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1.
Front Vet Sci ; 10: 1229071, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37711433

RESUMO

Introduction: The 2022-2023 highly pathogenic avian influenza (HPAI) H5N1 outbreak in the United States (U.S.) is the largest and most costly animal health event in U.S. history. Approximately 70% of commercial farms affected during this outbreak have been turkey farms. Methods: We conducted a case-control study to identify potential risk factors for introduction of HPAI virus onto commercial meat turkey operations. Data were collected from 66 case farms and 59 control farms in 12 states. Univariate and multivariable analyses were conducted to compare management and biosecurity factors on case and control farms. Results: Factors associated with increased risk of infection included being in an existing control zone, having both brooders and growers, having toms, seeing wild waterfowl or shorebirds in the closest field, and using rendering for dead bird disposal. Protective factors included having a restroom facility, including portable, available to crews that visit the farm and workers having access and using a shower at least some of the time when entering a specified barn. Discussion: Study results provide a better understanding of risk factors for HPAI infection and can be used to inform prevention and control measures for HPAI on U.S. turkey farms.

2.
Front Vet Sci ; 10: 1229008, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37559891

RESUMO

Introduction: The 2022-2023 highly pathogenic avian influenza (HPAI) H5N1 outbreak in the United States (U.S.) is the most geographically extensive and costly animal health event in U.S. history. In 2022 alone, over 57 million commercial and backyard poultry in 47 U.S. states were affected. Over 75% of affected poultry were part of the commercial table egg production sector. Methods: We conducted a case-control study to identify potential risk factors for introduction of HPAI virus onto commercial table egg operations. Univariate and multivariable analyses were conducted to compare farm characteristics, management, and biosecurity factors on case and control farms. Results: Factors associated with increased risk of infection included being in an existing control zone, sightings of wild waterfowl, mowing or bush hogging vegetation less than 4 times a month, having an off-site method of daily mortality disposal (off-site composting or burial, rendering, or landfill), and wild bird access to feed/feed ingredients at least some of the time. Protective factors included a high level of vehicle washing for trucks and trailers entering the farm (a composite variable that included having a permanent wash station), having designated personnel assigned to specific barns, having a farm entrance gate, and requiring a change of clothing for workers entering poultry barns. Discussion: Study results improve our understanding of risk factors for HPAI infection and control measures for preventing HPAI on commercial U.S. table egg farms.

3.
BMC Vet Res ; 17(1): 18, 2021 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-33413373

RESUMO

BACKGROUND: Mycoplasma bovis causes mastitis, otitis, pneumonia and arthritis in cattle and is a major contributor to bovine respiratory disease complex. Around the year 2000, it emerged as a significant threat to the health of North American bison. Whether healthy bison are carriers of M. bovis and when they were first exposed is not known. To investigate these questions we used a commercially available ELISA that detects antibodies to M. bovis to test 3295 sera collected from 1984 through 2019 from bison in the United States and Canada. RESULTS: We identified moderately to strongly seropositive bison from as long ago as the late 1980s. Average seroprevalence over the past 36 years is similar in the United States and Canada, but country-specific differences are evident when data are sorted by the era of collection. Seroprevalence in the United States during the pre-disease era (1999 and prior) was significantly higher than in Canada, but was significantly lower than in Canada during the years 2000-2019. Considering individual countries, seroprevalence in the United States since the year 2000 dropped significantly as compared to the years 1985-1999. In Canada the trend is reversed, with seroprevalence increasing significantly since the year 2000. ELISA scores for sera collected from free-ranging bison do not differ significantly from scores for sera from more intensively managed animals, regardless of the era in which they were collected. However, seroprevalence among intensively raised Canadian bison has nearly doubled since the year 2000 and average ELISA scores rose significantly. CONCLUSIONS: Our data provide the first evidence that North American bison were exposed to M. bovis many years prior to the emergence of M. bovis-related disease. Patterns of exposure inferred from these results differ in the United States and Canada, depending on the era under consideration. Our data further suggest that M. bovis may colonize healthy bison at a level sufficient to trigger antibody responses but without causing overt disease. These findings provide novel insights as to the history of M. bovis in bison and will be of value in formulating strategies to minimize the impact of mycoplasmosis on bison health and production.


