Modelling Human Brucellosis Based on Infection Rate and Vaccination Coverage of Sheep and Goats.

In this study, the vaccination coverage, serological sampling and infection rate of sheep and goats were evaluated as predictors for the modeling of human brucellosis in Greece. The human brucellosis disease frequency per local regional unit (RU) varied significantly (RR90) among consecutive years. The notification rate was higher (p < 0.001) in the RUs with implementation of vaccination in sheep and goats (vaccination zone-VZ) with a median of 1.4 (IQR 0.0-3.1) compared with the RUs of the eradication zone (EZ) with a median of 0.0 (IQR 0.0-0.0). In VZ, the increased frequency of human cases was associated with delayed vaccine administration (estimate: 0.14 (0.04; 0.29), p = 0.03) and higher vaccination coverage of the animals (estimate: -0.349 (-0.72; -0.07), p < 0.01). However, the flock sampling rate was highly heterogenous among RUs (IQR 10.56-52.93), and inconsistent within RUs throughout the period of the study 2013-2017 (p = 0.001), limiting the reliable estimation of the infection rate in livestock and the design of an integrated One Health model for human disease.

Molecular Evidence of a Broad Range of Pathogenic Bacteria in Ctenocephalides spp.: Should We Re-Examine the Role of Fleas in the Transmission of Pathogens?

The internal microbiome of common cat and dog fleas was studied for DNA evidence of pathogenic bacteria. Fleas were grouped in pools by parasitized animal. DNA was extracted and investigated with 16S metagenomics for medically relevant (MR) bacteria, based on the definitions of the International Statistical Classification of Diseases and Related Health Problems (WHO). The MR bacterial species totaled 40, were found in 60% of flea-pools (N = 100), and included Acinetobacterbaumannii, Bacteroidesfragilis, Clostridiumperfringens, Enterococcusfaecalis, E. mundtii, Fusobacteriumnucleatum, Haemophilusaegyptius, Kingellakingae, Klebsiellapneumoniae, Leptotrichiabuccalis, L. hofstadii, Moraxellalacunata, Pasteurellamultocida, Propionibacteriumacnes, P. propionicum, Proteusmirabilis, Pseudomonasaeruginosa, Rickettsiaaustralis, R. hoogstraalii, Salmonellaenterica, and various Bartonella, Staphylococcus, and Streptococcus species. B. henselae (p = 0.004) and B. clarridgeiae (p = 0.006) occurred more frequently in fleas from cats, whereas Rickettsiahoogstraalii (p = 0.031) and Propionibacteriumacnes (p = 0.029) had a preference in fleas from stray animals. Most of the discovered MR species can form biofilm, and human exposure may theoretically occur through the flea-host interface. The fitness of these pathogenic bacteria to cause infection and the potential role of fleas in the transmission of a broad range of diseases should be further investigated.

Sunbathing, a possible risk factor of murine typhus infection in Greece.

BACKGROUND: There are few studies about the presence of murine typhus in Greece. Our objective was to conduct a large scale retrospective investigation to determine the clinical and epidemiological features of patients diagnosed with murine typhus in Greece. METHODOLOGY/PRINCIPAL FINDINGS: From 2012 to 2019 serum samples from hospitalized patients and outpatients throughout Greece suspected for murine typhus infection were tested by immunofluorescence assay for Rickettsia typhi. Immunofluorescence positive samples obtained since 2016 were also tested by qPCR targeting R. typhi. Clinical and epidemiological data were retrospectively collected for the patients with confirmed murine typhus. Overall, we tested 5,365 different patients and, in total, 174 patients from all geographic regions of Greece were diagnosed with murine typhus. The most frequently reported sign or symptom was fever (89%), followed by headache (84%) and rash (81%). The classical triad of fever, headache, and rash was present in 72% of patients during their illness. Severe infections with complications including acute renal failure or septic shock were not recorded. The majority of cases (81%) occurred during May-October and peaked in June and September. Most of patients (81%) infected in Athens, recalled that their only activity the last weeks before symptoms onset was swimming on the beach and 59% of them also reported an insect bite while sunbathing. CONCLUSIONS/SIGNIFICANCE: Our results may reflect the reemergence of murine typhus in Greece and we highlight the importance of awareness of this difficult-to-recognize undifferentiated febrile illness.

Sero-epidemiology investigation of Coxiella burnetii in domestic ruminants throughout most Greek regions.

Q fever is not considered as a public health problem in Greece where most regions are considered as Coxiella burnetii free possibly because of the low interest for this agent. Our objective was to conduct a large-scale study to investigate the sero-epidemiology of C. burnetii in domestic ruminants throughout the most of Greek regions. We tested serum samples obtained from goats, sheep and bovines from different regions of Greece. All sera were tested for C. burnetii IgG antibodies by a commercial ELISA according to the manufacturer's recommendations. We tested 1,173 goats and sheep obtained from 177 different herds and totally 194 (17%) animals from 78 (44%) herds were positive for C. burnetii. Positive animals were present in seven (88%) different regions and seropositivity varied widely among these regions. The highest percentage was observed in Peloponnese (44%), where all the tested herds presented animals with C. burnetii antibodies. Ιn all Aegean Islands except the island of Limnos we detected goats and sheep positive for C. burnetii with seroposivity varying between 2% in Kos to 37% in Rhodes. Finally, in 22 (85%) Greek prefectures we found C. burnetii IgG-positive animals whereas in 14 (54%) prefectures more than 50% of tested herds had seropositive animals. We also tested 28 cows from five different herds in Macedonia and Aegean Islands and six (21%) of them, obtained from two (40%) herds were positive. Considering the importance of C. burnetii for public health, our data reflect the lack of awareness by veterinarians, physicians and competent authorities as we provide evidence of C. burnetii seropositivity in productive animals throughout the most of Greek territories. Due to the increased risk of inhalation of the bacterium by people who entered the affected farms we raise the question of Q fever emergence in Greece.