Occupationally Acquired Q Fever in Shepherds and Sheep Milk Cheesemakers
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Ó 2020 EcoHealth Alliance
Short Communication
Occupationally Acquired Q Fever in Shepherds and Sheep Milk Cheesemakers Rita Cruz,1 Carla Santos,1 Fernando Esteves,1 Ana Sofia Ferreira,2 Carmen Vasconcelos-No´brega,1,3 Cristina Mega,1,3 Carlos Albuquerque,4 Edite Teixeira-de-Lemos,1 Ana Cla´udia Coelho,5 Helena Vala,1,3 and Joa˜o Rodrigo Mesquita 6,7 1
Centre for Studies in Education and Health Technologies (CI&DETS), Agrarian School of Viseu, Polytechnic Institute of Viseu, 3500-606 Viseu, Portugal 2 Laboratory of Microbiology, Department of Biological Sciences, Faculty of Pharmacy, University of Oporto, 4050-313 Porto, Portugal 3 Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Tra´s-os-Montes and Alto Douro, 5001801 Vila Real, Portugal 4 Health Superior School, Polytechnic Institute of Viseu, UNICISA-E, CIEC, CI&DEI, Viseu, Portugal 5 Animal and Veterinary Research Centre (CECAV), University of Tra´s-os-Montes and Alto Douro, 5001-801 Vila Real, Portugal 6 Epidemiology Research Unit (EPIUnit), Institute of Public Health, University of Porto, 4050-313 Porto, Portugal 7 Abel Salazar Institute of Biomedical Sciences (ICBAS), University of Porto, Porto, Portugal
Abstract: Q fever is a zoonosis caused by Coxiella burnetii, and transmission to humans is often associated with contact with ovine and caprine livestock. Those exposed to sheep are particularly at high risk of infection. Recent studies show that Q fever is increasing in sheep farms in Portugal raising alerts on spillover to humans. We detected anti-C. burnetii IgG in shepherds and sheep milk cheesemakers (27 [28.1%] in a total of 96; 95% confidence interval [CI] 19.4–38.2%) and in controls (21 [8.1%] in a total of 260; 95% CI 5.1–12.1%), pointing to an increased risk of C. burnetii infection (P = 0.0001), with an odds ratio for anti-C. burnetii of 4.45 (95% CI 2.4–8.4%; P = 0.0001), in individuals with occupational contact with sheep in Portugal. Keywords: Coxiella burnetii, Portugal, Occupational exposure
Q fever is a zoonotic disease with an almost worldwide occurrence caused by Coxiella burnetii, a nonmotile Gramnegative and obligate intracellular bacterium that has the ability to subsist several weeks under environmental stresses (Maurin and Raoult 1999; Angelakis and Raoult 2010; Mori and Roest 2018). Transmission to humans is often associated with abortive episodes in domestic ruminants, particularly in ovine and caprine livestock, mainly through inhalation of contaminated aerosols but also by the alimentary route and through the bite
Correspondence to: Joa˜o Rodrigo Mesquita, e-mail: [email protected]
of ticks (Maurin and Raoult 1999; Angelakis and Raoult 2010; Mori and Roest 2018). Thus, populations that are in particularly high risk often include individuals with occupational contact with animals, such as workers in tanneries, abattoirs, fur and meat industries, on agricultural farms, and in veterinary profession (Fenga et al. 2015; Szyman´ska-Czerwin´ska et al. 2015). Q fever in
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