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Surveillance Open Access
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Abstract

Background

Q fever is a bacterial zoonosis caused by Spain has the highest number of notified human cases in Europe. Small ruminants are a key reservoir for the pathogen, transmission from animals to humans is usually airborne.

Aim

We aimed at exploring temporal and spatial epidemiological patterns of sporadic and outbreak cases of Q fever in four Spanish regions with the highest number of notified cases.

Methods

We extracted data on Q fever cases in the Canary Islands, Basque Country, La Rioja and Navarre between 2016 and 2022 from the Spanish National Epidemiological Surveillance Network. We calculated standardised incidence ratios (SIR), spatial relative risks (sRR) and posterior probabilities (PP) utilising Besag-York-Mollié models.

Results

There were 1,059 notifications, with a predominance of males aged 30–60 years. In Basque Country, La Rioja and Navarre area, 11 outbreaks were reported, while no in the Canary Islands. A seasonal increase in incidence rates was observed between March and June. In the Canary Islands, elevated sRR was seen in La Palma, Gran Canaria, Lanzarote and Fuerteventura. In Basque Country, La Rioja and Navarre area, the highest sRR was identified in the south of Biscay province.

Conclusion

Goats were the main source for humans in outbreaks reported in the literature. Seasonal increase may be related to the parturition season of small ruminants and specific environmental conditions. Local variations in sRR within these regions likely result from diverse environmental factors. Future One Health-oriented studies are essential to deepen our understanding of Q fever epidemiology.

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/content/10.2807/1560-7917.ES.2024.29.27.2300688
2024-07-04
2024-12-26
/content/10.2807/1560-7917.ES.2024.29.27.2300688
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References

