Persistent High IgG Phase I Antibody Levels against Coxiella burnetii among Veterinarians Compared to Patients Previously Diagnosed with Acute Q Fever after Three Years of Follow-Up

Wielders, Cornelia C. H.; Boerman, Anneroos W.; Schimmer, Barbara; Brom, René van den; Notermans, Daan W.; Hoek, Wim van der; Schneeberger, Peter M.

doi:10.1371/journal.pone.0116937

Cited by 17 publications

(20 citation statements)

References 29 publications

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“…Antibody profiles suggestive of possible persistent (chronic) infection were identified in five (14%) of the workers, which was similar to that reported for veterinarians in Belgium (12%) (Pozzo et al, ). These serological profiles appear to be more common in veterinarians following Q fever diagnosis compared to patients with no occupational risk of exposure, and may be due to persistent exposure rather than pathological disease (Wielders et al, ).…”

Section: Discussionmentioning

confidence: 99%

Coxiella burnetii seroprevalence in unvaccinated veterinary workers in Australia: Evidence to support Q fever vaccination

Sellens

Bosward

Norris

et al. 2019

Zoonoses and Public Health

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Q fever (caused by Coxiella burnetii) is a serious zoonotic disease that occurs almost worldwide. Occupational contact with animals increases the risk of exposure, and Q fever vaccination is recommended for veterinary workers in Australia. This study aimed to investigate C. burnetii seroprevalence among unvaccinated veterinary workers in Australia and determine factors associated with a positive serological result. During 2014 and 2015, convenience sampling at veterinary conferences and workplace vaccination clinics was undertaken. Participants completed a questionnaire and provided a blood sample for C. burnetii serology. Participants were predominantly veterinarians (77%), but veterinary support staff, animal scientists, and administration workers also participated. Blood samples (n = 192) were analysed by an immunofluorescence assay and considered positive where the phase I or phase II IgG titre was ≥1/50. Seroprevalence was 19% (36/192; 95% CI 14%–25%). A positive serological result was significantly associated with (a) working in outer regional/remote areas (odds ratio [OR] 6.2; 95% CI 1.9–20.8; reference = major cities; p = .009) and (b) having spent more than 50% of total career working with ruminants (OR 4.8; 95% CI 1.7–13.5; reference = <15% of career; p = .025). These findings confirm an increased risk of exposure to C. burnetii compared to the general population, providing new evidence to support Q fever vaccination of veterinary workers in Australia.

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Section: Discussionmentioning

confidence: 99%

Coxiella burnetii seroprevalence in unvaccinated veterinary workers in Australia: Evidence to support Q fever vaccination

Sellens

Bosward

Norris

et al. 2019

Zoonoses and Public Health

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“…Concerning chronic Q fever, the diagnostic criteria are still under debate and the proposed cut‐offs for IgG phase I of 1 : 1024 and/or 1 : 1600 showed low specificity (Frankel et al., ; van der Hoek et al., ). Despite this, the cut‐off 1 : 1024 is the one currently used in the Netherlands, and it has been recently used in a follow‐up study among seropositive veterinarians (Wielders et al., ). During the 3‐year observation period, the authors found that IgG phase I titres remained constant or slightly increased and they formulated the hypothesis that the continuous exposure to C. burnetii and the consequent boostering effect on the immune system could be at the origin of the persistently high antibody levels.…”

Section: Discussionmentioning

confidence: 99%

“…During the 3‐year observation period, the authors found that IgG phase I titres remained constant or slightly increased and they formulated the hypothesis that the continuous exposure to C. burnetii and the consequent boostering effect on the immune system could be at the origin of the persistently high antibody levels. Despite the high IgG phase I titres, the veterinarians did not show any other signs of chronic infection (Wielders et al., ). Similarly to what was described in the Dutch study, here we found also a group of six healthy veterinarians with IgG phase I titres ≥1 : 1024.…”

Section: Discussionmentioning

confidence: 99%

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Q Fever Serological Survey and Associated Risk Factors in Veterinarians, Southern Belgium, 2013

Pozzo

Martinelle

Léonard

et al. 2016

Transbound Emerg Dis

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A sero-epidemiological survey was organized among veterinarians working in Southern Belgium to estimate the seroprevalence of Q fever and the risk factors associated with exposure. A total of 108 veterinarians took part to this cross-sectional study, with a majority practicing with livestock animals. The overall seroprevalence was 45.4%, but it increased to 58.3% among veterinarians having contact with livestock. Three main serological profiles were detected (relatively recent, past and potentially chronic infections). The contact with manure during the prior month was the risk factor associated with seropositivity after multivariate logistic regression analysis. Classification and regression tree analysis identified the age as the most predictive variable to exclude potentially chronic infection in apparently healthy seropositive veterinarians. In conclusion, livestock veterinarians practicing in Southern Belgium are highly exposed to Q fever, a neglected zoonosis for which serological and medical examinations should be envisaged in at risk groups.

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“…Indeed, the seasonal reproduction in small ruminants may lead to the exposure to larger sizes of inocula possibly inhaled, compared to cattle. Finally, it is still debatable whether or not the presence of antibodies in occupationally exposed people with frequent boosting is of clinical significance [16]. All these make compatible the co-existence of high seroprevalence and low incidence rates of Q fever cases among humans exposed to cattle.…”

Section: Discussionmentioning

confidence: 99%

Coxiella burnetiiinfection in humans: to what extent do cattle in infected areas free from small ruminants play a role?

et al. 2020

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Domestic ruminants (cattle, goats and sheep) are considered to be the main reservoirs for human Coxiella burnetii infection. However, there is still a need to assess the specific contribution of cattle. Indeed, most seroprevalence studies in humans were carried out in areas comprising both cattle and small ruminants, the latter being systematically implicated in human Q fever outbreaks. Therefore, we conducted a cross-sectional study in areas where C. burnetii infection in cattle was endemic, where the density of cattle and small ruminant farms were respectively high and very low. The aim was to estimate the seroprevalence rates among two occupational (cattle farmers and livestock veterinarians), and one non-occupational (general adult population) risk groups. Sera were collected in 176 cattle farmers, 45 veterinarians and 347 blood donors, and tested for phase I and II antibodies using immunofluorescence assay. Seroprevalence rates were 56.3% among cattle farmers, 88.9% among veterinarians and 12.7% among blood donors. This suggests that a specific risk for acquiring C. burnetii infection from cattle in endemically infected areas exists, mainly for occupational risk groups, but also for the general population. Further research is needed to identify risk factors for C. burnetii infection in humans in such areas.

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Persistent High IgG Phase I Antibody Levels against Coxiella burnetii among Veterinarians Compared to Patients Previously Diagnosed with Acute Q Fever after Three Years of Follow-Up

Cited by 17 publications

References 29 publications

Coxiella burnetii seroprevalence in unvaccinated veterinary workers in Australia: Evidence to support Q fever vaccination

Coxiella burnetii seroprevalence in unvaccinated veterinary workers in Australia: Evidence to support Q fever vaccination

Q Fever Serological Survey and Associated Risk Factors in Veterinarians, Southern Belgium, 2013

Coxiella burnetiiinfection in humans: to what extent do cattle in infected areas free from small ruminants play a role?

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