Occurrence and risk factors of Coxiella burnetii in domestic ruminants in Lebanon.

Coxiella burnetii causes diseases in humans (Q fever) and animals, domestic ruminants playing a major role in the epidemiology of the infection. Information on C. burnetii infection in Lebanon is scanty. In order to assess the prevalence of C. burnetii infection in ruminants, a cross-sectional study was undertaken in 2014. A total of 1633 sera from ruminants (865 cattle, 384 sheep and 384 goats) from 429 farms (173 cattle, 128 sheep and 128 goats), in seven provinces of Lebanon were randomly selected and assayed for the presence of antibodies. 39.86% of farms (95% CI: 35.23-44.56) resulted positive. The seroprevalence was 30.63% in Cattle-farms, 46.88% in sheep-farms and 45.31% in goat-farms. Milk samples collected from 282 seropositive animals (86 cows, 93 sheep and 103 goats) from 171 positive farms were tested by a high sensitive Real-Time PCR targeted to the IS1111 transposon of C. burnetii. The overall prevalence in farms was estimated to be 14.04%. Cattle-, sheep- and goat farm prevalence rates were 15.09%, 10% and 17.24%, respectively. The findings of the study show that C. burnetii prevalence in Lebanese domestic ruminants is related to animal species and farming practices. Indeed, the mixed herds with sheep (p < 0.01), the presence of common lambing/kidding areas (p < 0.001) in farms where the use of disinfectants was not a routine practice (p < 0.05) were identified as important risk factors. The results of the study provide baseline information for setting up herd management and public health measures for the prevention and control of Q fever in Lebanon.

Analysis of seroprevalence against Coxiella burnetii in a sample of farm workers in Western Sicily.

INTRODUCTION AND OBJECTIVE: Little is known about the development of chronic Q fever caused by Coxiella burnetii in occupational risk groups and in the general population in Italy, as well as in many countries in the world. The aim of this study was to highlight the presence of the infection in a sample of workers operating outdoors (but not directly in contact with animals), in three provinces of western Sicily, in order to detect the human seroprevalence and compare the obtained data with those found in animals raised in the same territory. MATERIALS AND METHODS: The study included 126 generic seasonal agricultural workers (labourers), 84 male and 42 female; none of whom were aware of any previous contact with Coxiella burnetii. Their immunologic status against Coxiella burnetii was tested through research and titration of both phases I and II specific antibodies (IgG) with an indirect immunofluorescence assay, using anti-antibodies labeled with fluorescein isothiocyanate. All data were statistically analyzed, comparing all positive results from the three provinces through variance analysis, and then comparing human results with those obtained from animals raised in the considered areas, specifically, 1,511 cows, 46 of which were found positive (3.04%), and 3,391 sheep, 548 of which were found positive (16.16%). RESULTS: Anti-Coxiella antibodies were found in nine of 42 females sampled (21.4%; 95%CI=[9.0-33.8]) and 21 of 84 males sampled (25.0%; 95%CI=[15.7-34.3]). 60% (18 of 30; 95%CI=[42.5-77.5]) of seropositive samples were positive either for Phase I antigen or for both Phase I and II antigens, representing cases of chronic infection. Applying Spearman's rank correlation, the percentage of seropositive humans was significantly correlated with that observed for sheep (r=1.00; p<0.001), but not for cows (r=-0.5; p=0.667). CONCLUSIONS: The results obtained, although based on a small sample, suggest that the disease is present in the territory of Western Sicily, both in animals and in humans. A closer collaboration between doctors and veterinarians is therefore necessary to fight against the spread of the infection.

What do we know about risk factors for infection in humans with Toxoplasma gondii and how can we prevent infections?