  1. Eldin C, Mélenotte C, Mediannikov O, Ghigo E, Million M, Edouard S, et al. From Q fever to Coxiella burnetii Infection: a paradigm change. Clin Microbiol Rev. 2017;30(1):115-90.  https://doi.org/10.1128/CMR.00045-16  PMID: 27856520 
  2. Van den Brom R, van Engelen E, Roest HIJ, van der Hoek W, Vellema P. Coxiella burnetii infections in sheep or goats: an opinionated review. Vet Microbiol. 2015;181(1-2):119-29.  https://doi.org/10.1016/j.vetmic.2015.07.011  PMID: 26315774 
  3. van Roeden SE, Wever PC, Kampschreur LM, Gruteke P, van der Hoek W, Hoepelman AIM, et al. Chronic Q fever-related complications and mortality: data from a nationwide cohort. Clin Microbiol Infect. 2019;25(11):1390-8.  https://doi.org/10.1016/j.cmi.2018.11.023  PMID: 30543852 
  4. Barandika JF, Alvarez-Alonso R, Jado I, Hurtado A, García-Pérez AL. Viable Coxiella burnetii in hard cheeses made with unpasteurized milk. Int J Food Microbiol. 2019;303:42-5.  https://doi.org/10.1016/j.ijfoodmicro.2019.05.010  PMID: 31132730 
  5. González-Barrio D, Ruiz-Fons F. Coxiella burnetii in wild mammals: a systematic review. Transbound Emerg Dis. 2019;66(2):662-71.  https://doi.org/10.1111/tbed.13085  PMID: 30506629 
  6. Yessinou RE, Katja MS, Heinrich N, Farougou S. Prevalence of Coxiella-infections in ticks - review and meta-analysis. Ticks Tick Borne Dis. 2022;13(3):101926.  https://doi.org/10.1016/j.ttbdis.2022.101926  PMID: 35190334 
  7. Roest HJ, van Gelderen B, Dinkla A, Frangoulidis D, van Zijderveld F, Rebel J, et al. Q fever in pregnant goats: pathogenesis and excretion of Coxiella burnetii. PLoS One. 2012;7(11):e48949.  https://doi.org/10.1371/journal.pone.0048949  PMID: 23152826 
  8. Clark NJ, Soares Magalhães RJ. Airborne geographical dispersal of Q fever from livestock holdings to human communities: a systematic review and critical appraisal of evidence. BMC Infect Dis. 2018;18(1):218.  https://doi.org/10.1186/s12879-018-3135-4  PMID: 29764368 
  9. Roest HIJ, Tilburg JJHC, van der Hoek W, Vellema P, van Zijderveld FG, Klaassen CHW, et al. The Q fever epidemic in the Netherlands: history, onset, response and reflection. Epidemiol Infect. 2011;139(1):1-12.  https://doi.org/10.1017/S0950268810002268  PMID: 20920383 
  10. European Food Safety AuthorityEuropean Centre for Disease Prevention and Control. The European Union One Health 2021 Zoonoses Report. EFSA J. 2022;20(12):e07666. PMID: 36524203 
  11. Alende-Castro V, Macía-Rodríguez C, Novo-Veleiro I, García-Fernández X, Treviño-Castellano M, Rodríguez-Fernández S, et al. Q fever in Spain: Description of a new series, and systematic review. PLoS Negl Trop Dis. 2018;12(3):e0006338.  https://doi.org/10.1371/journal.pntd.0006338  PMID: 29543806 
  12. Instituto de Salud Carlos III (ISCII). Informe epidemiológico sobre la situación de la Fiebre Q en España. Años 2019, 2020 y 2021. [Epidemiological report on the situation of Q fever in Spain. Years 2019, 2020 and 2021]. Madrid: ISCII; Oct 2022. Spanish. Available from: https://www.isciii.es/QueHacemos/Servicios/VigilanciaSaludPublicaRENAVE/EnfermedadesTransmisibles/Documents/archivos%20A-Z/Fiebre_Q/Fiebre%20Q%20INFORME%2019-21%20final.pdf
  13. Hurtado A, Zendoia II, Alonso E, Beraza X, Bidaurrazaga J, Ocabo B, et al. A Q fever outbreak among visitors to a natural cave, Bizkaia, Spain, December 2020 to October 2021. Euro Surveill. 2023;28(28):2200824.  https://doi.org/10.2807/1560-7917.ES.2023.28.28.2200824  PMID: 37440349 
  14. European Commission (EC). Commission implementing decision 2018/945 of 22 June 2018 on the communicable diseases and related special health issues to be covered by epidemiological surveillance as well as relevant case definitions. Brussels: EC; 22 Jun 2018. Available from: https://eur-lex.europa.eu/eli/dec_impl/2018/945/oj
  15. Besag J, York J, Mollié A. Bayesian image restoration, with two applications in spatial statistics. Ann Inst Stat Math. 1991;43(1):1-20.  https://doi.org/10.1007/BF00116466 
  16. Bolaños M, Santana OE, Angel-Moreno A, Pérez-Arellano JL, Limiñana JM, Serra-Majem L, et al. Seroprevalence of infection by Coxiella burnetii in Canary Islands (Spain). Eur J Epidemiol. 2003;18(3):259-62.  https://doi.org/10.1023/A:1023342624475  PMID: 12800952 
