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Q-fever bacteria is fairly common in US

Gert van der Hoek

In Memoriam - Editor, Senior Moderator
Presence of Coxiella burnetii DNA in the environment of the United States (2006-2008)

published online ahead of print on 14 May 2010

Gilbert J. Kersh, Teresa M. Wolfe, Kelly A. Fitzpatrick, Amanda J. Candee, Lindsay D. Oliver, Nicole E. Patterson, Joshua S. Self, Rachael A. Priestley, Amanda D. Loftis, and Robert F. Massung*
Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA


Abstract

Coxiella burnetii is an obligate intracellular bacterium that causes the zoonotic disease Q fever. Because C. burnetii is highly infectious, can survive under a variety of environmental conditions, and has been weaponized in the past, it is classified as a select agent and is considered a potential bioweapon.

The agent is known to be present in domestic livestock and in wild animal populations, but the background levels of C. burnetii in the environment have not been reported.

To better understand the amount of C. burnetii present in the environment of the U.S., greater than 1,600 environmental samples were collected from 6 geographically diverse U.S. states in the years 2006-2008. DNA was purified from these samples, and the presence of C. burnetii DNA was evaluated by quantitative PCR of the IS1111 repetitive element.

Overall, 23.8% of the samples were positive for C. burnetii DNA. The prevalence in the different states ranged from 6 to 44 percent. C. burnetii DNA was detected in locations with livestock and also in locations with primarily human activity (post offices, stores, schools, etc.).

This study demonstrates that C. burnetii is fairly common in the environment in the U.S., and any analysis of C. burnetii after a suspected intentional release should be interpreted in light of these background levels.

It also suggests that human exposure to C. burnetii may be more common than what is suggested by the number of reported cases of Q fever.

http://aem.asm.org/cgi/content/abstract/AEM.00042-10v1?ct=ct

Let me add a quote from a presentation on US soldiers with Q-fever in Iraq, :


…..in many other regions in Africa and
..the Middle East, Q fever is so highly
endemic in domestic animals that
practically all rural residents become
infected during childhood. A sequel is
that local adults are immune and overt
infection is only in newcomers.

-- E.H.Derrick(1973) Med. J. Aust Aust.

slide 7

http://www.dsjf.org/IZ_Diseases/Q Fever in OIF Deployed Soldiers Emerging Threat.pdf


In the Netherlands we have a Q-fever epidemic, which is weakening now.

It seems the Q-fever bacteria can be found everywhere, in any place, in any country, not only the US or the Netherlands: everywhere.

However in some circumstances the bacteria can cause a human outbreak .
The current outbreak here seems to be related to:

- Sudden explosion of number of bacteria, sheep of goats which abort. Number of goat farms with 1000+ goats increased.
Through vacination you can prevent this to happen. As a precautionary measure pregnant goats were culled from farms with Q-fever baceria in their bulk milk . Probably in the future the culling won't be necessary after all goates will be vaccinated.

- Presence of a lot of dust including industrial dust, dust from cars etc.. The Q-fever bacteria can travel for miles attached to dust.
Goatfarms have a protocol now, how to handle placenta's (which can have billions of Q-fever bacteria) and other related hygiene measures.

- Dry weather , wind.

- Not much vegetation

- A number of farms are close to the village

- Last but not least: people seem to be more vulnerable. In the Netherlands for instance some 40 years ago, you could find anti-bodies at 40% or 50% more of the average population. Babies got it via their mother. So they were protected.
Now it is 2% or 3 % who are positive. Vets and farmers: 80% or more of them are positive, without having been ill.

Some riskgroups could be helped with vaccination. No human vaccin available in Europe now. May the Australian vax will be used; a new vaccine will be developed.

 
Re: Q-fever bacteria is fairly common in US

Summary of related research, published in 2002:

Q fever in humans and animals in the United States.

McQuiston JH, Childs JE.

Viral and Rickettsial Zoonoses Branch, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. fzh7@cdc.gov

Abstract

Coxiella burnetii, the etiologic agent of Q fever, is a worldwide zoonotic pathogen. Although Q fever is present in the United States, little is known about its current incidence or geographic distribution in either humans or animals.

Published reports of national disease surveillance, individual cases, outbreak investigations, and serologic surveys were reviewed to better characterize Q fever epidemiology in the United States. In national disease surveillance reports for 1948-1986, 1,396 human cases were reported from almost every state.

Among published individual case reports and outbreak investigations, occupational exposures (research facilities, farm environments, slaughterhouses) were commonly reported, and sheep were most frequently implicated as a possible source of infection.

In studies conducted on specific groups, livestock handlers had a significantly higher prevalence of antibodies to C. burnetii than did persons with no known risk.

Animal studies showed wide variation in seroprevalence, with goats having a significantly higher average seroprevalence (41.6%) than sheep (16.5%) or cattle (3.4%).

Evidence of antibody to C. burnetii was reported among various wild-animal species, including coyotes, foxes, rodents, skunks, raccoons, rabbits, deer, and birds.

This literature review suggests that C. burnetii is enzootic among ruminants and wild animals throughout much of the United States and that there is widespread human exposure to this pathogen.

Sheep and goats appear to be a more important risk for human infection in the United States than cattle or wild animals, and research studies examining the natural history and transmission risk of Q fever in sheep and goats in this country should be encouraged.

http://www.ncbi.nlm.nih.gov/pubmed/12737547
 
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