Assuntos
Bison , Infecções por Mycoplasma/veterinária , Mycoplasma bovis/isolamento & purificação , Criação de Animais Domésticos , Animais , Canadá/epidemiologia , Ensaio de Imunoadsorção Enzimática/veterinária , Infecções por Mycoplasma/epidemiologia , Prevalência , Estudos Soroepidemiológicos , Estados Unidos/epidemiologia
4.
Geospat Health ; 15(2)2020 12 10.
Artigo em Inglês | MEDLINE | ID: mdl-33461269

RESUMO

Comprehensive and spatially accurate poultry population demographic data do not currently exist in the United States; however, these data are critically needed to adequately prepare for, and efficiently respond to and manage disease outbreaks. In response to absence of these data, this study developed a national-level poultry population dataset by using a novel combination of remote sensing and probabilistic modelling methodologies. The Farm Location and Agricultural Production Simulator (FLAPS) (Burdett et al., 2015) was used to provide baseline national-scale data depicting the simulated locations and populations of individual poultry operations. Remote sensing methods (identification using aerial imagery) were used to identify actual locations of buildings having the characteristic size and shape of commercial poultry barns. This approach was applied to 594 U.S. counties with > 100,000 birds in 34 states based on the 2012 U.S. Department of Agriculture (USDA), National Agricultural Statistics Service (NASS), Census of Agriculture (CoA). The two methods were integrated in a hybrid approach to develop an automated machine learning process to locate commercial poultry operations and predict the number and type of poultry for each operation across the coterminous United States. Validation illustrated that the hybrid model had higher locational accuracy and more realistic distribution and density patterns when compared to purely simulated data. The resulting national poultry population dataset has significant potential for application in animal disease spread modelling, surveillance, emergency planning and response, economics, and other fields, providing a versatile asset for further agricultural research.


Assuntos
Aves Domésticas , Tecnologia de Sensoriamento Remoto , Animais , Conjuntos de Dados como Assunto , Surtos de Doenças , Influenza Aviária/epidemiologia , Doenças das Aves Domésticas/epidemiologia , Estados Unidos
5.
Vet Sci ; 5(4)2018 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-30380736

RESUMO

Diseases that affect both wild and domestic animals can be particularly difficult to prevent, predict, mitigate, and control. Such multi-host diseases can have devastating economic impacts on domestic animal producers and can present significant challenges to wildlife populations, particularly for populations of conservation concern. Few mathematical models exist that capture the complexities of these multi-host pathogens, yet the development of such models would allow us to estimate and compare the potential effectiveness of management actions for mitigating or suppressing disease in wildlife and/or livestock host populations. We conducted a workshop in March 2014 to identify the challenges associated with developing models of pathogen transmission across the wildlife-livestock interface. The development of mathematical models of pathogen transmission at this interface is hampered by the difficulties associated with describing the host-pathogen systems, including: (1) the identity of wildlife hosts, their distributions, and movement patterns; (2) the pathogen transmission pathways between wildlife and domestic animals; (3) the effects of the disease and concomitant mitigation efforts on wild and domestic animal populations; and (4) barriers to communication between sectors. To promote the development of mathematical models of transmission at this interface, we recommend further integration of modern quantitative techniques and improvement of communication among wildlife biologists, mathematical modelers, veterinary medicine professionals, producers, and other stakeholders concerned with the consequences of pathogen transmission at this important, yet poorly understood, interface.

