Abstract
An outbreak of Q fever occurred in February–April 2014 among workers at a waste-sorting plant in Bilbao (Spain). The outbreak affected 58.5% of investigated employees, 47.2% as confirmed cases (PCR and/or serology) and 11.3% as probable cases (symptoms without laboratory confirmation). Only employees who had no-access to the waste processing areas of the plant were not affected and incidence of infection was significantly higher among workers not using respiratory protection masks. Detection by qPCR of Coxiella burnetii in dust collected from surfaces of the plant facilities confirmed exposure of workers inside the plant. Animal remains sporadically detected among the residues received for waste-sorting were the most probable source of infection. After cleaning and disinfection, all environmental samples tested negative. Personal protection measures were reinforced and made compulsory for the staff and actions were taken to raise farmers’ awareness of the biological risk of discharging animal carcasses as urban waste.
Highlights
Q fever is a zoonotic disease caused by the obligate intracellular bacterium Coxiella burnetii
This study describes the clinical, epidemiological, diagnostic and environmental investigation of a Q fever outbreak occurred among workers of a solid waste-sorting plant in Bizkaia between February and April 2014, where 58.5% of the staff was affected
One week after the first case of pneumonia in a worker of the waste-sorting plant was declared, C. burnetii was identified by Phase II IgM detection in ELISA test (March 25)
Summary
Q fever is a zoonotic disease caused by the obligate intracellular bacterium Coxiella burnetii. Placenta of infected sheep and goats can contain 109C. About 50– 60% of cases remain asymptomatic Both symptomatic and asymptomatic patients with acute Q fever, can progress to a chronic form that can lead to endocarditis in 1–5% of infected people [4,8]. In the region (1,158,000 inhabitants), Q fever in humans has been historically associated with sheep since human cases appear in spring, coinciding with the end of the lambing season [9]. This study describes the clinical, epidemiological, diagnostic and environmental investigation of a Q fever outbreak occurred among workers of a solid waste-sorting plant in Bizkaia between February and April 2014, where 58.5% of the staff was affected
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