Peculiarities of Q fever and human cases reported so far in the Czech Republic

Česká verzia

Authors: M. Špačková ; K. Fabiánová; H. Orlíková ; J. Košťálová
Authors place of work: Centrum epidemiologie a mikrobiologie, Státní zdravotní ústav, Praha
Published in the journal: Epidemiol. Mikrobiol. Imunol. 72, 2023, č. 1, s. 9-18
Category: Původní práce

Summary

Introduction: Q fever is a zoonosis with a worldwide occurrence. Coxiella burnetii infection is most commonly transmitted by inhalation of air containing contaminated dust in cow, sheep and goat farming areas. The other modes of transmission are alimentary route (ingestion) and through sucking ticks. We set ourselves the goal of presenting a descriptive analysis of cases of Q fever in the Czech Republic (CZ) and former Czechoslovakia and draw attention to this often-overlooked issue.

Methods: Summary of available information about Q fever was processed, and a narrative search of published cases of Q fever in the CZ and former Czechoslovakia, in Czech, Slovak and English, without time restrictions was performed. Furthermore, a descriptive analysis of Q fever cases reported to the Czech infectious diseases reporting system in 1982–2021 was done. After analysis, the available information system data were supplemented with data from a search of published scientific literature and weekly reports on the current epidemiological situation of the public health protection authorities of the CZ.

Results: The disease has been reported in former Czechoslovakia and then in CZ since 1952. In 1952–1954, six outbreaks were reported with a total of 150 cases, mostly in connection with work with cattle. In 1980, a large-scale outbreak of Q fever affected 526 employees of the cotton production plant at Staré Město near Uherské Hradiště. Otherwise, units to dozens of cases were reported. From 1993 to 2021, 27 cases of the disease were detected in the CZ, of which 22 (81.5%) occurred in men. The age range was 0–60 years (mean 31, median 30 years). Seasonality by reporting month was highest in January and September.

Conclusion: There has been a decline in human cases of Q fever in the European Union (EU) in recent years, and only few cases of the disease occur in the CZ. Still, due to potential severity of the disease, the current climate change with the consequent increase in the spread of ticks as vectors of Coxiella, and animal movements associated with the global market, it is important to consider Q fever in the differential diagnosis. As part of the prevention, it is necessary to ensure compliance with basic hygiene rules, especially in at-risk occupations, and to consume only pasteurized dairy products. Vaccination of humans is not available in EU countries, although vaccination of livestock is possible.

Keywords:

Epidemiology – Czech Republic – analysis – Q fever – Queensland fever – Query fever

Zdroje

1. Derrick E. „Q“ fever, a new fever entity: clinical features, diagnosis and laboratory investigation. Rev Infect Dis, 1983;5(4):790– 800.

2. Porter SR, Czaplicki G, Mainil J, et al. Q fever: current state of knowledge and perspectives of research of a neglected zoonosis. Int J Microbiol, 2011:2011.

3. Pexara A, Solomakos N, Govaris A. Q fever and prevalence of Coxiella burnetii in milk. Trends Food Sci Technol, 2018;71:65–72.

4. Centers for disease control and prevention. Q Fever. 2022 [cit. 2022-04-06]; Dostupné na www: https://www.cdc.gov/qfever/ index.html.

5. Schimmer B, Ter Schegget R, Wegdam M, et al. The use of a geographic information system to identify a dairy goat farm as the most likely source of an urban Q-fever outbreak. BMC Infect Dis, 2010;10(1):1–7.

6. Špitalská E, Sparagano O, Stanko M, et al. Diversity of Coxiella- -like and Francisella-like endosymbionts, and Rickettsia spp., Coxiella burnetii as pathogens in the tick populations of Slovakia, Central Europe. Ticks Tick Borne Dis, 2018;9(5):1207–1211.

7. Shapiro A, Norris J, Heller J, et al. Seroprevalence of Coxiella burnetii in Australian dogs. Zoonoses Public Health, 2016;63(6):458– 466.

8. Shapiro AJ, Bosward KL, Heller J, et al. Seroprevalence of Coxiella burnetii in domesticated and feral cats in eastern Australia. Vet Microbiol, 2015;177(1–2):154–161.