6.
Prev Vet Med ; 161: 41-49, 2018 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-30466657

RESUMO

Foot-and-mouth disease (FMD) is a highly infectious viral disease of cloven-hoofed animals. FMD outbreaks have the potential to cause significant economic consequences, and effective control strategies are needed to minimize the damage to livestock systems and the economy. Although not the predominant route of infection, airborne transmission has been implicated in previous outbreaks. Under favorable weather conditions, airborne spread of FMD can make the rapid containment of an outbreak more difficult. Our objective was to identify seasonal and geographic differences in patterns of conditions favorable to airborne FMD spread in the United States. Data from a national network of surface weather stations were examined for three study years (December 2011-November 2012, December 2012-November 2013, December 2014-November 2015). Weather conditions were found to be most frequently favorable to airborne spread during the winter (December, January, February). Geographically, conditions were most frequently favorable to airborne FMD spread in the upper Midwestern United States, a region where swine and cattle populations are common. Across study years, conditions for airborne FMD spread were more frequently favorable when weather conditions were generally mild with few extremes with respect to temperature and precipitation (e.g., 2014-2015). However, national patterns in risk areas for airborne FMD spread were similar across study years even though the degree of risk differed based on variations in weather patterns among study years. Our findings suggest that airborne transmission could contribute to FMD spread between livestock premises in the event of an outbreak in the coterminous United States, and that some geographic areas are at an increased risk particularly in seasons with conducive weather conditions. To our knowledge, this is the first study to characterize the risk of airborne FMD spread on a national scale in the United States. The findings presented here can be used to enhance preparedness and surveillance activities by identifying specific geographic areas in the United States where airborne spread is most likely to be a risk factor for transmission during an outbreak.


Assuntos
Microbiologia do Ar , Febre Aftosa/epidemiologia , Febre Aftosa/transmissão , Gado/virologia , Estações do Ano , Animais , Bovinos , Doenças dos Bovinos/transmissão , Geografia , Doenças das Cabras/transmissão , Cabras , Fatores de Risco , Ovinos , Doenças dos Ovinos/transmissão , Análise Espacial , Suínos , Doenças dos Suínos/transmissão , Estados Unidos/epidemiologia , Tempo (Meteorologia)
7.
Sci Rep ; 7(1): 13193, 2017 10 16.
Artigo em Inglês | MEDLINE | ID: mdl-29038498

RESUMO

Recent decline of sea ice habitat has coincided with increased use of land by polar bears (Ursus maritimus) from the southern Beaufort Sea (SB), which may alter the risks of exposure to pathogens and contaminants. We assayed blood samples from SB polar bears to assess prior exposure to the pathogens Brucella spp., Toxoplasma gondii, Coxiella burnetii, Francisella tularensis, and Neospora caninum, estimate concentrations of persistent organic pollutants (POPs), and evaluate risk factors associated with exposure to pathogens and POPs. We found that seroprevalence of Brucella spp. and T. gondii antibodies likely increased through time, and provide the first evidence of exposure of polar bears to C. burnetii, N. caninum, and F. tularensis. Additionally, the odds of exposure to T. gondii were greater for bears that used land than for bears that remained on the sea ice during summer and fall, while mean concentrations of the POP chlordane (ΣCHL) were lower for land-based bears. Changes in polar bear behavior brought about by climate-induced modifications to the Arctic marine ecosystem may increase exposure risk to certain pathogens and alter contaminant exposure pathways.


Assuntos
Ecossistema , Ursidae/microbiologia , Animais , Regiões Árticas , Brucella/imunologia , Brucella/isolamento & purificação , Coxiella burnetii/imunologia , Coxiella burnetii/isolamento & purificação , Poluentes Ambientais/toxicidade , Francisella tularensis/imunologia , Francisella tularensis/isolamento & purificação , Camada de Gelo , Neospora/imunologia , Neospora/isolamento & purificação , Toxoplasma/imunologia , Toxoplasma/isolamento & purificação
8.
Avian Dis ; 60(1 Suppl): 132-45, 2016 05.
Artigo em Inglês | MEDLINE | ID: mdl-27309049

