Serological and Molecular Detection of Coxiella Burnetii in Clinical Samples from Veterinarians and Cattle Farm Workers from Gabrovo Region, Bulgaria

  • Petia Genova-Kalou National Centre of Infectious and Parasitic Diseases (NCIPD), Virology Department, 44A “Gen. Stoletov” Blvd., 1233 Sofia, Bulgaria
  • Stefka Krumova National Centre of Infectious and Parasitic Diseases (NCIPD), Virology Department, 44A “Gen. Stoletov” Blvd., 1233 Sofia, Bulgaria
  • Miroslav Parvanov Bulgarian Veterinary Association, 15A Pencho Slaveykov Blvd., 1606 Sofia, Bulgaria
  • Radostina Stefanova National Centre of Infectious and Parasitic Diseases (NCIPD), Virology Department, 44A “Gen. Stoletov” Blvd., 1233 Sofia, Bulgaria
  • Radoslav Marinov National Centre of Infectious and Parasitic Diseases (NCIPD), Virology Department, 44A “Gen. Stoletov” Blvd., 1233 Sofia, Bulgaria
  • Ivona Andonova National Centre of Infectious and Parasitic Diseases (NCIPD), Virology Department, 44A “Gen. Stoletov” Blvd., 1233 Sofia, Bulgaria
  • George Dyankov Bulgarian Veterinary Association, 15A Pencho Slaveykov Blvd., 1606 Sofia, Bulgaria
  • Konstantin Simeonov National Diagnostic and Research Veterinary Medical Institute "Prof. Dr. G. Pavlov”, Bulgarian Food Safety Agency (BFSA), 15A Pencho Slaveykov Blvd., 1606 Sofia, Bulgaria,
Keywords: Coxiella burnetii, seroepidemiology, end-point PCR, freelance veterinarians and cattle farm workers, Gabrovo regions, Bulgaria

Abstract

Coxiella burnetii, which causes Q fever, is a highly infectious agent that is widespread around the world.  During the last decades, the number of cases reported in Bulgaria varied from year to year. The present study aimed to determine the frequency of C. burnetii infection using ELISA and conventional PCR among freelance veterinarians and cattle farm workers in Gabrovo province, Bulgaria. In the period April 2020 to June, 2021 a total of 154 blood samples of target group was tested in the National Reference Laboratory of Cell cultures, rickettsia and oncogenic viruses (NRL CCROV) at NCIPD - Sofia. Diagnosis of C. burnetii was performed by indirect enzyme-linked immunosorbent assay ELISA (anti-Coxiella burnetii ph. II IgG/IgM) and by end-point PCR technique (to detect the sodB gene region of C. burnetii). By indirect ELISA assay of the tested 154 clinical samples, anti-C. burnetii positive ph. II IgM antibodies were registered in 37% of samples. A relatively high percentage are affected in the active age between 50-60 years old. Anti-C. burnetii positive ph. II IgG antibodies were proven at 50% of tested samples. A positive PCR signal for C. burnetii DNA was obtained at 37/154 (20% of samples) and follows the above reported trend of acute infection of active age patients. Around 10% of tested samples were positive for three C. burnetii laboratory markers. We conclude that Q fever is endemic in Bulgaria. More research is necessary in different Bulgarian regions to set the human risk groups, to diagnose acute and chronic Q fever and to determine the economic impact of Q fever in the cattle industry. In the NRL CCROV was developed diagnostic scheme including complex methods to improve early laboratory diagnosis of C. burnetii, allowing taking proper treatment of suspected with Q fever patients.

References

. Jones K, Patel N, Levy M, et al. (2008). “Global trends in emerging infectious diseases”. Nature. 451:990-94. Available: https://doi.org/10.1038/nature06536

. Karesh W, Dobson A, Lloyd-Smith J, et al. (2012). “Ecology of zoonoses: natural and unnatural histories”. Lancet. 380:1936–45. Available: https://doi.org/10.1016/S0140-6736(12)61678-X.