9. Gale P, Kelly L, Mearns R, et al. Q fever through consumption of unpasteurised milk and milk products – a risk profile and exposure assessment. J Appl Microbiol, 2015;118(5):1083–1095.

10. Forland F, Gomes HDC, Nokleby H, et al. Applicability of evidence- based practice in public health: risk assessment on Q fever under an ongoing outbreak. Euro Surveill, 2012;17(3):20060.

11. Heymann DL. Control of communicable diseases manual. 20. vydání. APHA Press; 2015.

12. Parker NR, Barralet JH, Bell AM. Q fever. Lancet, 2006;367(9511): 679–688.

13. Angelakis E, Raoult D. Q fever. Vet Microbiol, 2010;140(3–4):297– 309.

14. Dupuis G, Petite J, Péter O, et al. An important outbreak of human Q fever in a Swiss Alpine valley. Int J Epidemiol, 1987;16(2):282– 287.

15. Schneeberger P, Wintenberger C, Van der Hoek W, et al. Q fever in the Netherlands–2007–2010: what we learned from the largest outbreak ever. Med Mal Infect, 2014;44(8):339–353.

16. van der Hoek W, Meekelenkamp JC, Leenders AC, et al. Antibodies against Coxiella burnetii and pregnancy outcome during the 2007–2008 Q fever outbreaks in the Netherlands. BMC Infect Dis, 2011;11(1):1–9.

17. Nielsen SY, Andersen A-MN, Mølbak K, et al. No excess risk of adverse pregnancy outcomes among women with serological markers of previous infection with Coxiella burnetii: evidence from the Danish National Birth Cohort. BMC Infect Dis, 2013;13(1):1–8.

18. Jansen AF, Schoffelen T, Bleeker-Rovers CP, et al. Genetic variations in innate immunity genes affect response to Coxiella burnetii and are associated with susceptibility to chronic Q fever. Clin Microbiol Infect, 2019;25(5):631.e11–631.e15.

19. Maurin M, Raoult DF. Q fever. Clin Microbiol Rev, 1999;12(4):518– 553.

20. Morisawa Y, Wakiguchi H, Takechi T, et al. Intractable Q fever treated with recombinant gamma interferon. Pediatr Infect Dis J, 2001;20(5):546–547.

21. Maltezou HC, Raoult D. Q fever in children. Lancet Infect Dis, 2002;2(11):686–691.

22. Centers for disease control and prevention. Bioterrorism Agents/Diseases. 2022 [cit. 2022-04-13]; Dostupné na www: https://emergency.cdc.gov/agent/agentlist-category.asp.

23. Novák P, Malá G, Treml F. Zásady biosecurity v chovech hospodářských zvířat. 2017. [cit. 2022-05-12]; Dostupné na www: https://www.ctpz.cz.

24. Vláda České republiky. Zákon č. 166/1999 Sb., o veterinární péči a o změně některých souvisejících zákonů (veterinární zákon). 1999. [cit. 2022-05-10]; Dostupné na www: https://www.zakonyprolidi. cz/cs/1999-166.

25. Tigertt WD, Benenson AS, Gochenour WS. Airborne Q fever. Bacteriol Rev, 1961;25(3):285–293.

26. Sawyer LA, Fishbein DB, McDade JE. Q fever: current concepts. Rev Infect Dis, 1987;9(5):935–946.

27. Shannon JG, Heinzen RA. Adaptive immunity to the obligate intracellular pathogen Coxiella burnetii. Immunol Res, 2009;43(1):138–148.

28. Kermode M, Yong K, Hurley S, et al. An economic evaluation of increased uptake in Q fever vaccination among meat and agricultural industry workers following implementation of the National Q Fever Management Program. Aust N Z J Public Health, 2003;27(4):390–398.

29. Škultéty L. Q fever and prevention. Epidemiol Mikrobiol Imunol, 2020;69(2):87–94.

30. Fabiánová K, Beneš Č. Q horečka – epidemický výskyt v Nizozemí. Zprávy CEM (SZÚ, Praha), 2010;19(4):111–113.

31. Dorko E, Čisláková L, Kizek P. Q horúčka – klinický obraz. Prakt Lek, 2005;85(7):382–384.

32. Nakládalová M, Pastorková R, Landecká I. Q-horečka jako profesionální onemocnění vedoucí k invaliditě – kazuistika. Epidemiol Mikrobiol Imunol, 2014;63(2):149–152.