Fourteen case-control studies evaluating the importance of different risk factors for infection of humans with Toxoplasma gondii were identified. Surprisingly, up to two-thirds of infections could not be explained by risk factors such as consuming raw or undercooked meat or poor kitchen hygiene. Few studies reported population attributable risk, and when reported, it was low. Protocols including questionnaires used for collecting data, age and socio-economic groups studied, and sample sizes varied among studies. There is a need for carefully planned, case-control studies to identify sources of infection with T. gondii in humans. New risk factors, such as the manufacture of organic meat, and possible ways to sterilize meat to inactivate T. gondii tissue cysts are discussed.

Risk factors for toxoplasmosis in pigs bred in Sicily, Southern Italy.

The aim of the study was to determine the seroprevalence of Toxoplasma gondii infection in pigs raised and slaughtered in Sicily, Southern Italy, and to evaluate the risk factors associated with the infection. Samples were collected in seven slaughterhouses and on-site on 274 raising farms across Sicily, in the period from January 2006 until March 2007. For each sampled pig born and raised in Sicily, information was obtained on gender, age, origin, final destination of meat and farm management. Data on the farm included: farming type, presence of cats and dogs, rodent control by rodenticides, cleaning methods, water supply, altitude and herd size.T. gondii-specific antibodies were detected using a commercial Enzyme-Linked Immunosorbent Assay (Institut Pourquier, France).Antibodies against T. gondii were found in 16.3% of Sicilian pigs. The lowest seroprevalence, 7%, was found in the age group 5-7 months (market pig) and the highest, 19%, in the age group >24 months. Risk factors for seropositivity were: age 11-24 months compared to younger (OR 5.62; CI 1.52-20.8); farrow-to-finish farming type (OR 6.85; CI 1.87-25.01) compared to finishing and farrow-to-breed type; less than 50 pigs on the farm (OR 6.8; CI 1.76-26.2); no use of rodenticides (OR 2.71; CI 1.10-6.64), use of water coming from private sources (especially wells; OR 2.8; CI 1.03-7.72).Pigs raised in Sicily shows a high prevalence of antibodies against T. gondii. Pre-harvesting interventions to lower the risk of locally produced meat consumption for consumers should point as soon as possible to increase hygienic condition on the farm, by carefully removing waste with automatic cleaning and reducing biohazard by rodent control. Consumers must receive information on the correct handling and cooking locally produced pork meat derivatives.

Toxoplasma gondii infections in sheep in Sicily, southern Italy.

The aim of the study was to determine the burden of Toxoplasma gondii-infections in sheep in Sicily, southern Italy and the risk factors for infection. Sera from 1961 sheep were collected just before slaughtering from 62 farms located in 8 out of 9 Sicilian administrative districts. The sera were analysed for Toxoplasma-specific IgG antibodies using commercially available enzyme-linked immunosorbent assay. Sheep less than 4 weeks old were further analysed by ELISA for Toxoplasma-specific IgM-antibodies. Data on farm size and location were obtained from slaughterhouse sanitary reports and through structured telephone interviews of the veterinary officers from public health districts. The overall seroprevalence of Toxoplasma-specific IgG-antibodies were 49.9% (937/1876) by ELISA. Eighty-seven (54/62) percent of the farms had at least one Toxoplasma-positive animal. All the farms fed the animals outdoor on pasture and only one was claiming organic farming. Having cats on the farm, age of the animals, farm size and the use of surface water sources for drinking were all significantly associated with T. gondii-infected animals on the farm. T. gondii infection in mutton used for human consumption is very prevalent, and eating unprocessed sheep and lamb meat has a high risk of transmitting infections to humans. The presence of cats on the farm, farm size and using surface water as drinking water for the animals were risk factors for infection in sheep, with age as a significant confounder.

[Epidemiological aspects of leishmaniosis in Italian regions]. / Rilievi epidemiologici della leishmaniosi nel territorio italiano.

