Coxiella Burnetii Research Articles

Foodborne Pathogens Across Different Food Matrices in Sicily (Southern Italy)

Foodborne diseases result from the consumption of foods contaminated with pathogens or their toxins and represent a serious public health problem worldwide. This study aimed to assess the presence of Rotavirus (RoV), Adenovirus (AdV), Norovirus (NoV), Hepatitis A and Hepatitis E viruses (HAV and HEV, respectively), Toxoplasma gondii, Coxiella burnetii and Leptospira spp. across various food matrices in Sicily. The analysis concerned 504 samples, including mussels, farmed meat, game meat, vegetables and bulk milk. Following appropriate pre-treatment, acid nucleic extraction was carried out and amplification of pathogen nucleic acids was carried out by molecular methods. The mussels tested positive for NoVs (3/51, 5.9%) and farm meat resulted positive for T. gondii (1/34, 2.9%). The game offal samples tested positive for HEV, which was detected in 17 out of 222 samples (7.7%), and T. gondii (18/318, 5.7%) and Leptospira spp. (2/318, 0.6%). The milk samples tested positive for C. burnetii (15/ 85, 17.6%), T. gondii (2/85, 2.4%) and Leptospira spp. (1/85, 1.2%). This study highlights the variability in the risk of contamination of different food matrices, confirming the importance of vigilance in the consumption of potentially contaminated food products.

Coxiella burnetii caused lumbar infection: A case report and literature review

Coxiella burnetii (C. burnetii)is a significant microbe linked to the zoonotic disease Q fever, known for its atypical clinical manifestations and sporadic cases. It can cause lumbar infections. In this report, we present a 66-year-old male sheep farmer who experienced low back pain for five months, with worsening numbness in both lower limbs over two months. Several standard diagnostic tests were negative. Metagenomic next-generation sequencing (mNGS) was performed on lumbar spine tissue obtained via biopsy, identifying C. burnetii infection. After surgical excision of the lesion, the patient received a combination of levofloxacin, doxycycline, rifampicin, and supportive medications. Postoperatively, the patient's condition stabilized, showing a significant reduction in low back pain. This case highlights mNGS as a valuable tool for diagnosing rare infections, especially in patients with a history of animal exposure. It underscores the importance of considering zoonotic infections and the need for combined antibiotic and surgical management in suspected cases.

Metagenomic Nanopore Sequencing of Tickborne Pathogens, Mongolia.

We performed nanopore-based metagenomic screening on 885 ticks collected from 6 locations in Mongolia and divided the results into 68 samples: 23 individual samples and 45 pools of 2-12 tick samples each. We detected bacterial and parasitic pathogens Anaplasma ovis, Babesia microti, Coxiella burnetii, Borrelia miyamotoi, Francisella tularensis subsp. holarctica and novicida, Spiroplasma ixodetis, Theileria equi, and Rickettsia spp., including R. raoultii, R. slovaca, and R. canadensis. We identified the viral pathogens Crimean-Congo hemorrhagic fever virus (2.9%), recently described Alongshan virus (ALSV) (2.9%), and Beiji nairovirus (5.8%). We assembled ALSV genomes, and maximum-likelihood analyses revealed clustering with viruses reported in humans and ticks from China. For ALSV, we identified surface glycoprotein markers associated with isolates from Asia viruses hosted by Ixodes persulcatus ticks. We also detected 20 virus species of unknown public health impact, including a near-complete Yanggou tick virus genome. Our findings demonstrate that nanopore sequencing can aid in detecting endemic and emerging tickborne pathogens.

Molecular Epidemiology of Ticks and Tick-Borne Pathogens in the Ta-Pa Mountain Area of Chongqing, China