. Mishra J., Mishra P. & Arora N. (2021). “Linkages between environmental issues and zoonotic diseases: with reference to COVID-19 pandemic”. Environmental Sustainability. Available: https://doi.org/10.1007/s42398-021-00165-x

. Campbell-Lendrum D, Manga L, Bagayoko M, Sommerfeld J. (2015). “Climate change and vector-borne diseases: what are the implications for public health research and policy?”. Philos Trans R Soc Lond B Biol Sci. 370(1665):20130552. Available: https://doi.org/10.1098/rstb.2013.0552

. Brook C, Dobson A. (2015). “Bats as ‘special’ reservoirs for emerging zoonotic pathogens”. Trends in Microbiology. 23: 172– 180. Available: https://doi.org/10.1016/j.tim.2014.12.004

. Porter S, Czaplicki G, Mainil J, Guattéo R, Saegerman C. (2011). “Q Fever: current state of knowledge and perspectives of research of a neglected zoonosis”. Int J Microbiol. 248418. Available: https://doi.org/10.1155/2011/248418

. Eldin C, Mélenotte C, Mediannikov O, Ghigo E, Million M, Edouard S, et al. (2017) “From Q Fever to Coxiella burnetii Infection: a Paradigm Change”. Clin Microbiol Rev. 30(1):115–90. pmid:27856520. Available: https://doi.org/10.1128/CMR.00045-16

. Kagawa F, Wehner J., Mohindra. (2003) “Q fever as a biological weapon”. Eur PMC, 18, 183 - 195.

. Woldehiwet Z. (2004). “Q fever (coxiellosis): epidemiology and pathogenesis”. Res Vet Sci. 77:93–100. pmid:15196898. Available: https://doi.org/10.1016/j.rvsc.2003.09.001

. Tissot-Dupont H, Raoult D. (2008, Sep) Q fever. Infect Dis Clin North Am. 22(3):505-14, ix. Available: https://doi.org/10.1016/j.idc.2008.03.002

. Angelakis E, Raoult D. (2010). “Q fever”. Vet Microbiol. 140: 297–309. Available: https://doi.org/10.1016/j.vetmic.2009.07.016

. Arricau-Bouvery N, Rodolakis A. (2005). “Is Q Fever an emerging or re-emerging zoonosis?”. Veterinary Research, BioMed Central. 36 (3), pp.327-349. Available: https://hal.archives-ouvertes.fr/hal-00902979

. Honarmand H. (2012). "Q Fever: An Old but Still a Poorly Understood Disease", Interdisciplinary Perspectives on Infectious Diseases, vol. 2012, Article ID 131932, 8 pages. Available: https://doi.org/10.1155/2012/131932

. Healy B, Llewelyn M, Westmoreland D, Lloyd G, Brown N. (2006). “The value of follow-up after acute Q fever infection,” Journal of Infection, vol. 52, no. 4, pp. e109–e112.

. Million M, Walter G, Thuny F, Habib G, Raoult D. (2013, Sep). “Evolution from acute Q fever to endocarditis is associated with underlying valvulopathy and age and can be prevented by prolonged antibiotic treatment”. Clin Infect Dis. 57(6):836-44. Available: https://doi.org/10.1093/cid/cit419

. Wegdam-Blans MC, Vainas T, van Sambeek MR, et al. (2011). “Vascular complications of Q-fever infections”. Eur J Vasc Endovasc Surg. 42(3):384–392. Available: https://doi.org/10.1016/j.ejvs.2011.04.013

. Fournier P, Raoult D. (2003). “Comparison of PCR and serology assays for early diagnosis of acute Q fever|. J. Clin. Microbiol. 41:5094–5098. Available: https://doi.org/10.1128/JCM.41.11.5094-5098.2003

. Schneeberger P, et al. (2010). “Real-time PCR with serum samples is indispensable for early diagnosis of acute Q fever”. Clin. Vaccine Immunol. 17:286–290. Available: https://doi.org/10.1128/CVI.00454-09

. Wegdam-Blans M, Wielders C, Meekelenkamp J, et al. (2012). “Evaluation of commonly used serological tests for the detection of Coxiella burnetii antibodies in well-defined acute and followup sera”. Clin Vaccine Immunol. 19:1110–1115.

