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PubMed1990

Seroepidemiology of Q fever among cats in New Brunswick and Prince Edward Island.

The indirect microimmunofluorescence test was used to determine the presence of antibodies to phase I and phase II Coxiella burnetii antigens in New Brunswick and Prince Edward Island cats. Twenty of 104 (19.2%) New Brunswick cats tested had antibodies to phase II antigen; five of these (4.8%) also had antibodies to phase I antigen. Six of 97 (6.2%) Prince Edward Island cats tested had antibodies to phase I and phase II antigens. Our data suggest that cats may be important in the epidemiology of Q fever in these provinces.

Animals↗

PubMed1978

[Seroepidemiological investigations in domestic ruminants from Egypt, Somalia and Jordan for the demonstration of complement fixing antibodies against Rickettsia and Chlamydia (author's transl)].

1450 random serum samples of domestic ruminants from Egypt, Somalia and Jordan were investigated for complement fixing antibodies against Rickettsia and Chlamydia. Between 1.5 and 3.4% of the samples from the animals investigated had antibodies against the RMSF-group of Rickettsia, with exception of the sera from Somalian cattle and sheep from Jordan. Antibodies against Rickettsia of the Typhus-group were found in 4 cattle and 1 goat from Jordan and 2 sheep from Egypt; by agglutination test with type-specific antigen they were identified as antibodies against R. typhi. Using 2 different antigens, antibodies against Coxiella burnetii were found in every population tested. The prevalence was 2.0 to 12.2%, with the exception of cattle in Somalia, where only 1 positive serum (0.2%) was found. 27% of the serum samples from Jordan and 22% from Egypt but none of the 802 samples from Somalia had antibodies against Chlamydia. The results are discussed under an epidemiological point of view.

Animals↗

PubMed1985

Enzyme immunoassay for surveillance of Q fever.

An enzyme-linked immunosorbent assay (ELISA) was developed to monitor antibodies against Coxiella burnetii among animal populations used in research and teaching facilities. Various antigenic components of C burnetii prepared from phase I and phase II whole cells and commercially available antigens were evaluated. A trichloroacetic acid extract was selected for routine use. There was a linear relationship between the transformed absorbance readings of the ELISA results and microagglutination (MA) titers. Comparison between positive or negative results of the MA test and ELISA gave 98.6% concordance. Using the MA test as the standard, ELISA results were 97.8% sensitive and 100% specific. The efficacy of ELISA was evaluated by testing ruminants with known histories of C burnetii infection. Antibody prevalence was 0 in 117 sheep with no history of C burnetii infection, 22% in 145 naturally infected sheep used for research, and 53% in 115 sheep used for vaccine field trials. Forty-eight percent of 120 dairy cows and 52% of 79 goats from endemically infected herds were seropositive. These results indicate that ELISA should be the test of choice for mass screening and surveillance of animals when Q fever is a suspected biohazard.

Animals↗

PubMed1989

[Incidence of Coxiella burnetti and Chlamydia psittaci in cattle in southern Bohemia].

In 1986 and 1987 in six districts and 22 localities of the Southern Bohemian region, and in one district and one locality of the Western Bohemian region the total of 747 head of cattle was examined by a microagglutination method (MAR) and complement fixation method (KFR) for antibodies to Coxiella burnetii and Chlamydia psittaci. The positivity of C. burnetii detection was 44.4% in MAR and 16.5% in KFR. The positivity of Chl. psittaci detection was 7.1%. The widespread incidence and highly positive results of coxiellosis findings in the given regions are especially remarkable. This circumstance--for the closed herd turnover in this country has been abandoned--can be considered a potential risk of Q fever outbreak in the human population not only in the Southern Bohemian region, but also in other localities.

Animals↗

PubMed1983

A rapid immunofluorescent procedure for serodiagnosis of Q fever in mice, guinea pigs, sheep, and humans.

The ability to diagnose Q fever has been hampered by the fact that diagnosis depends upon difficult serologic tests such as complement fixation (CF) or slide immunofluorescence performed only at reference laboratories. A new quantitative solid phase fluorescent antibody test (FIAX) has recently been developed and applied to measure antibodies in several microbial systems. The test takes less than 2 hr to perform and employs stable reagents. We have utilized this technique and developed a rapid immunofluorescent assay for detection of antibodies to Coxiella burnetii in man and animals. Sera from guinea pigs and mice immunized with phase I vaccine and from naturally infected sheep show high levels of fluorescence against both phase I and phase II antigens by this technique. We have tested over 100 CF positive humans from a recent laboratory outbreak of Q fever and find an excellent correlation between FIAX and CF results.

Animals↗

PubMed1990

[Frequency of abortion and seroprevalence of the principal diseases causing ovine infectious abortion in the area of Rabat (Morocco)].