To validate the prevalence and biodiversity of ticks and tick-borne pathogens in Chongqing, a total of 601 ticks were collected from dogs, cattle, and goats within the Ta-pa Mountain range in Chongqing, China. Five distinct tick species were identified, including Ixodes ovatus (1.66%, 10/601), I. acutitarsus (0.50%, 3/601), Haemaphysalis flava (10.32%, 62/601), Ha. hystricis (9.82%, 59/601), and Ha. longicornis (77.70%, 467/601). A suit of semi-nest PCR and nest PCR primers were custom-synthesized for the detection of tick-borne pathogens. The analysis yielded positive results for 7.15% Rickettsia (Candidatus R. principis, R. japonica, and R. raoultii), 3.49% Anaplasma (A. bovis and A. capra), 1.16% Ehrlichia, 1.83% Coxiella burnetii, and 3.49% protozoa (Theileria. capreoli, T. orientalis, T. luwenshuni, and Babesia sp.) in ticks. Notably, Ca. R. principis was identified for the first time in I. ovatus and Ha. longicornis. These findings underscore the significant prevalence and diversity of ticks and their associated pathogens within the Chongqing Ta-pa Mountain region. This study accordingly provides an extensive dataset that contributes to the epidemiological understanding and disease prevention strategies for tick-borne illnesses in the local area.

Seroepidemiology of Coxiella burnetii in Domestic and Wild Ruminant Species in Southern Spain.

The European Food Safety Authority has recently listed Q fever as a priority for setting up a coordinated surveillance system. Although Spain is the country with the highest human incidence of the disease in the European Union, updated data on Coxiella burnetii in ruminants are still limited. A total of 780 serum samples from small ruminants and 605 sera from wild ruminants were collected in the Mediterranean ecosystems of southern Spain during the period 2015-2023. Anti-C. burnetii antibodies were detected using a commercial indirect ELISA. The overall individual seroprevalence in the small ruminants was 49.1% (383/780; 95% CI: 45.6-52.6). Antibodies against C. burnetii were identified in 40.0% (156/390) of sheep and in 58.2% (227/390) of goats. At least one seropositive animal was observed in all sheep (100%) and in 92.3% of goat flocks. The species (goat) and the existence of reproductive disorders in primiparous females were potential risk factors for C. burnetii exposure in small ruminant farms. In the wild ruminants, the overall seroprevalence against C. burnetii was 1.5% (9/605; 95% CI: 0.8-2.8). Anti-C. burnetii antibodies were found in 1.8% (2/110) of mouflon, 1.5% (6/390) of red deer, and 1.0% (1/105) of Iberian ibex. The high exposure of the small ruminants to C. burnetii, particularly in goats, detected in the present study is of animal and public health concern. Our results denote that wild ruminants only play a minor role in the epidemiology of this bacterium in southern Spain and suggest an independent epidemiological cycle of C. burnetii in domestic and wild ruminant species in the study area.

Increased pathogen exposure of a marine apex predator over three decades.

Environmental changes associated with global warming create new opportunities for pathogen and parasite transmission in Arctic wildlife. As an apex predator ranging over large, remote areas, changes in pathogens and parasites in polar bears are a useful indicator of changing transmission dynamics in Arctic ecosystems. We examined prevalence and risk factors associated with exposure to parasites and viral and bacterial pathogens in Chukchi Sea polar bears. Serum antibodies to six pathogens were detected and prevalence increased between 1987-1994 and 2008-2017 for five: Toxoplasma gondii, Neospora caninum, Francisella tularensis, Brucella abortus/suis, and canine distemper virus. Although bears have increased summer land use, this behavior was not associated with increased exposure. Higher prevalence of F. tularensis, Coxiella burnetii, and B. abortus/suis antibodies in females compared to males, however, could be associated with terrestrial denning. Exposure was related to diet for several pathogens indicating increased exposure in the food web. Elevated white blood cell counts suggest a possible immune response to some pathogens. Given that polar bears face multiple stressors in association with climate change and are a subsistence food, further work is warranted to screen for signs of disease.

Establishment and validation of a real-time fluorescent PCR freeze-dried type assay for 11 sheep and goats pathogens