  17. Sanzo JM, García-Calabuig MA, Audicana A, Dehesa V. Q fever: prevalence of antibodies to Coxiella burnetii in the Basque country. Int J Epidemiol. 1993;22(6):1183-8.  https://doi.org/10.1093/ije/22.6.1183  PMID: 8144303 
  18. Woldeyohannes SM, Gilks CF, Baker P, Perkins NR, Reid SA. Seroprevlance of Coxiella burnetii among abattoir and slaughterhouse workers: A meta-analysis. One Health. 2018;6:23-8.  https://doi.org/10.1016/j.onehlt.2018.09.002  PMID: 30302365 
  19. Walsh MG. Assessing Q fever in a representative sample from the United States population: identification of a potential occupational hazard. Epidemiol Infect. 2012;140(1):42-6.  https://doi.org/10.1017/S0950268811000227  PMID: 21371363 
  20. Groten T, Kuenzer K, Moog U, Hermann B, Maier K, Boden K. Who is at risk of occupational Q fever: new insights from a multi-profession cross-sectional study. BMJ Open. 2020;10(2):e030088.  https://doi.org/10.1136/bmjopen-2019-030088  PMID: 32041851 
  21. Alonso E, Eizaguirre D, Lopez-Etxaniz I, Olaizola JI, Ocabo B, Barandika JF, et al. A Q fever outbreak associated to courier transport of pets. PLoS One. 2019;14(11):e0225605.  https://doi.org/10.1371/journal.pone.0225605  PMID: 31765433 
  22. Álvarez-Alonso R, Basterretxea M, Barandika JF, Hurtado A, Idiazabal J, Jado I, et al. A Q fever outbreak with a high rate of abortions at a dairy goat farm: Coxiella burnetii shedding, environmental contamination, and viability. Appl Environ Microbiol. 2018;84(20):e01650-18.  https://doi.org/10.1128/AEM.01650-18  PMID: 30076194 
  23. Ruiz-Fons F, Astobiza I, Barandika JF, Hurtado A, Atxaerandio R, Juste RA, et al. Seroepidemiological study of Q fever in domestic ruminants in semi-extensive grazing systems. BMC Vet Res. 2010;6(1):3.  https://doi.org/10.1186/1746-6148-6-3  PMID: 20089188 
  24. Ministerio de Agricultura, Pesca y Alimentación. Resultados de las Encuestas de Ganado Ovino-Caprino. Noviembre 2022. Results of surveys of sheep and goats. Madrid: Ministerio de Agricultura, Pesca y Alimentación; Nov 2022. Spanish. Available from: https://www.mapa.gob.es/es/estadistica/temas/estadisticas-agrarias/resultados_nov2022_ovino-caprinod_tcm30-644163.pdf
  25. Zendoia II, Barandika JF, Hurtado A, López CM, Alonso E, Beraza X, et al. Analysis of environmental dust in goat and sheep farms to assess Coxiella burnetii infection in a Q fever endemic area: Geographical distribution, relationship with human cases and genotypes. Zoonoses Public Health. 2021;68(6):666-76.  https://doi.org/10.1111/zph.12871  PMID: 34240552 
  26. Espejo E, Gil-Díaz A, Oteo JA, Castillo-Rueda R, García-Alvarez L, Santana-Báez S, et al. Clinical presentation of acute Q fever in Spain: seasonal and geographical differences. Int J Infect Dis. 2014;26:162-4.  https://doi.org/10.1016/j.ijid.2014.06.016  PMID: 25080353 
  27. Espí A, Del Cerro A, Oleaga Á, Rodríguez-Pérez M, López CM, Hurtado A, et al. One Health approach: an overview of Q fever in livestock, wildlife and humans in Asturias (northwestern Spain). Animals (Basel). 2021;11(5):1395.  https://doi.org/10.3390/ani11051395  PMID: 34068431 
  28. González-Martín C, Pérez-González CJ, González-Toril E, Expósito FJ, Aguilera Á, Díaz JP. Airborne bacterial community composition according to their origin in Tenerife, Canary Islands. Front Microbiol. 2021;12:732961.  https://doi.org/10.3389/fmicb.2021.732961  PMID: 34737729 
  29. González-Barrio D, Carpio AJ, Sebastián-Pardo M, Peralbo-Moreno A, Ruiz-Fons F. The relevance of the wild reservoir in zoonotic multi-host pathogens: The links between Iberian wild mammals and Coxiella burnetii. Transbound Emerg Dis. 2022;69(6):3868-80.  https://doi.org/10.1111/tbed.14758  PMID: 36335588 
  30. Ministerio de Agricultura, Pesca y Alimentación. Procedimiento ante una comunicación de sospecha de fiebre Q en una explotación de rumiantes y/o comunicación de un brote en personas. [Procedure for reporting suspected Q fever in a ruminant farm and/or reporting an outbreak in people]. Madrid: Ministerio de Agricultura, Pesca y Alimentación; Sep 2023. Spanish. Available from: https://www.mapa.gob.es/es/ganaderia/temas/sanidad-animal-higiene-ganadera/procedimientofrenteafiebreqenrumiantessept2023_tcm30-659891.pdf
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