A survey was carried out on 23 sheep flocks to estimate the frequency of abortion as well as the prevalence of antibodies against abortive infections. During the visit of each farm, a questionnaire was completed with the collaboration of the owner and blood samples were collected from all aborted ewes and some of those with normal lambing. A rate of 7% abortion was reached in both aborted and normally lambed ewes. Anti-Chlamydia psittaci antibodies were the most frequently detected (14 flocks). Anti-Coxiella burnetii and anti-Toxoplasma gondii antibodies were found in 9 flocks, whereas anti-Brucella and anti-Salmonella abortus ovis were present in only 1 flock each. None of the 5 infections was detected in 2 flocks. Mixed infections were prevalent: 13 flocks were simultaneously infected by at least 2 abortive pathogens. The procedure used does not allow the cause of abortion to be identified in all cases.

Abortion, Veterinary↗

PubMed1987

[Endocarditis with unusual causative agents].

In the period 1947-1985, 601 patients with infective endocarditis were seen at the University Hospital Zurich and the Kantonsspital Lucerne. Streptococci, enterococci and staphylococci were the predominant causative organisms in two-thirds of all cases. In more than 25% of the patients blood cultures remained negative. In 6 patients endocarditis was caused by very rare organisms, viz. Coxiella burnetii (2 cases), Hemophilus parainfluenzae, Corynebacterium bovis (diphtheroids), Brucella melitensis and Aspergillus terreus. The clinical and microbiological characteristics of these cases are described and compared with the results in the literature. Diagnostic and therapeutic problems are discussed. Only with special awareness of the role of these unusual organisms in causing infective endocarditis, especially Q fever endocarditis with its notoriously atypical course, can the number of "culture negative" cases be diminished and the prognosis thereby improved.

Adult↗

PubMed1984

[Serodiagnosis of human Q-fever--demonstration of non-complement binding IgM antibodies in the enzyme-linked immunosorbent assay (ELISA)].

The application of an indirect ELISA for detection of IgM and IgG antibodies against Coxiella burnetii in five Q fever patients--among them one with endocarditis and one with hepatitis--is described. In the acute phase of infection, within a few days after onset of clinical symptoms, a significant rise of IgM antibodies could be detected. It was followed by a rise of IgG in the second and third week. In chronic Q fever endocarditis, IgM antibodies persisted over a period of nine months. High IgM and low IgG values indicated acute infection, while in convalescent sera the IgM/IgG relationship was vice versa. In a comparative investigation with complement fixation (CF) test it could be shown that CF antibodies were associated exclusively with immunoglobulin G. IgM separated from IgG by gel chromatography did not fix complement. So, the CF test does not appear to be suitable for detection of antibodies against Coxiella in the early stages of the disease. Because of the persistence of IgG antibodies over a longer period of time, sole detection of a titer against the agent is insufficient for diagnosis of current disease, if not a rise or fall in titer can be detected in a second serum sample. Using the sensitive ELISA technique, a diagnosis is usually possible with one serum sample--in connection with history and clinical investigation--by differentiation of IgM and IgG antibodies.

Antibodies, Anti-Idiotypic↗

PubMed1989

Truckin' pneumonia--an outbreak of Q fever in a truck repair plant probably due to aerosols from clothing contaminated by contact with newborn kittens.

We describe an outbreak of Q fever affecting 16 of 32 employees at a truck repair plant. None of the cases were exposed to cattle, sheep or goats, the traditional reservoirs of Q fever. The cases did not work, live on, or visit farms or attend livestock auctions. One of the employees had a cat which gave birth to kittens 2 weeks prior to the first case of Q fever in the plant. The cat owner fed the kittens every day before coming to work as the cat would not let the kittens suckle. Serum from the cat had high antibody titres to phase I and phase II Coxiella burnetii antigens. The attack rate among the employees where the cat owner worked, 13 of 19 (68%), was higher than that of employees elsewhere, 3 of 13 (28%) [P less than 0.01]. The cat owner's wife and son also developed Q fever. None of the family members of the other employees with Q fever was so affected. We conclude that this outbreak of Q fever probably resulted from exposure to the contaminated clothing of the cat owner.

Adult↗

PubMed2003

Blood culture negative endocarditis: analysis of 63 cases presenting over 25 years.