Small ruminants are economic mainstay in developing countries because of its direct contribution to food security, but the occurrence of epidemics poses a continuous threat. Early diagnosis can strengthen the prevention of zoonosis. Therefore, a high-sensitivity real-time fluorescent PCR freeze-dried type assay that can be stored and transported at room temperature was developed for 11 sheep and goats pathogens in this study. The results showed that there was no non-specific amplification in systems containing different pathogen positive controls; The areas under the ROC curves were all in the range of 0.99 to 1.00; The LOD counted by Digital PCR were 194, 96, 84, 40, 265, 68, 208, 236, 118, 53 and 723 copies/mL for M. ovis, Pathogenic Leptospira, C. burnetii, BTV, PPRV, Brucella, exJSRV, C. abortus, ORFV, FMDV and CPV, respectively. The coefficients of variation of both intra-group and inter-group replicate tests were less than 5.00%; The accelerated thermostatic lyophilization test was used to predict the validity period; The LOD of each positive pathogen was still detected after 6 days at 56 ℃, suggesting that the validity period can be at least 567 days at room temperature. In this study, a high-sensitivity real-time fluorescent PCR freeze-dried type assay that can be stored and transported at room temperature was developed for 11 sheep and goats pathogens, which were Mycoplasma ovis (M. ovis), Pathogenic Leptospira, Coxiella burnetii (C. burnetii), Bluetongue virus (BTV), Peste des pestis ruminants virus (PPRV), Brucella, exogenous jaagsiekte sheep retrovirus (exJSRV), Chlamydia abortus (C. abortus), Orf virus (ORFV), Foot-and-mouth disease virus (FMDV), and Capripox virus (CPV).

Coxiella burnetii Nine Mile phase I primary infection derived protective immunity against C. burnetii reinfection in mice depends on both B and T cells, but T cells play a critical role.

Coxiella burnetii is an obligate intracellular Gram-negative bacterium that causes acute and chronic Q fever in humans. Acute Q fever is usually a flu-like, self-limiting or treatable illness, but some infections can turn into a severe and sometimes fatal chronic disease. There is currently no FDA-approved vaccine available for the prevention of human Q fever in the US, development of a safe and effective vaccine for the prevention of human Q fever remains an important goal for public health. However, there is a fundamental gap in knowledge regarding the mechanism of protective immunity against C. burnetii infection. To understand the mechanism of C. burnetii infection induced protective immunity, we examined if C. burnetii Nine Mile phase I (NMI) infection induces protection against C. burnetii reinfection in mice. Our results indicate that NMI-infected mice conferred significant protection against C. burnetii reinfection. We also found that NMI infection derived protection did not depend on the routes of infection and antibodies are required for NMI infection derived protection. In addition, NMI infection elicited a comparable level of protection in Wild type, CD4+ T cell deficient, and CD8+ T cell deficient mice, partial protection in B cell deficient mice but no protection in T cell deficient mice. These results suggest that both B cells and T cells are required for NMI-infection derived protection, but T cells may play a critical role. Therefore, the new generation vaccine for the prevention of human Q fever should be focused on boosting both humoral and T cell immune responses.

Molecular detection of Coxiella burnetii in blood and hard tick-infested Egyptian camels and the possibility of coinfections

Coxiella burnetii, a bacterium that causes Q fever. It can infect mammals and has a global geographical distribution, but data on its occurrence in Egyptian dromedaries and the associated ticks are limited. Therefore, this study aims to detect C. burnetii in the blood of infested camels and associated ticks collected from Egypt by using molecular techniques and to examine the possibility of coinfections with C. burnetii. A total of 133 blood samples and 1260 hard ticks infesting these camels were collected from Egyptian slaughterhouses. Nested PCR and sequencing were used based on the IS1111 gene for molecular detection of C. burnetii. The identification of tick species at the molecular level was performed using the COX1 gene. C. burnetii was detected in Hyalomma (H) dromedarii, H. anatolicum, H. marginatum, Amblyomma (Am) lipidium, and Am. cohaerens with an overall prevalence rate of 1.3% (16/1260), while in the camel blood samples, it was 15.8% (21/133). Out of C. burnetii-positive ticks, there were double infections by Borrelia species and C. burnetii in H. dromedarii and Am. lipidium and triple infections at one Am. cohaerens tick (C. burnetii, Borrelia spp., and Babesia microti). In addition, two positive camel blood samples were found to carry C. burnetii with Borrelia spp. Our research findings indicate the presence of Coxiella burnetii among camels and their associated ticks in Egypt and emphasize the potential of having coinfection. To prevent the transmission of this infection to other animal species or humans, appropriate control measures should be implemented.

