Abstract
On August 3rd, 2017, a Q fever outbreak alert was issued at a courier company that in addition to urgent freight transport offered pet delivery services. The epidemiological investigation set the exposition period between June 1 and August 8. In this period, 180 workers from two operational platforms for parcel distribution located in two provinces of the Basque Country (Bizkaia and Araba) were exposed; 64 filled a questionnaire and provided blood samples for serological testing, resulting in 10 confirmed cases (15.6%) and six (9.4%) probable cases. Nine workers (8 confirmed and 1 probable) showed Q fever symptoms, including pneumonia (five cases), and required medical care services, including one hospital admission. The attack rate was 25% (16/64), being higher among workers that visited the Bizkaia platform. This suggested that the origin of the outbreak was in the Bizkaia platform, where animals in transit waited at a pet holding site until being moved to their destination. Environmental samples consisting on 19 surface dust and two aerosol samples were collected at the Bizkaia platform to investigate the presence of C. burnetti DNA. All dust samples were positive by real time PCR, the lowest Ct values being found in dust collected at the pet holding facilities, and therefore suggesting that contamination originated at the pet holding site. The genotype identified in dust was SNP1/MST13, one of the most commonly identified genotypes in goats and sheep in the Basque Country. During the exposure period, two deliveries of miniature goats were made, of which only one could be investigated and tested negative. Although the contamination source could not be unequivocally identified, transport of ruminants was banned at the company, and Q fever was included among the occupational-associated health risks.
Highlights
The intracellular bacterium Coxiella burnetii is the causative agent of Q fever in people and animals
This is due to the fact that Q fever infected farm animals shed millions of bacteria during abortion and parturition through different routes of excretion such as feces, uterine fluids, milk, and placentas [3]
A Q fever outbreak was declared in August 2017 at a courier company
Summary
The intracellular bacterium Coxiella burnetii is the causative agent of Q fever in people and animals. EFSA [2] compiled 39 outbreaks of Q fever in Europe between 1982 and 2007, 32 of them being related to small ruminants. This is due to the fact that Q fever infected farm animals shed millions of bacteria during abortion and parturition through different routes of excretion such as feces, uterine fluids, milk, and placentas [3]. Outbreaks of human Q fever are related to contact with the animal reservoirs, which maintain the infection active and shed C. burnetii by different routes to the environment. In this study we present the investigation of an outbreak of Q fever in an express transport company authorized for the transport of pets
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