OBJECTIVE: To analyse cases of blood culture negative endocarditis (BCNE) seen at St Thomas' Hospital, London, between 1975 and 2000. METHODS: Data on all episodes of endocarditis with negative blood cultures seen at St Thomas' Hospital between 1975 and 2000 were collected prospectively and analysed retrospectively. RESULTS: Sixty three patients with BCNE were seen during the study period: 48 (76%) with native and 15 (24%) prosthetic valve infection. BCNE accounted for 12.2% of the 516 cases of endocarditis seen at St Thomas' Hospital. The diagnosis of endocarditis was clinically definite by the Duke criteria in only 21% (7 of 34) of cases of pathologically proven native valve endocarditis but in 62% (21 of 34) of cases by the St Thomas' modifications of the criteria. Comparable figures for the 11 cases of pathologically proven prosthetic valve endocarditis were 45% and 73%. Despite negative blood cultures a causative organism was identified in 31 (49%) of the 63 cases: in 15 by serology (8 Coxiella burnetii, 6 Bartonella species, and 1 Chlamydia psittaci); in 9 cases by culture of the excised valve; in 3 by microscopy of the excised valve, on which large numbers of Gram positive cocci were seen although the culture was sterile; and in the other 4 by isolation from a site other than the excised valve (2 respiratory specimens, 1 from the pacemaker tip, and 1 from an excised embolus). In addition 5 of the 6 cases of Bartonella infection were confirmed by polymerase chain reaction study of the excised valve. Two thirds of the 32 patients for whom no pathogen was identified had received antibiotics before blood was cultured. Thus truly "negative" endocarditis was very uncommon (6% of the cases). CONCLUSION: If blood cultures are negative in definite or suspected endocarditis, serum should be analysed for Bartonella, Coxiella, and Chlamydia species antibodies, and the excised valve or (rarely) embolus should be analysed by microscopy, culture, histology, and relevant polymerase chain reaction. Other specimens may be relevant. The Duke criteria performed poorly in BCNE; St Thomas' additional minor criteria gave more definite diagnoses.

Endocarditis, Bacterial↗

PubMed1991

Pathogenesis of rickettsial infections emphasis on Q fever.

The underlying mechanisms at the organismic, cellular and molecular levels that account for rickettsial pathogenesis are beginning to be revealed. In the case of Coxiella burnetii infection, relatively recent genetic and biochemical data, as well as drug susceptibility studies, indicate a correlation between isolate type and clinical disease--chronic or short-term acute. The use of cultured cells as model host systems has revealed that, indeed, different isolates from the major classified strains of C. burnetii cause different host cell responses. Use of this and other models (guinea pigs, mice) have revealed other characteristics and properties of the rickettsiae and the infected hosts and host cells that may account, in part, for acute disease and persistent infection culminating in chronic disease. The virulence factors involved apparently include the agent's surface lipopolysaccharide; other unidentified factors have not been excluded. Molecular cloning will play a major role in elucidating the roles of these factors and in identifying other virulence determinants.

Acute Disease↗

PubMed1990

Zoonotic infections in Northern Ireland farmers.

Evidence of past zoonotic infection was investigated serologically in randomly selected Northern Ireland farmers. The percentage of farmers with antibody was: Brucella abortus (0.7), Leptospira interrogans serovars (8.1), Borrelia burgdorferi (14.3), Toxoplasma gondii (73.5), Coxiella burnetii (28.0), Chlamydia psittaci (11.1) and Hantavirus (1.2). The results show that Northern Ireland farmers have been exposed in the past to zoonotic infections. It is not known if these infections contributed to ill health in farmers but it is now time for the health of farm workers and their medical services to be reassessed.

Adult↗

PubMed1991

Q fever meningoencephalitis in five patients.

Within the last four years, we have observed five patients with epidemiological, clinical, and serological features that were consistent with Q fever meningoencephalitis. Attempts to isolate Coxiella burnetii from the cerebrospinal fluid of two patients were unsuccessful. Neurological features ranged from coma, general seizures, confusion, to palsy and meningitis. All patients were febrile. These patients were neuroradiologicaly investigated. Since 1984, four other cases have been reported in the literature. Antibiotics with good penetration into the cerebrospinal fluid, such as new quinolones, may be useful for treatment of confirmed cases. Q fever should be considered as a possible etiology of meningitis in endemic areas, and diagnosis should be confirmed by serology.

Adolescent↗

PubMed1988

Acute heart failure due to Q fever endocarditis.

We report a case of Q fever endocarditis in a patient who presented with a slight pyrexia and acute cardiac failure due to aortic incompetence. The diagnosis was made by detecting high titres of serum IgG and IgA antibody against Coxiella burnetii phase I antigens and confirmed by demonstrating C. burnetii on the excised aortic valve using immunofluorescence and electron microscopy. Aortic valve replacement was followed by initially successful antibiotic treatment for 15 months. Reappearance of IgA anti-phase I antibodies 5 months later suggested continued presence of bacteria, although the patient's condition remained satisfactory. In endemic areas, such as rural southern France, Q fever endocarditis should be considered when there is evidence of acute heart valve damage but are few other features of infection.

Acute Disease↗

PubMed1988

Enzyme-linked immunosorbent assay for diagnosis of chronic Q fever.