Evaluation of the phase-specific antibody response in water buffalo (Bubalus bubalis) after two doses of an inactivated phase I Coxiella burnetii vaccine

The control and management of Q fever outbreaks in ruminants are currently based on vaccination. Although buffalo (Bubalus bubalis) are intensively farmed in several countries and represent a reservoir for Coxiellosis, no evidence has been described regarding the efficacy of vaccination in this species. This work aimed to evaluate the humoral response, using appropriate phase-specific ELISAs, and the effects on abortion rate in buffalo by a field study. A total of 15 seropositive and 20 seronegative animals were vaccinated twice, three weeks apart, with a commercial phase I vaccine, and phase-specific antibodies were determined in the course of vaccination. Although anti-phase II antibody reactivity predominated after vaccination compared to phase I, both anti-phase I- and -phase II-antibody-reactivity significantly increased after the first (p = 0.001) and again after the second vaccination (p = 0.05). Seroconversion did not significantly depend on age or natural infection status. Once the vaccination cycle was completed, the herd study observed a reduced rate of abortion and placenta retention. Our data demonstrated that the vaccine principally induced a similar antibody response as in goats and sheep. These preliminary data appeared to support vaccination in buffalo, even in seropositive animals, although further studies are needed to better define the dynamics concerning seroconversion in this species.

Epidemiological and clinical characteristics of cases and detection of pathogens’ markers of tick-borne infections in the Tomsk region

BACKGROUND: Among the spectrum of the tick-borne infections, Lyme borreliosis and tick-borne encephalitis are most often recorded in the Tomsk region, however it is obviously that possible range of the pathogens is not limited to these ones. AIM: To make epidemiological and clinical characteristics of cases and detect frequencies of pathogen’s markers of tick-borne infections among adult patients applying serological and molecular genetic techniques in the Tomsk region during 2020–2023. METHODS: A single-center prospective sample study was conducted applying a comprehensive approach in peripheral blood specimens obtained from 197 patients with suspected tick-borne infections hospitalized during 2020–2023. To verify the diagnoses of tick-borne encephalitis or Lyme borreliosis, specific immunoglobulins of classes M and G to the antigens of virus of tick-borne encephalitis and Borrelia burgdorferi s.l. were determined in paired blood serum samples applying enzyme-linked immunosorbent assay. Additionally, the polymerase chain reaction was used to detect genetic markers of virus of tick-borne encephalitis, B. burgdorferi s.l., B. miyamotoi, Rickettsia spp., Coxiella burnetii, and Francisella tularensis. Epidemiological surveillance data of incidence rates of tick-borne infections obtained from official reports were analyzed as well. MS Office Excel 2010 software was used to calculate frequency morbidity measures. RESULTS: We verified the final diagnosis of tick-borne encephalitis in 52 (26.4%) patients, Lyme borreliosis in 116 (58.9%) patients, co-infection of tick-borne encephalitis and Lyme borreliosis 15 (7.6%) patients, hard tick relapsing fever caused by B. miyamotoi in 8 (4.1%) patients, coinfection of Q fever caused by C. burnetii with tick-borne encephalitis or Lyme borreliosis in 4 (2.0%) patients, and coinfection of tularemia with tick-borne encephalitis or Lyme borreliosis in 2 (1.0%) cases. We identified markers of tick-borne encephalitis and Lyme borreliosis pathogens by polymerase chain reaction in 3.6% and 4.1% of the patients. Most number of individuals with tick bites, and the highest incidence rates of Lyme borreliosis and tick-borne encephalitis were recorded in the suburbs of Tomsk. The age groups of 40–59 years, and elderly people 60 years and older were predominated among the patients. CONCLUSIONS: It was found out that, in addition to Lyme borreliosis and tick-borne encephalitis, there were such tick-borne infections as tick relapsing fever, Q fever, and tularemia in the Tomsk region in the 2020–2023 period.

A first insight into seropositivity and risk factors for Brucella spp. and Coxiella burnetii in free-roaming dogs in Ecuador

Brucellosis and Q fever are two bacterial zoonoses caused by Brucella spp. and Coxiella burnetii, respectively. Dogs are reservoirs of these pathogens and play an important role in their spread. In this research, we determined the seroprevalence of antibodies against Brucella spp. and C. burnetii in free-roaming dogs from Ecuador and conducted a statistical analysis based on geographical variables. Serum samples were collected from 397 free-roaming dogs between November 2018 and May 2019 and analyzed with commercial ELISA tests for Brucella spp. and Q fever. An overall seroprevalence of 2.8 % (CI: 95 %, 0.0–6.2 %) and 1.8 % (CI: 95 %, 0.0–5.6 %) was found for Brucella spp. and C. burnetii, respectively. No statistical differences in seroprevalence values were found between geographical regions in Ecuador or between dogs from rural or urban settings, except for the association of C. burnetii infection with the Coastal Region. This is the first study of this kind in Ecuador and points out the need for a One Health approach for control and surveillance of zoonotic diseases like brucellosis and Q fever including feral and stray dogs as reservoirs to spread those pathogens to cattle, humans, or wildlife.