. Dupuis G, Péter O, Peacock M, Burgdorfer W, Haller E. (1985). “Immunoglobulin responses in acute Q fever”. J. Clin. Microbiol. 22:484–487. Available: https://doi.org/10.1128/jcm.22.4.484-487.1985

. Aitken ID, Bögel K, Cračea E, et al. (1987). “Q fever in Europe: current aspects of aetiology, epidemiology, human infection, diagnosis and therapy”. Infection. 15(5):323–327. Available: https://doi:10.1007/BF01647731

. Frankel D, Richet H, Renvoisé A, Raoult D. (2011). “Q fever in France, 1985-2009”. Emerg Infect Dis. 17(3):350-356. Available: https://doi.org/10.3201/eid1703.100882

. Amitai Z, Bromberg M, Bernstein M, Raveh D, Keysary A, David D, et al. (2010). “A large Q fever outbreak in an urban school in central Israel”. Clin Infect Dis. 50:1433–8. Available: https://doi.org/10.1086/652442

. Enserink M. (2010). “Infectious diseases. Questions abound in Q-fever explosion in the Netherlands”. Science. 327:266–7. Available: https://doi.org/10.1126/science.327.5963.266-a

. Hellenbrand W, Breuer T, Petersen L. (2001). “Changing epidemiology of Q fever in Germany, 1947–1999”. Emerg Infect Dis. 7:789–96. Available: https://doi.org/10.3201/eid0705.010504

. Wallensten A, Moore P, Webster H, Johnson C, van der Burgt G, Pritchard G, et al. (2010). “Q fever outbreak in Cheltenham, United Kingdom, in 2007 and the use of dispersion modelling to investigate the possibility of airborne spread”. Euro Surveill. 15:19521. Available: https://doi.org/10.2807/ese.15.12.19521-en

. Anderson A. et al. (2013). “Diagnosis and management of Q fever–United States, 2013: Recommendations from CDC and the Q Fever Working Group”. MMWR Recomm. Rep. 62, 1–30. Available: https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6203a1.htm

. Mitov A, Shindarov L, Serbezov V. (1959). “Q fever in Bulgaria”. Mod Med. 1-2:39-46.

. Serbezov V, Kazár J, Novkirishki V, Gatcheva N, Kovácová E, Voynova V. (1999). “Q fever in Bulgaria and Slovakia”. Emerg Infect Dis. 5(3):388-94. Available: https://doi.org/10.3201/eid0503.990309

. Kamenov G, Tiholova M. (2004). “Q fever outbreak in Botevgrad, Bulgaria: May-June 2004”. Euro Surveill. 8(35):2535. Available: https://doi.org/10.2807/esw.08.35.02535-en

. Genova-Kalou P, Vladimirova N, Stoitsova S, Krumova S, Kurchatova A, Kantardjiev T. (2019). “Q fever in Bulgaria: Laboratory and epidemiological findings on human cases and outbreaks, 2011 to 2017”. Euro Surveill. 24(37):1900119. Available: https://doi.org/10.2807/1560-7917.ES.2019.24.37.1900119

. Stein A, Raoult D. (1992). “Detection of Coxiella burnetti by DNA amplification using polymerase chain reaction”. J Clin Microbiol. 30(9):2462-6. Available: https://doi.org/10.1128/jcm.30.9.2462-2466.1992

. Mathews K, Toribio J, Norris J, Phalen D, Wood N, Graves S, Sheehy P, Bosward K. (2020, Nov). Coxiella burnetii seroprevalence and Q fever in Australian wildlife rehabilitators. One Health; 12:100197. Available: https://doi: 10.1016/j.onehlt.2020.100197.

. Miller H, Kersh G. (2020, Dec). Analysis of recombinant proteins for Q fever diagnostics. Sci Rep. 1; 10(1):20934. Available: https://doi: 10.1038/s41598-020-77343-0.

Published
2021-08-22
Section
Articles