Toxoplasma gondii infection in humans and animals in the United States.

Serological responses of equids fed Toxoplasma gondii oocysts.

Manual of Standards for Diagnostic Tests and Vaccines

Q fever is a zoonotic disease considered as emerging or re-emerging in many countries. It is caused by Coxiella burnetii, a bacterium developing spore-like forms that are highly resistant to the environment. The most common animal reservoirs are livestock and the main source of infection is by inhalation of contaminated aerosols. Although the culture process for Coxiella is laborious, advances on the knowledge of the life cycle of the bacterium have been made. New tools have been developed to (i) improve the diagnosis of Q fever in humans and animals, and especially animal shedders, (ii) perform epidemiological studies, and (iii) prevent the disease through the use of vaccines. This review summarizes the state of the knowledge on the bacteriology and clinical manifestations of Q fever as well as its diagnosis, epidemiology, treatment and prevention in order to understand what factors are responsible for its emergence or re-emergence.

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Is Q Fever an emerging or re-emerging zoonosis?

Q fever, a zoonotic disease caused by the bacterium Coxiella burnetii, can cause acute or chronic illness in humans. Transmission occurs primarily through inhalation of aerosols from contaminated soil or animal waste. No licensed vaccine is available in the United States. Because many human infections result in nonspecific or benign constitutional symptoms, establishing a diagnosis of Q fever often is challenging for clinicians. This report provides the first national recommendations issued by CDC for Q fever recognition, clinical and laboratory diagnosis, treatment, management, and reporting for health-care personnel and public health professionals. The guidelines address treatment of acute and chronic phases of Q fever illness in children, adults, and pregnant women, as well as management of occupational exposures. These recommendations will be reviewed approximately every 5 years and updated to include new published evidence.

Diagnosis and management of Q fever--United States, 2013: recommendations from CDC and the Q Fever Working Group

Adult ewes (17 months of age) were vaccinated against Coxiella burnetii, using a formalin-inactivated whole cell (WC) phase I Henzerling strain vaccine or a chloroform methanol residue (CMR) vaccine. Nineteen pregnant ewes were placed in 3 categories [(i) unvaccinated, (ii) WC vaccine, and (iii) CMR vaccine] and were challenge exposed at approximately the 100th day of gestation with 210,000 plaque-forming units of C burnetii inoculated subcutaneously. Shedding of rickettsiae was measurably reduced, but was not prevented in vaccinated groups, as shown by inoculating ewes' placental tissues, amniotic fluid, and colostrum into mice, as well as by histopathologic lesions of placental tissues. The rickettsiae were shed in the placenta, amniotic fluid, or colostrum in 6 nonvaccinated ewes. In comparison, rickettsiae were detected in placental inoculations from 2 of 6 ewes in the WC vaccine group and 1 of 6 in the CMR group. In contrast to those in the vaccinated ewes, placentitis, high concentrations of rickettsiae in microscopic preparations, and weak lambs were typical for the nonvaccinated ewes.

Q fever vaccination of sheep: challenge of immunity in ewes.

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.

Enzyme immunoassay for surveillance of Q fever.

The immunity of Holstein-Friesian dairy cows vaccinated against Coxiella burnetii was challenged with 4 X 10(8) infective guinea pig doses of viable rickettsiae. Cows that were vaccinated had normal full-term calves, whereas 2 nonvaccinated cows aborted late in pregnancy. Intrauterine infection of the fetus was indicated by recovery of the organism from tissues of the fetus. Coxiella burnetii was recovered from milk, colostrum, and placenta of vaccinated and nonvaccinated cows after challenge inoculation, but the rickettsiae recovered were as many as 1,000 times more numerous in nonvacinated cows.

Q fever (Coxiella burnetii) investigations in dairy cattle: challenge of immunity after vaccination

Sera from 153 wild animals of 18 species were tested for antibodies against 12 serovars of Leptospira by the microscopic agglutination (MA) test. Seventy-five percent of the animals tested were seropositive against one or more of the 12 serovars used. The most commonly found serovars were pomona, autumnalis, pyrogenes, icterohaemorrhagiae, australis, and canicola. Of 62 carnivores representing 7 species, 55 (89%) were seropositive, as were 46 (60%) of 77 rodents from 9 species. Leptospira of the serovar copenhageni serogroup icterohaemorrhagiae were recovered from kidney tissues of a Norway rat (Rattus norvegicus). Of 443 wildlife sera tested by the indirect hemagglutination (IHA) test using cells sensitized with L. illini antigen, 47 (11%), mainly carnivores and deer, gave a heterophile reaction. Of the remaining 396 sera, 164 (41%) were seropositive for leptospirosis by the IHA test. To compare the IHA test with the MA test, 143 serum samples were tested by both methods. There was 84% concordance betwee...

Evaluation of the hemagglutination test for epidemiologic studies of leptospiral antibodies in wild mammals.

A phase I formalin-inactivated Q fever vaccine, using the Nine Mile strain of the organism, was tested for its ability to prevent dairy cows from shedding Coxiella burnetti in their milk. More than 1,400 Holstein-Friesian dairy calves and heifers from 5 dairies were used in field trials lasting over a 3-year period. Vaccination of 476 calves resulted in a geometric mean antibody titer of 1:123.3 compared with 1:2.4 for 486 nonvaccinated calves. The milk samples from 163 vaccinated calves were tested by mouse inoculation after the cows commenced lactation and were placed in their respective milking herds. Of these vaccinated animals, only 2 cows (1%) from 1 herd were suspected shedders, but on subsequent testing gave negative results. Among 164 nonvaccinated (control) cows, 39 (24%) were shedding C burnetii in their milk; this figure corresponded to the prevalence (23%) of shedders in the general population of dairy cows in California. The results of the current field trials indicated that vaccination greatly reduced the shedding of the Q fever organism in the milk of dairy cows.

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Papers

Q fever vaccination of sheep: challenge of immunity in ewes.

Enzyme immunoassay for surveillance of Q fever.

Q fever (Coxiella burnetii) investigations in dairy cattle: challenge of immunity after vaccination

Evaluation of the hemagglutination test for epidemiologic studies of leptospiral antibodies in wild mammals.

Vaccination of dairy cattle against Q fever (Coxiella burneti): results of field trials.