Q Fever in French Guiana

Eldin, Carole; Mahamat, Aba; Demar, Magalie; Abboud, Philippe; Djossou, Félix; Raoult, Didier

doi:10.4269/ajtmh.14-0282

Cited by 38 publications

(28 citation statements)

References 36 publications

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“…The same year, a patient died of respiratory distress syndrome due to acute Q fever (82). The incidence continued to rise, with up to 150 cases per 100,000 inhabitants in 2005 (3). The majority of cases (81%) occurred in the Cayenne area and its suburbs, in contrast with the usual rural distribution of the disease.…”

Section: The Different Epidemiological Profilesmentioning

confidence: 99%

“…Moreover, the classification of C. burnetii by the CDC as a potential bioterrorism agent resulted in the disease becoming reportable in many countries, such as in the United States, which revealed that the disease is more common than previously thought. Third, the recent war in the Middle East (1) and research in the tropics (2,3) have shown that Q fever may be a very common cause of fever in the intertropical area. Finally, a very large outbreak in the Netherlands has shown that this disease could become a major public health problem (4).…”

Section: Introductionmentioning

confidence: 99%

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From Q Fever to Coxiella burnetii Infection: a Paradigm Change

et al. 2017

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Coxiella burnetii is the agent of Q fever, or "query fever," a zoonosis first described in Australia in 1937. Since this first description, knowledge about this pathogen and its associated infections has increased dramatically. We review here all the progress made over the last 20 years on this topic. C. burnetii is classically a strict intracellular, Gram-negative bacterium. However, a major step in the characterization of this pathogen was achieved by the establishment of its axenic culture. C. burnetii infects a wide range of animals, from arthropods to humans. The genetic determinants of virulence are now better known, thanks to the achievement of determining the genome sequences of several strains of this species and comparative genomic analyses. Q fever can be found worldwide, but the epidemiological features of this disease vary according to the geographic area considered, including situations where it is endemic or hyperendemic, and the occurrence of large epidemic outbreaks. In recent years, a major breakthrough in the understanding of the natural history of human infection with C. burnetii was the breaking of the old dichotomy between "acute" and "chronic" Q fever. The clinical presentation of C. burnetii infection depends on both the virulence of the infecting C. burnetii strain and specific risks factors in the infected patient. Moreover, no persistent infection can exist without a focus of infection. This paradigm change should allow better diagnosis and management of primary infection and long-term complications in patients with C. burnetii infection.

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Section: The Different Epidemiological Profilesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

From Q Fever to Coxiella burnetii Infection: a Paradigm Change

et al. 2017

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“…Q fever, a cosmopolitan zoonosis caused by the intracellular bacterium Coxiella burnetii, is a public health concern in Cayenne, the main city of French Guiana, a French overseas entity located on the northeast coast of South America [1,2]. In a prospective study conducted from 1996 to 2000, the mean annual incidence rate was estimated to 37 cases per 100,000 inhabitants, one of the highest in the world [3].…”

Section: Introductionmentioning

confidence: 99%

Q fever epidemic in Cayenne, French Guiana, epidemiologically linked to three-toed sloth

Santi

Briolant

Mahamat

et al. 2018

Comparative Immunology, Microbiology and Infectious Diseases

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A Q fever epidemic occurred in 2013 in a small military residential area in Cayenne, French Guiana. A retrospective cohort study was conducted to identify Q fever risk factors. Confirmed acute Q fever case was defined as positive serology (IgM ≥ 50 and phase II IgG ≥ 200) and/or positive qPCR on serum or blood. In addition, wild mammals were captured at the study site and tested by serology and real-time PCR performed on blood, vaginal swabs and ticks. The attack rate was 20 percent (11/54). All the cases were symptomatic with fever >38.5 °C and community-acquired pneumonia for four cases. Log binomial multivariate models identified two independent risk factors associated with Q fever: to clean the house (RRa = 7.5 CI95% [1.03-55.3]) and to carry a three-toed sloth in arms (RRa = 2.6 CI95% [1.1-5.8]). Eighteen marsupial individuals were captured, all PCRs were negative but 17% (3/18) had a positive serology. Another study conducted after the epidemic found only one (1/4) three-tooth sloth (Bradypus tridactylus) with feces highly infectious for C. burnetii MST17. The same strain C. burnetii genotype 17 has been laboratory- confirmed in this mammal and in human cases. These results support the implication of three-toed-sloth in this epidemic. Human contamination mainly occurs through inhalation of infectious aerosols as suggested by high relative risk associated with house cleaning activities and pulmonary forms of the disease, and through direct contact with three- toed-sloth. Positive serological results among marsupials confirm wildlife exposure and suggest a more complex sylvatic transmission cycle among wild mammals.

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“…It is currently responsible for 24% community-acquired pneumonia in this region. 1 The epidemiology of the infection is quite unusual because most of the cases have been described in areas where no classical reservoir is found, 2 leading to the hypothesis that a wild reservoir exists. 3 C. burnetii is present in high concentrations in the birth products of its usual reservoirs.…”

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confidence: 99%