RESUMO

Risk management decisions associated with live poultry movement during a highly pathogenic avian influenza (HPAI) outbreak should be carefully considered. Live turkey movements may pose a risk for disease spread. On the other hand, interruptions in scheduled movements can disrupt business continuity. The Secure Turkey Supply (STS) Plan was developed through an industry-government-academic collaboration to address business continuity concerns that might arise during a HPAI outbreak. STS stakeholders proposed outbreak response measure options that were evaluated through risk assessment. The developed approach relies on 1) diagnostic testing of two pooled samples of swabs taken from dead turkeys immediately before movement via the influenza A matrix gene real-time reverse transcriptase polymerase chain reaction (rRT-PCR) test; 2) enhanced biosecurity measures in combination with a premovement isolation period (PMIP), restricting movement onto the premises for a few days before movement to slaughter; and 3) incorporation of a distance factor from known infected flocks such that exposure via local area spread is unlikely. Daily exposure likelihood estimates from spatial kernels from past HPAI outbreaks were coupled with simulation models of disease spread and active surveillance to evaluate active surveillance protocol options that differ with respect to the number of swabs per pooled sample and the timing of the tests in relation to movement. Simulation model results indicate that active surveillance testing, in combination with strict biosecurity, substantially increased HPAI virus detection probability. When distance from a known infected flock was considered, the overall combined likelihood of moving an infected, undetected turkey flock to slaughter was predicted to be lower at 3 and 5 km. The analysis of different active surveillance protocol options is designed to incorporate flexibility into HPAI emergency response plans.


Assuntos
Vírus da Influenza A/isolamento & purificação , Influenza Aviária/virologia , Carne/virologia , Doenças das Aves Domésticas/virologia , Perus/virologia , Matadouros , Animais , Surtos de Doenças , Inocuidade dos Alimentos , Vírus da Influenza A/genética , Vírus da Influenza A/fisiologia , Influenza Aviária/epidemiologia , Doenças das Aves Domésticas/epidemiologia , Vigilância em Saúde Pública , Medição de Risco , Estados Unidos/epidemiologia
9.
Avian Dis ; 60(2): 460-6, 2016 06.
Artigo em Inglês | MEDLINE | ID: mdl-27309288

RESUMO

A case-control study was conducted among commercial table-egg layer and pullet operations in Iowa and Nebraska, United States, to investigate potential risk factors for infection with highly pathogenic avian influenza (HPAI) H5N2. A questionnaire was developed and administered to 28 case farms and 31 control farms. Data were collected at the farm and barn levels, enabling two separate analyses to be performed-the first a farm-level comparison of case farms vs. control farms, and the second a barn-level comparison between case barns on case farms and control barns on control farms. Multivariable logistic regression models were fit using a forward-selection procedure. Key risk factors identified were farm location in an existing control zone, rendering and garbage trucks coming near barns, dead-bird disposal located near barns, and visits by a company service person. Variables associated with a decreased risk of infection included visitors changing clothing, cleaning and disinfecting a hard-surface barn entryway, and ceiling/eaves ventilation in barns.


Assuntos
Vírus da Influenza A Subtipo H5N2/fisiologia , Influenza Aviária/epidemiologia , Influenza Aviária/transmissão , Doenças das Aves Domésticas/epidemiologia , Doenças das Aves Domésticas/transmissão , Animais , Estudos de Casos e Controles , Galinhas , Fazendas , Feminino , Influenza Aviária/virologia , Iowa/epidemiologia , Nebraska/epidemiologia , Doenças das Aves Domésticas/virologia
10.
PLoS Biol ; 14(4): e1002448, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27100532

RESUMO

The One Health initiative is a global effort fostering interdisciplinary collaborations to address challenges in human, animal, and environmental health. While One Health has received considerable press, its benefits remain unclear because its effects have not been quantitatively described. We systematically surveyed the published literature and used social network analysis to measure interdisciplinarity in One Health studies constructing dynamic pathogen transmission models. The number of publications fulfilling our search criteria increased by 14.6% per year, which is faster than growth rates for life sciences as a whole and for most biology subdisciplines. Surveyed publications clustered into three communities: one used by ecologists, one used by veterinarians, and a third diverse-authorship community used by population biologists, mathematicians, epidemiologists, and experts in human health. Overlap between these communities increased through time in terms of author number, diversity of co-author affiliations, and diversity of citations. However, communities continue to differ in the systems studied, questions asked, and methods employed. While the infectious disease research community has made significant progress toward integrating its participating disciplines, some segregation--especially along the veterinary/ecological research interface--remains.