The analysis of infectious diseases in Italy and regarding some working activities has pointed out several cases of leishmaniosis, in various shapes. Its persistent presence in some endemic areas in our country, together with possibility of work exposure and in assence of very sensitive or specific diagnostic methods, represents a problem in medical practice. It's necessary for physicians and veterinaries take greater attention about this illness and the other anthropozoonosis, always actual in some areas and increasing for AIDS's sicks, representing other infection sources.

[Occupational exposure to Mycobacterium tuberculosis complex: state of the art and prospects]. / Esposizione professionale a Mycobacterium tuberculosis complex: stato dell'arte e prospettive.

Tuberculosis, disease never wiped out in the world, is still actual for many reasons, such as imposing emigration from poor to industrialized countries, spreading of Mycobacteria drug-resistant and presence of AIDS sick subjects. Estimation of world cases seems to under-value real number; moreover physicians consider as etiological agent only Mycobacterium tuberculosis, disregarding others Mycobacteria, such as M. bovis, giving rise a disease similar to that caused by M. tuberculosis. To single out all these variants, it's necessary to use very specific and sensitive diagnostic methods, such as Polymerase Chain Reaction, evaluating also possible work exposure, especially when occurs contacts with infectious animals.

Evaluation of the Leishmania recombinant K39 antigen as a diagnostic marker for canine leishmaniasis and validation of a standardized enzyme-linked immunosorbent assay.

Canine infections with Leishmania infantum are important as a cause of serious disease in the dog and as a reservoir for human visceral leishmaniasis (VL). Accurate diagnosis of canine infections is essential to the veterinary community and for VL surveillance programs. A standardized ELISA using a purified recombinant antigen (rK39) specific to VL was compared to the immunofluorescent antibody test (IFAT) as the standard. The ELISA was developed, optimized and evaluated using sera from 6368 dogs. The standardized ELISA and IFAT results were highly concordant. The timing and pattern of ELISA and IFAT seroconversion in dogs followed prospectively after natural infections were very similar. Antibodies reacting with rK39 were more common in asymptomatic canine infections than reported for subclinical human VL. The rK39 ELISA is a relatively simple and rapid assay for assessing the infection status of dogs, and is an alternative to IFAT, especially when screening large numbers of samples.

[Carbuncle in humans and animals: modern aspects of an ancient disease]. / Il Carbonchio in patologia umana ed animale: aspetti odierni di un'antica entità nosologica.

Carbuncle, very remarkable disease in the past for its spreading, recently seems to be forgotten as risk for general population and exposed workers too, among them we remember especially veterinary physicians, breeders, tanners, etc. World epidemiological data aren't exact, but a lot of researchers in vary countries confirm that this is a present problem in many areas. Therefore it's indispensable to know correct diffusion of this disease, to fight it and other zoonosis in some environments and mostly in working ones, hoping phycians identify and declare new cases.

[Case study of a population of subjects in Sicily operated for hydatidosis: correlation with profession and living environment]. / Studio casistico di una popolazione di soggetti residenti in Sicilia operati per idatidosi: correlazione con l'attività professionale e con l'ambiente di vita.

The aim of the study was to evaluate significant factors in the spread of echinococcosis in certain areas of Sicily. Data was obtained from operating registers of four surgical departments of the University Hospital of Palermo which covered 104 subjects, 57 women and 47 men, who underwent an operation for echinococcosis cysts in the period January 1996-June 1999. About 15% of these subjects were farmers, slaughterers, shepherds or gardeners and more than 80% lived in rural areas. The study showed that echinococcosis is still widespread in Sicily, at higher rates than the population, physicians and Health and safety Institutes generally believe. The place of origin is of particular importance because in rural areas it is very easy to be contaminated by infected animals or eat vegetables contaminated by parasitic eggs.

[Rickettsia infections in Sicily and mass media: attention not entirely groundless]. / Rickettsiosi in Sicilia e mezzi di comunicazione di massa: attenzione non del tutto immotivata.