33. Hiemer I. Kazuistika: Případ importované Q horečky. Očkování a cestovní medicína, 2017;1(8):27–29.

34. European Food Safety Authority, European Centre for Disease Prevention and Control. The European Union One Health 2020 Zoonoses Report. EFSA J, 2021;19(12):e06971.

35. Leone M, Honstettre A, Lepidi H, et al. Effect of sex on Coxiella burnetii infection: protective role of 17β-estradiol. J Infect Dis, 2004;189(2):339–345.

36. Serbezov V, Kazar J, Novkirishki V, et al. Q fever in Bulgaria and Slovakia. Emerg Infect Dis, 1999;5(3):388–394.

37. Kováčová E, Kazar J, Šimková A. Clinical and serological analysis of a Q fever outbreak in western Slovakia with four-year follow- -up. Eur J Clin Microbiol Infect Dis, 1998;17(12):867–869.

38. Varga V. An explosive outbreak of Q-fever at Jedlové-Kostoľany, Slovakia. Centr Eur J Publ Hlth, 1997;5:180–182.

39. Řehácek J. Epidemiology and significance of Q fever in Czechoslovakia. Zentralbl Bakteriol Mikrobiol Hyg A, 1987;267(1):16–19.

40. Reusken C, van der Plaats R, Opsteegh M, et al. Coxiella burnetii (Q fever) in Rattus norvegicus and Rattus rattus at livestock farms and urban locations in the Netherlands; could Rattus spp. represent reservoirs for (re) introduction? Prev Vet Med, 2011;101(1–2):124–130.

41. van der Hoek W, Hogema B, Dijkstra F, et al. Relation between Q fever notifications and Coxiella burnetii infections during the 2009 outbreak in The Netherlands. Euro Surveill, 2012;17(3):20058.

42. Hackert VH, van der Hoek W, Dukers-Muijrers N, et al. Q fever: single-point source outbreak with high attack rates and massive numbers of undetected infections across an entire region. Clin Infect Dis, 2012;55(12):1591–1599.

43. Vranakis I, Kokkini S, Yachnakis E, et al. Q fever in Greece: Findings of a 13 years surveillance study. Comp Immunol Microbiol Infect Dis, 2020;69:101340.

44. Filioussis G, Theodoridis A, Papadopoulos D, et al. Serological prevalence of Coxiella burnetii in dairy goats and ewes diagnosed with adverse pregnancy outcomes in Greece. Ann Agric Environ Med, 2017;24(4):702–705.

45. Bulsara M, Mak D, Fry D. Prevalence of markers of Q fever exposure in the Kimberley, Western Australia. Commun Dis Intell Q Rep, 2003;27(2):267–271.

46. Boroduske A, Trofimova J, Kibilds J, et al. Coxiella burnetii (Q fever) infection in dairy cattle and associated risk factors in Latvia. Epidemiol Infect, 2017;145(10):2011–2019.

47. Zendulková D, Lány P, Rosenbergová K, et al. Analýza a vyhodnocení sérologického monitoringu Q horečky – nebezpečné zoonózy v chovech skotu s ohledem na bezpečnost potravin. 2011 [cit. 2022-05-21]; Dostupné na www: https://www.vri.cz.

48. Zendulková D, Rosenbergová K, Lány P, et al. Výskyt původce Q horečky u volně žijících přežvýkavců z pohledu bezpečnosti a kvality potravin a surovin živočišného původu. 2011 [cit. 2022- 05-21]; Dostupné na www: https://www.vri.cz.

49. Státní veterinární správa. Zpráva o činnosti v oblasti ochrany zdraví zvířat v roce 2021. 2022 [cit. 2022-05-12]; Dostupné na www: https://www.svscr.cz/zprava-o-cinnosti-v-oblasti-ochrany- zdravi-zvirat-v-roce-2021/.

50. Körner S, Makert GR, Ulbert S, et al. The prevalence of Coxiella Burnetii in hard ticks in Europe and their role in Q fever transmission revisited – A systematic review. Front Vet Sci, 2021;8:655715.