Assuntos
Comportamento Cooperativo , Editoração
12.
Prev Vet Med ; 120(2): 131-140, 2015 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-25944175

RESUMO

We describe a method for de-identifying point location data used for disease spread modeling to allow data custodians to share data with modeling experts without disclosing individual farm identities. The approach is implemented in an open-source software program that is described and evaluated here. The program allows a data custodian to select a level of de-identification based on the K-anonymity statistic. The program converts a file of true farm locations and attributes into a file appropriate for use in disease spread modeling with the locations randomly modified to prevent re-identification based on location. Important epidemiological relationships such as clustering are preserved to as much as possible to allow modeling similar to those using true identifiable data. The software implementation was verified by visual inspection and basic descriptive spatial analysis of the output. Performance is sufficient to allow de-identification of even large data sets on desktop computers available to any data custodian.


Assuntos
Doenças dos Animais/transmissão , Anonimização de Dados , Métodos Epidemiológicos/veterinária , Gado , Software , Animais
13.
Ecohealth ; 12(3): 528-39, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25791679

RESUMO

Disease was a listing criterion for the polar bear (Ursus maritimus) as threatened under the Endangered Species Act in 2008; it is therefore important to evaluate the current state of knowledge and identify any information gaps pertaining to diseases in polar bears. We conducted a systematic literature review focused on infectious agents and associated health impacts identified in polar bears. Overall, the majority of reports in free-ranging bears concerned serosurveys or fecal examinations with little to no information on associated health effects. In contrast, most reports documenting illness or pathology referenced captive animals and diseases caused by etiologic agents not representative of exposure opportunities in wild bears. As such, most of the available infectious disease literature has limited utility as a basis for development of future health assessment and management plans. Given that ecological change is a considerable risk facing polar bear populations, future work should focus on cumulative effects of multiple stressors that could impact polar bear population dynamics.


Assuntos
Doenças Transmissíveis/veterinária , Ursidae , Animais , Animais Selvagens , Meio Ambiente
14.
Sci Total Environ ; 514: 371-8, 2015 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-25679818

RESUMO

The meaning of health for wildlife and perspectives on how to assess and measure health, are not well characterized. For wildlife at risk, such as some polar bear (Ursus maritimus) subpopulations, establishing comprehensive monitoring programs that include health status is an emerging need. Environmental changes, especially loss of sea ice habitat, have raised concern about polar bear health. Effective and consistent monitoring of polar bear health requires an unambiguous definition of health. We used the Delphi method of soliciting and interpreting expert knowledge to propose a working definition of polar bear health and to identify current concerns regarding health, challenges in measuring health, and important metrics for monitoring health. The expert opinion elicited through the exercise agreed that polar bear health is defined by characteristics and knowledge at the individual, population, and ecosystem level. The most important threats identified were in decreasing order: climate change, increased nutritional stress, chronic physiological stress, harvest management, increased exposure to contaminants, increased frequency of human interaction, diseases and parasites, and increased exposure to competitors. Fifteen metrics were identified to monitor polar bear health. Of these, indicators of body condition, disease and parasite exposure, contaminant exposure, and reproductive success were ranked as most important. We suggest that a cumulative effects approach to research and monitoring will improve the ability to assess the biological, ecological, and social determinants of polar bear health and provide measurable objectives for conservation goals and priorities and to evaluate progress.


Assuntos
Conservação dos Recursos Naturais/métodos , Monitoramento Ambiental/métodos , Ursidae/fisiologia , Animais , Mudança Climática , Ecossistema , Poluentes Ambientais , Camada de Gelo
15.
Prev Vet Med ; 110(3-4): 510-24, 2013 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-23398856

RESUMO

Epidemiologic simulation modeling of highly pathogenic avian influenza (HPAI) outbreaks provides a useful conceptual framework with which to estimate the consequences of HPAI outbreaks and to evaluate disease control strategies. The purposes of this study were to establish detailed and informed input parameters for an epidemiologic simulation model of the H5N1 strain of HPAI among commercial and backyard poultry in the state of South Carolina in the United States using a highly realistic representation of this poultry population; to estimate the consequences of an outbreak of HPAI in this population with a model constructed from these parameters; and to briefly evaluate the sensitivity of model outcomes to several parameters. Parameters describing disease state durations; disease transmission via direct contact, indirect contact, and local-area spread; and disease detection, surveillance, and control were established through consultation with subject matter experts, a review of the current literature, and the use of several computational tools. The stochastic model constructed from these parameters produced simulated outbreaks ranging from 2 to 111 days in duration (median 25 days), during which 1 to 514 flocks were infected (median 28 flocks). Model results were particularly sensitive to the rate of indirect contact that occurs among flocks. The baseline model established in this study can be used in the future to evaluate various control strategies, as a tool for emergency preparedness and response planning, and to assess the costs associated with disease control and the economic consequences of a disease outbreak.