The aim of the study was to assess the prevalence of rickettsiosis cases in Sicily with special attention to possible occupational exposure. This research was prompted by the high number of cases reported in the press in the summer of 1999. Epidemiological data for previous years showed that Sicily was always the region where most cases of rickettsiosis occurred; we therefore examined the clinical data of patients admitted to the major infectious diseases hospital department in Palermo in the period 1996-1999. Analysis of the cases showed that an occupational risk existed (among small farmers), but that there was also an environmental risk for subjects living in rural areas due to contact with infected dogs or rural areas activities. It is therefore of fundamental importance to carry out a primary prevention programme against rickettsiosis for everyone exposed to the risk either occupationally or in leisure activities in rural areas.

Detection of Leishmania infantum in dogs by PCR with lymph node aspirates and blood.

The PCR technique was applied to the diagnosis of leishmaniasis in dogs, both serologically negative and positive. DNA was taken from lymph node aspirates and blood. The primers 13a and 13b, derived from Leishmania amazonies and Leishmania braziliensis kinetoplast DNA (kDNA), also amplified Leishmania infantum IPT1 constant region of minicircle kDNA. The amplified fragment is 116 bp long. It was cloned and the sequence was determined. A 70-bp inner fragment was designed and used as a probe in dot blot hybridization. A group of 124 dogs was examined, 37 of which showed typical symptoms of disease. PCR was performed on 124 blood samples and 52 lymph node aspirates. Using microscopic examination as the "gold standard," we calculated sensitivity, specificity, and positive and negative predictive values of 100% using lymph node aspirates and values of 85, 80, 95, and 57%, respectively, using blood samples. We found that 40% of the animals without lesions and 38% of the animals with clinical signs gave false-negative results by indirect immunofluorescence antibody testing. These animals could contribute to the spreading of infection among dogs, and represent a potential risk for human health as well.

[The epidemiological trend of brucellosis in the provinces of Sicily]. / Considerazioni sull'andamento epidemiologico della brucellosi nelle province siciliane.

The epidemiological trend of brucellosis in Italy has been uneven over the last few years since there was a decrease in incidence in some regions and an increase in others, including Sicily. The peak was reached in 1997 when 59% of the cases were reported in Sicily alone. Appropriate intervention strategies are therefore needed both as regards the general population and exposed workers in order to reduce the spread of this disease.

Detection of Mycobacterium tuberculosis complex in cattle by PCR using milk, lymph node aspirates, and nasal swabs.

The PCR technique was applied to the diagnosis of tuberculosis in live cattle, and both skin-test-negative and skin-test-positive animals were studied. DNA was taken from various sources including specimens of lymph node aspirates, milk, and nasal swabs. After slaughter and visual inspection, tissues such as lymph nodes, lungs, and udders from tuberculin reactors were tested by the same technique. Specific oligonucleotide primers internal to the IS6110 insertion element were used to amplify a 580-bp fragment. A 182-bp fragment was obtained by designating a nested PCR from the first amplification product. This fragment was cloned and sequenced, and after being labeled it was employed in dot blot hybridization. A total of 100 cattle were tested, and PCR analysis was performed using nasal swab, milk, and lymph node aspirate. Sixty skin-test-positive cows were also tested to detect mycobacterial DNA in tissue samples from lymph nodes, lungs, and udders, and the infection was confirmed in all of the animals. Using PCR analysis of tissue samples from slaughtered animals as a "gold standard" we calculated 100% values for sensitivity, specificity, and positive and negative predictive values for milk and lymph node aspirate samples. The respective values for nasal swab samples were 58, 100, 100, and 28%. The respective values for all of the samples were 74, 100, 100, and 35%, while for visual inspection the values were 81, 100, 100, and 58%, respectively. PCR analysis of specimens of lymph node aspirates, milk, and nasal swabs from skin-test-negative animals showed that 52% of these skin test results were false negatives. These animals, not being removed from the farms, represent a potential source of further infection.