers in Korea to determine seroreactivity and identify risk factors for C. burnetii infection. METHODS: This cross-sectional study included 1,824 of 7,219 dairy cattle farms (25.3%) in the study region. The selected dairy cattle farmers visited the nearest public health centers or branches with completed questionnaires. Serum samples from the farmers were tested using an indirect immunofluorescence assay to detect phase II C. burnetii immunoglobulin (Ig) G or M antibodies. RESULTS: A total of 1,222 dairy cattle farmers from 784 dairy cattle farms (43.0%) participated in this study, and 11.0% (134/1,222) exhibited seroreactivity, defined as a phase II antigen IgG or IgM titer ≥ 1:16. In the multivariate analysis, male sex, residence in Gyeonggi Province, a larger herd size, and ocular/oral contact with birth products during calf delivery were significantly associated with a higher risk of C. burnetii infection. Furthermore, the risk was significantly lower among farmers who always wore protective gloves while cleaning cattle excretion, compared to those who sometimes or rarely wore protective gloves. CONCLUSION: Dairy cattle farmers should exercise caution by avoiding ocular/oral contact with birth products during calf delivery and by using protective equipment (including gloves).

Q fever vaccines / 中国人兽共患病学报

Q fever is a worldwide zoonosis and vaccination is the best measure to against its prevalence.Coxiella burnetii (Cb) is an obligate intracellular pathogen responsible for Q fever.Inactivated phase I Cb (Whole cell vaccine,WCV) can provide 100％ protection against Q fever,but its side effect of vaccination is strong.Phase I Cb is treated with chloroform-methanol or trichloroacetic acid and the chloroform-methanol residual (CMR) or the trichloroacetic acid extract (TCA) is used to substitute for WCV.Both CMR and TCA vaccine retain the protective efficient of WCV and significantly reduce the side effects.However,both CMR and TCA vaccine are required to isolate and purify Cb from chick embryos where Cb grows in a biosafety laboratory with the complex procedures.In recent 10 years,the scientists have investigated from protective antigens to CD4+ and CD8+ T cell epitopes of Cb,expecting that the genes encoding the T cell epitopes express highly and induce an efficient protection against Q fever in bodies.

Detection of Coxiella burnetii in Hya lomma asiaticun from Northern Xinjiang, China / 中华地方病学杂志

Objective To investigate the infection of Coxiella burnetii (C. burnetii) in Hyalomma asiaticum (Hy. asiaticum) from Northern Xinjiang, China, and to provide basis for reducing the incidence of Q fever in humans and livestock. Methods Questing ticks were collected via the dragging-flag method and directly sampled from animals in Fuhai County, Alataw Pass, Shihezi City, Hutubi County and Karamay City between April and July in 2016. Genomic DNA was extracted after morphological identification. PCR was used to identify tick species and Coxiella pathogen. BLAST and Mega 6.0 were used in the sequence analysis and the construction of phylogenetic trees. Results A total of 822 ticks were collected from 5 counties (cities) in Northern Xinjiang, among which the dominant ticks were Hy. asiaticum, and 580 were collected. Hy. asiaticum was sequenced, and BLAST results showed that the sequence had a high similarity with that of Yuli County from Xinjiang (accession no. KF527439). The nucleotide of C. burnetii was amplified via the PCR method, and its positive rate was 19.48% (113/580). Blast analysis showed that positive sequences had a high similarity with that of C . burnetii (99.66%, 296/297). Phylogenetic tree showed that the sequences of C. burnetii had genetic diversity. Conclusions C. burnetii extensively exists in Hy. asiaticum from 5 counties (cities) in Northern Xinjiang. These results suggest Q fever survey should be strengthened in different regions of Xinjiang.