Molecular Detection and Characterisation of Coxiella burnetii in Koala (Phascolarctos cinereus) Urogenital Tract Swabs.

Q fever is a zoonosis caused by Coxiella burnetii, primarily affecting those in close contact with domestic ruminants, the main source of human infection. Coxiella burnetii has also been detected in various wildlife species globally. In Australia, serological and molecular studies have shown exposure to and infection by C. burnetii in macropods, bandicoots, and koalas. However, the extent to which these species contribute to human infection remains unclear. An unpublished public health investigation into a Q fever case in a person involved in koala care could not conclusively link the infection to koalas due to the patient's broad animal exposure. This study aimed to explore the potential role of koalas in transmitting C. burnetii to humans by investigating the presence of C. burnetii DNA in urogenital tract (UGT) swabs from koalas. DNA was extracted from UGT swabs from koalas in three regions in New South Wales, Australia. An optimised multiplex qPCR assay detected C. burnetii DNA in 2 out of 225 samples (0.89%) at approximately 10 genome equivalents per reaction. Both positive samples amplified all three gene targets. MLVA genotyping identified two distinct C. burnetii genotypes previously isolated from Australian Q fever cases. These findings highlight the need for vaccination against Q fever for those in close contact with koalas.

Molecular investigation of Coxiella burnetii, Brucella spp., Ehrlichia spp., and Borrelia spp. among patients suspected of having Crimean-Congo Hemorrhagic Fever in Iran

ObjectivesCrimean-Congo Hemorrhagic Fever (CCHF) is a tick-borne zoonotic viral disease that could be a public health concern. The overlapping of clinical symptoms of some acute bacterial febrile diseases with CCHF is of importance for clinical diagnosis. This study aimed to molecularly examination of Brucella, Coxiella burnetii, Borrelia, and Ehrlichia infections among individuals suspected of CCHF in Iran. MethodsIn this study, 260 serum samples of suspected cases of CCHF with definitively negative laboratory test results for CCHF virus infection, were examined for Brucella spp., Coxiella burnetii, Borrelia spp., and Ehrlichia spp. by Real-time PCR. ResultsAccording to the results, 3.46% and 3.07% of the patients were positive for brucellosis and Q fever, respectively. Notably, no cases of borreliosis or ehrlichiosis were detected. Among the positive cases for brucellosis (N= 9), three cases were identified as Brucella abortus infection. Individuals under the age of 43 displayed a significantly higher positivity rate for Q fever (p < 0.01). Furthermore, patients presenting with chills had a 5.81-fold increased likelihood of being infected with Q fever (95% CI: 1.39–24.26) compared to those without chills. Notably, no other variables demonstrated a statistically significant association with Q fever infection. Discussion and ConclusionsThe results of this study showed that bacterial infections such as Q fever and brucellosis should be considered as differential diagnoses of CCHF. It is recommended that other bacterial infections that can cause early clinical symptoms similar to CCHF should also be taken into consideration in future studies and serological and molecular investigations of these infections should be tested on a wide scale.

Molecular detection and phylogeny analysis of Coxiella burnetii detected from cattle and buffalo milk based on plasmid cbhE gene in West Azerbaijan of Iran

Humans and animals may get Q fever, which is caused by the Gram-negative coccobacillus Coxiella burnetii. The symptoms of Q fever may include a self-limiting febrile illness, pneumonia, endocarditis, or hepatitis. Infections are classified as either acute or persistent. Cattle, sheep, and goats are the most prevalent reservoir animals for this zoonosis. This research was conducted to identify C. burnetii using transposable and isocitrate dehydrogenase genes (IS1111, icd) and QpH1 plasmids. A total of 142 samples of raw buffalo and cow milk were collected from various locations within the West Azerbaijan region (see map). We used "nested" PCR techniques using primers based on the IS1111 and icd genes of C. burnetii, as well as conserved and variable portions of plasmid sequences, to identify C. burnetii and their plasmids in milk samples from buffalo and calves. Out of 142 milk samples that were positive for the chromosomal transposable genes (IS1111 and icd) at a rate of 16.9 percent (95 percent CI: 14.5 percent to 19.6 percent) and 7.1% (95 percent CI: 5.59 percent to 9.08 percent), respectively, 86 samples were positive for the QpH1 plasmid at a rate of 60.5 percent (95 percent CI: 52.35 percent to 68.2 percent). Based on a phylogenetic study of the icd and QpH1 genes, the majority of the isolates had a similarity of 99.45 to 99.9 percent. Conclusion: It was determined that the buffalo population in West Azerbaijan province represents a significant epidemiological factor with respect to Q fever and consequently public health.