From 1982 through 1987 we diagnosed 13 chronic Q fever cases. Clinically these patients presented a culture-negative endocarditis, and all but two had high complement-fixing antibody titers to Coxiella burnetii phase I (reciprocal titer above 200). With the enzyme-linked immunosorbent assay (ELISA), titers of immunoglobulin G (IgG) to phases I and II of C. burnetii averaged 158,000 and 69,900, respectively, whereas they reached 300 and 3,200 in acute Q fever cases. Similarly, IgA to both phases of C. burnetii and IgM to phase I were consistently higher during chronic than acute Q fever. The serological follow-up of one patient with chronic Q fever over a 4-year period showed a good correlation between the titers of IgG and IgM antibody titers detected by ELISA and indirect fluorescent-antibody test (IFA) to both phases of C. burnetii. Few discrepancies appeared with IgA. Shortly after initiation of antibiotic treatment, a slow and steady decrease of the antibody titers to C. burnetii phases I and II was observed. The complement fixation, IFA, and ELISA tests showed the same type of antibody response. The ELISA proved to be an excellent diagnostic test for chronic Q fever. It distinguished negative from positive reactions clearly, and results were highly reproducible. The reading is objective, and the test is simple to perform and more sensitive than the IFA and complement fixation tests. The ELISA is recommended for serologic evaluation of patients with chronic Q fever.

Antibodies, Bacterial↗

PubMed1983

Serological evaluation of O fever in humans: enhanced phase I titers of immunoglobulins G and A are diagnostic for Q fever endocarditis.

Serological parameters were compared in 15 cases of Coxiella burnetii infection comprising 5 cases each of primary Q fever, chronic granulomatous hepatitis, and endocarditis. The diagnosis was made on the basis of clinical history and serology and on the isolation of C. burnetii phase I from biopsy specimens of liver and bone marrow from two patients with granulomatous hepatitis and from the aortic valve vegetations of five patients with endocarditis. The temporal sequences of immunoglobulin levels, rheumatoid factor, and specific antibody responses to phase II and phase I antigens of C. burnetii were evaluated as predictive correlates of the three Q fever entities. Serum levels of immunoglobulin classes G, M, and A were variable in all the entities of Q fever. Increased mean levels (in milligrams per deciliter) of immunoglobulin G (IgG) and IgA were noted with chronic disease in the sera of some patients, whereas IgM levels were not significantly different from normal values. Rheumatoid factor was significantly elevated in chronic disease but not in primary Q fever. The temporal sequence of C. burnetii phase II and phase I antibodies were compared by microagglutination, complement fixation, and indirect microimmunofluorescence tests. All of these serological tests were useful in distinguishing primary from chronic disease. Thus, the ratio of anti-phase II to anti-phase I antibodies was greater than 1, greater than or equal to 1, and less than or equal to 1 for primary Q fever, granulomatous hepatitis, and Q fever endocarditis, respectively. Moreover, the high phase-specific IgA antibody titers in the indirect microimmunofluorescence test were diagnostic for endocarditis.

Antibodies, Bacterial↗

PubMed1988

Seroepidemiology of Q fever in New Brunswick and Manitoba.

A seroepidemiological survey, using an indirect immunofluorescence test, was carried out on serum samples obtained from New Brunswick and Manitoba blood donors during 1986. The antigens were Coxiella burnetii phase I and phase II from strain Nine Mile. Eighty of the 503 (15.9%) Manitoba blood donors had a phase II antibody titer of greater than or equal to 1:8, while 41 (4.2%) of the 966 New Brunswick blood donors had such antibodies. We have recently diagnosed three cases of Q fever in New Brunswick but none have been diagnosed in Manitoba. Our data suggest that Q fever may be increasing in New Brunswick and repeated seroepidemiological studies are indicated. It is likely that undetected cases of Q fever are occurring in Manitoba.

Antibodies, Bacterial↗

PubMed1983

Serologic survey of California wild hogs for antibodies against selected zoonotic disease agents.

Blood samples were collected from trapped or hunter-killed wild hogs (Sus scrofa) in 4 areas of California. Sera were tested for antibodies against 7 zoonotic disease agents. Antibodies against Brucella sp were detected in 21 (15%) of 136 samples. Antibodies against Coxiella burnetii were found in 50% of the collected samples (67 of 135 tested). Of the 135 wild hogs screened for pseudorabies virus, 4 (3%) were seropositive. Leptospira interrogans antibodies were discovered in 118 (87%) of the 136 samples tested. Of the 130 samples screened for antibodies against Mycobacterium avium complex, 111 (85%) were seropositive. Antibodies against Toxoplasma gondii were detected in 17 (13%) of 135 wild hogs. Antibodies against Yersinia pestis were found in 9 (15%) of 59 sera tested.

Animal Population Groups↗