Screening of post-mortem tissue donors for Coxiella burnetii infection after large outbreaks of Q fever in The Netherlands

Abstract

BackgroundAfter the largest outbreaks of Q fever ever recorded in history occurred in the Netherlands, concern arose that Coxiella may be transmitted via donated tissues of latent or chronically infected donors. The Dutch Health Council recently advised to screen tissue donors, donating high risk tissues, for Coxiella infection.MethodsAfter validation of an enzyme immunoassay (EIA) test for IgG antibodies against phase 2 of C. burnetii for use on post-mortem samples, serum samples of 1033 consecutive Dutch post-mortem tissue donors were tested for IgG antibodies against phase 2 of C. burnetii. Confirmation of reactive results was done by immunofluorescence assay (IFA). All available tissues (corneas, heart valves, skin and bone marrow) from donors with IgG reactivity were tested for presence of Coxiella DNA by PCR. Risk factors for IgG reactivity were investigated.ResultsAfter validation of the tests for use on post-mortem samples, 50/1033 donors (4.8%) screened positive for phase 2 anti-Coxiella IgG by EIA, and 31 were confirmed by IFA (3.0%). One donor showed a serological profile compatible with chronic infection. All tested tissues (25 corneas, 6 heart valves, 4 skin and 3 bone marrow) from donors with IgG reactivity tested negative for the presence of Coxiella DNA. Except for living in a postal code area with a high number of Q fever notifications, no risk factors for IgG reactivity were found.ConclusionsThe strong correlation between notifications and seroprevalence confirms that the used assays are sufficiently specific for use on post-mortem samples, although one has to be aware of differences between batches. Thus, this study provides a validated method for screening tissue donors for infection with Coxiella burnetii that can be used in future outbreaks.

Comparative sensitivity of the test with tuberculosis recombinant allergen, containing ESAT6-CFP10 protein, and Mantoux test with 2 TU PPD-L in newly diagnosed tuberculosis children and adolescents in Moscow

“…All undergo the vaccination, annual tuberculin diagnostics, Diaskintest (with positive reactions to TST), computed tomography with positive Diaskintest reaction, bacteriological and molecular genetic examination, long-term controlled therapy in a hospital with tuberculosis, and outpatient or in a sanatorium with LTBI (at the request of parents). Data on the high sensitivity of the skin test with the drug containing the specific ESAT6–CFP10 protein, corresponds to the data of S. Sollai [39] that in high-income countries the sensitivity of IGRA tests is higher than in low-income countries.…”

Screening of blood donors for chronic Coxiella burnetii infection after large Q fever outbreaks

“…These findings indicated a poor specificity of lot SKA.CD. This was later confirmed by the manufacturer and was also noted in a study of postmortem samples of tissue donors . The problem only related to the specificity; the sensitivity of lot SKA.CD was at least as good as that from other lots.…”

Molecular detection of Coxiella burnetii from the formalin-fixed tissues of Q fever patients with acute hepatitis

“…burnetii in 12 cardiovascular biopsy specimens [ 4 ]. It has been also reported that PCR for Q fever can be also performed on cerebrospinal fluid, pleural fluid, bone marrow, bone biopsies, liver biopsies, milk, placenta, and fetal tissue [ 5 – 7 ]. However, there are limited data on whether PCR on formalin-fixed liver tissue can be used for diagnosing Q fever hepatitis.…”