Tick-, flea- and mite-borne pathogens and associated diseases of public health importance in Bangladesh: a review: Vector-borne diseases in Bangladesh

BackgroundThis scoping review provides a baseline summary of the current records of the ticks, fleas, and mites of public health importance that are present in Bangladesh. It summarizes their geographic distributions and reports the levels of their infestation of livestock, pets, wildlife, and humans, and the clinical and epidemiological studies pertinent to these vectors and their pathogens. MethodsSixty-one articles were identified in a literature search, including 43 published since 2011. ResultsTwelve articles contained reliable information on ticks and their associated hosts. However, information on fleas and mites in Bangladesh is very limited. Seventeen species of ixodid ticks that commonly parasitize peridomestic animals and can bite humans are described: Rhipicephalus microplus, R. appendiculatus, R. sanguineus, Haemaphysalis bispinosa, Hyalomma anatolicum, and Amblyomma testidarium. Thirty-eight veterinary articles describe livestock pathogens, including Babesia, Anaplasma, and Theileria, and the diseases they cause. Few of those studies used modern molecular techniques to identify these pathogens. Eleven articles reported human diseases or surveillance studies, 10 from the last 10 years. Two country-wide serosurveys of 1,209 and 720 patients, using Enzyme Linked Immunosorbent Assay (ELISA) and Indirect Immunofluorescence Assay (IFA), respectively, reported human exposure to Orientia tsutsugamushi (8.8%–23.7%), typhus and spotted-fever group rickettsiae (19.7%–66.6%), and Coxiella burnetii (3%). The seropositivity rates varied regionally. PCR-based studies confirmed that febrile patients in Bangladesh may be infected with O. tsutsugamushi, Rickettsia typhi, Rickettsia felis, or Bartonella elizabethae. Only limited molecular research has been done with dogs and cats. These studies have reported PCR-confirmed canine infections with Babesia gibsoni (30%), Anaplasma bovis (58%), or Rickettsia monacenis (14%, n = 50), and feline infections with Rickettsia felis (21%, n = 100). Similarly, fleas from cats tested positive for Rickettsia felis (20.6%). ConclusionsThese findings indicate that diseases borne by non-mosquito vectors in Bangladesh urgently require more attention from public health, medical, and veterinary specialists to establish their true occurrence.

Endocapillary proliferative glomerulonephritis associated with Q fever endocarditis: A case report.

Acute Coxiella burnetti (Q fever) infection is known to activate the autoimmune inflammatory response. We report a rare case of glomerulonephritis associated with the Coxiella infection. An elderly male first presented with recurrent fevers of unknown origin and was subsequently diagnosed with Q fever infection and treated with doxycycline. He represented 2 months later with an acute kidney injury and active urinary sediment. Renal biopsy demonstrated a mesangiopathic pattern with staining for both C1q and IgM, raising possibilities of infection-related glomerulonephritis, C1q nephropathy and lupus nephritis. This case demonstrates glomerulonephritis as a complication of Q fever infection and the differential diagnosis and workup up that needs to be considered in cases of chronic Q fever.