Assuntos
Galinhas , Virus da Influenza A Subtipo H5N1/fisiologia , Influenza Aviária/transmissão , Doenças das Aves Domésticas/transmissão , Codorniz , Perus , Criação de Animais Domésticos , Animais , Simulação por Computador , Feminino , Virus da Influenza A Subtipo H5N1/patogenicidade , Influenza Aviária/epidemiologia , Influenza Aviária/virologia , Masculino , Modelos Teóricos , Doenças das Aves Domésticas/epidemiologia , Doenças das Aves Domésticas/virologia , Sensibilidade e Especificidade , South Carolina/epidemiologia
16.
Vector Borne Zoonotic Dis ; 12(8): 666-73, 2012 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-22607069

RESUMO

Rabies remains an important public health concern in the United States, with most human cases associated with bat rabies virus variants. Cases of rabies virus (RV) infection in bats are widely distributed across the continental United States and elsewhere in the Americas. In this retrospective study, data on bats submitted to state laboratories for RV diagnosis between 2001 and 2009 were analyzed to investigate epidemiological trends in the United States. Season, region, and roosting habits were the primary risk factors of interest. During the study interval, more than 205,439 bats were submitted for RV diagnosis, and 6.7% of these bats were rabid. Increased odds of a submitted bat being rabid were associated with species that exhibit inconspicuous roosting habits, bats originating in the Southwest, and bats submitted for diagnosis during the fall. Periodic analysis of zoonotic disease surveillance is recommended to detect changes in trends regarding geographic distribution, seasonal fluctuations, and host associations; this is particularly necessary, as existing trends may be influenced by climate change or other emerging factors.


Assuntos
Quirópteros/virologia , Vírus da Raiva/isolamento & purificação , Raiva/veterinária , Animais , Reservatórios de Doenças , Feminino , Humanos , Masculino , Raiva/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Estações do Ano , Vigilância de Evento Sentinela , Estados Unidos/epidemiologia , Zoonoses
17.
Vector Borne Zoonotic Dis ; 12(3): 192-5, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22017469

RESUMO

The decline in the number of northern fur seal (NFS; Callorhinus ursinus) pups on St. Paul Island, Alaska, has led to multidisciplinary research, including investigation into issues of reproductive health and success. Given the recent identification of Coxiella burnetii in the placenta of two other marine mammal species, NFS placentas were collected from Reef rookery on St. Paul Island, Alaska, during the 2010 pupping season, examined histologically, and tested for C. burnetii using polymerase chain reaction (PCR). Of 146 placentas examined, gram-negative intratrophoblastic bacteria that were positive for C. burnetii on immunohistochemistry were observed in 5 (3%) placentas. Placental infection was usually devoid of associated inflammation or significant ancillary pathology. One hundred nine (75%) of the placentas were positive for C. burnetii on PCR. C. burnetii is globally distributed and persists for long periods in the environment, providing ample opportunity for exposure of many species. The significance of this finding for the declining fur seal population, potential human exposure and infection, and impact on other sympatric marine mammal or terrestrial species is unclear; further investigation into the epidemiology of Coxiella in the marine ecosystem is warranted.


Assuntos
Coxiella burnetii/isolamento & purificação , Otárias/microbiologia , Placenta/microbiologia , Complicações Infecciosas na Gravidez/veterinária , Febre Q/veterinária , Alaska/epidemiologia , Animais , Coxiella burnetii/genética , DNA Bacteriano/genética , Feminino , Humanos , Ilhas , Placenta/patologia , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/microbiologia , Prevalência , Febre Q/epidemiologia , Febre Q/microbiologia
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