Fièvre Q chronique. Revue de la littérature à propos d’un cas de spondylodicite à hémocultures négatives

IntroductionFever is a cosmopolit zoonosis due to Coxiella burnetii. The diagnosis of chronic Q fever can be really misleading. The growth of this bacterium is difficult and blood cultures are often negatives. Case presentationWe rapport here the case of a 69-year-old man presenting with an alteration of his general condition and low back pain. He suffered from a well-controlled HIV infection and lower limb arteriopathy treated with a cross-femoral bypass. A computed tomography scan revealed a L3–L4 abscessed spondylodiscitis but multiple blood cultures remained sterile, and the transthoracic echocardiography was normal. PET scan showed a hypermetabolism on L3–L4 vertebrae but also indicated an intense uptake of the cross-femoral bypass. C. burnetii serology was in favour of a chronic Q fever. The management of this chronic Q fever needed a multidisciplinary discussion. Three months after the treatment initiation, C. burnetii serology was reduced by a titer and has stabilized 6months to a year. ConclusionChronic Q fever and mostly osteoarticular diseases are difficult to diagnose. We have to evoke the diagnosis of osteoarticular chronic Q fever in case of insidious inflammatory syndrome, negatives blood cultures spondylodiscitis especially when associated to endocarditis or vascular infection, and in case of spondylodiscitis with a granulomatous histology without Mycobacterium tuberculosis. Although there are many complementary tests (PET scanner, PCR), serology remains the cornerstone of diagnosis.

Vector-borne diseases in Cyprus: A detailed review of the literature.

Vector-borne diseases have been a growing health concern in recent decades due to the global warming, globalization, and increased international travel. With the typical Mediterranean climate and geographical features, Cyprus provides favorable conditions for the growth and survival of arthropod species. For the purpose of this review article, the terms "Cyprus", "vectors" and "vectorborne diseases" were searched in the National Library of Medicine ('PubMed') and the Google Scholar databases. Published articles in the literature have documented mosquito (including Anopheles, Aedes, Culex, and Culiseta), sandfly (Phlebotomus, Sergentomyia), flea (including Ctenocephalides, Xenopsylla, Leptopsylla), and tick (including Rhipicephalus, Ixodes, Hyalomma, Haemaphysalis) species in the island. The presence of these arthropods poses a risk to public health as they can transmit a variety of diseases to both humans and animals. Research studies in Cyprus have identified infectious agents such as West Nile virus, Leishmania spp., sandfly viruses, Rickettsia spp., Coxiella burnetii, and Bartonella spp. in the local arthropods. More importantly, West Nile virus infection and imported malaria cases (mosquitoborne diseases); leishmaniasis and sandfly fever (sandfly-borne diseases); rickettsiosis, tularemia, Q fever, anaplasmosis, tick-borne relapsing fever, and Lyme disease (tick-borne diseases); and flea-borne rickettsiosis were reported in Cyprus. Taken together with the presence of arthropod vectors, published evidence in the literature suggests that Cyprus is an important region for VBDs. In addition to its climatic and geographical conditions, international travels particularly from endemic countries pose a risk for the circulation of VBDs on the island. Therefore, vector control programs should be continuously implemented, and public awareness must be raised in the region. This review, which to the best of our knowledge is the first comprehensive report on VBDs from Cyprus, will provide insight into future islandwide studies and also will be an important contribution to the elimination of VBDs in the region.

The epidemiological and infectious characteristics of novel types of Coxiella burnetii co-infected with Coxiella-like microorganisms from Xuyi County, Jiangsu province, China

Coxiella burnetii (C. burnetii) is the causative agent of Q fever, a type of zoonoses withwidespread distribution. In 2019, a case of Q fever was diagnosed by metagenomic next-generation sequencing (mNGS) method in Xuyi County (Jiangsu province, China). The seroprevalence of previous fever patients and the molecular epidemiology of Coxiella in wild hedgehogs and harbouring ticks around the confirmed patient were detected to reveal the genetic characteristics and pathogenicity of the Coxiella strains. Four of the 90 serum samples (4.44%) were positive for specific C. burnetii IgM antibody, suggesting that local humans are at risk of Q fever. The positive rates of C. burnetii in hedgehogs and ticks were 21.9% (7/32) and 70.5% (122/173), respectively. At least 3 strains of Coxiella were found prevalent in the investigated area, including one new genotype of pathogenic C. burnetii (XYHT29) and two non-pathogenic Coxiella-like organisms (XYHT19 and XYHT3). XYHT29 carried by ticks and wild hedgehogs successfully infected mice, imposing a potential threat to local humans. XYHT19, a novel Coxiella-like microorganism, was first discovered in the world to co-infect with C. burnetii in Haemaphysalis flava. The study provided significant epidemic information that could be used for prevention and control strategies against Q fever for local public health departments and medical institutions.