Q fever and coxiellosis in Brazil: an underestimated disease? A brief review.

Q fever, caused by the γ-proteobacterium Coxiella burnetii, is a zoonosis of great importance and global impact. This agent has high transmissibility and can spread over long distances via wind, in which a small number of aerosolized particles are needed to infect susceptible hosts. The clinical diagnosis of Q fever is difficult owing to the variety of clinical signs shared with other diseases. In Brazil, studies related to C. burnetii are constantly being conducted, and this review aims to increase the number of approaches already studied, leading to the following question: is Q fever an unknown, neglected disease, or does it have a focal occurrence in certain areas (exotic/rare) in the country?

Rickettsial infection in free-ranging capybaras (Hydrochoerus hydrochaeris) and their ticks (Acari, Ixodidae) in the Caatinga and Atlantic forest biomes, Northeastern Brazil.

Caatinga and Atlantic Forest are Brazilian biomes threatened by anthropogenic disturbances, which are a serious threat to biodiversity and favor the emergence of zoonotic pathogens. Capybara populations are increasingly present in urban and rural areas due to the loss of their natural habitats. There are no studies on the rickettsial infection in these rodents in Northeastern Brazil, although there are case records of Brazilian Spotted Fever (BSF) in this region. In this context, we evaluated rickettsial infection in capybaras and their ticks in four areas of the Atlantic Forest and Caatinga biomes in Northeastern Brazil. Blood sera from 21 capybaras were tested by indirect immunofluorescence assay (IFA) using Rickettsia rickettsii, R. parkeri, and R. amblyommatis antigens. Blood samples and ticks (Amblyomma sp., Amblyomma dubitatum and Amblyomma sculptum) were tested by PCR, targeting a fragment of the rickettsial gltA gene and R. bellii primers. Overall, 15 out of 21 capybaras (71.4%) reacted positively (titer ≥64) to at least one of the three Rickettsia antigens tested, with final titers ranging from 64 to 1024. No rickettsial DNA was found in capybara blood samples. Rickettsial DNA was detected in 22 of 31 adult tick pools using gltA gene, being all nine pools of A. sculptum and 16 of the 19 of A. dubitatum, but all samples were negative to R. bellii specific primers. All attempts to sequence the amplicon were unsuccessful, indicating a possible low rickettsial load in the tick samples. The present study reports for the first time the serological evidence of Rickettsia spp. infection in free-ranging capybaras and suggest the rickettsial infection in A. sculptum and A. dubitatum in the Caatinga and Atlantic Forest biomes in Northeastern Brazil.

Serological evidence of Rickettsia in horses from a semi-arid Brazilian region.

Brazilian spotted fever (BSF) is a common tick-borne disease caused by Rickettsia rickettsii. Horses are the primary hosts of the main vector, Amblyomma sculptum, and are considered efficient sentinels for circulation of Rickettsia. Therefore, the aim of this study was to detect antibodies reactive to R. rickettsii antigens in horses from a non-endemic area in the north-central region of Bahia state, Brazil. Blood samples and ticks were collected from 70 horses from the municipalities of Senhor do Bonfim, Antônio Gonçalves, Pindobaçu, and Campo Formoso. The sera obtained were tested by an indirect immunofluorescence assay to detect anti-Rickettsia antibodies. Overall, 5.7% (4/70) of the horses reacted to R. rickettsii antigens. Ticks were collected from 18.6% (13/70) of the horses and were identified as A. sculptum and Dermacentor nitens. Despite being a non-endemic area, seropositive animals were identified in our study, suggesting circulation of rickettsial agents in the region. This is the first serological survey of this agent in horses from the north-central region of Bahia, and further studies are needed to understand the epidemiology of BSF in these locations.

Serological evidence of Rickettsia in horses from a semi-arid Brazilian region / Evidência sorológica de Rickettsia em cavalos da região semiárida do Brasil

Abstract Brazilian spotted fever (BSF) is a common tick-borne disease caused by Rickettsia rickettsii. Horses are the primary hosts of the main vector, Amblyomma sculptum, and are considered efficient sentinels for circulation of Rickettsia. Therefore, the aim of this study was to detect antibodies reactive to R. rickettsii antigens in horses from a non-endemic area in the north-central region of Bahia state, Brazil. Blood samples and ticks were collected from 70 horses from the municipalities of Senhor do Bonfim, Antônio Gonçalves, Pindobaçu, and Campo Formoso. The sera obtained were tested by an indirect immunofluorescence assay to detect anti-Rickettsia antibodies. Overall, 5.7% (4/70) of the horses reacted to R. rickettsii antigens. Ticks were collected from 18.6% (13/70) of the horses and were identified as A. sculptum and Dermacentor nitens. Despite being a non-endemic area, seropositive animals were identified in our study, suggesting circulation of rickettsial agents in the region. This is the first serological survey of this agent in horses from the north-central region of Bahia, and further studies are needed to understand the epidemiology of BSF in these locations.

Resumo A Febre Maculosa Brasileira (FMB) é uma importante zoonose causada por Rickettsia rickettsii, sendo seu vetor o Amblyomma sculptum. Cavalos são os principais hospedeiros desse carrapato e considerados sentinelas eficientes para detectar a circulação de Rickettsia. O objetivo deste estudo foi detectar anticorpos reativos a antígenos de R. rickettsii em cavalos de uma área não-endêmica na região Centro-Norte da Bahia, Brasil. Foram coletadas amostras de sangue e carrapatos de 70 cavalos nos municípios de Senhor do Bonfim, Antônio Gonçalves, Pindobaçu e Campo Formoso. Os soros obtidos foram testados pela reação de imunofluorescência indireta para detectar anticorpos anti-Rickettsia. No geral, 5,7% (4/70) dos cavalos reagiram sorologicamente para antígenos de R. rickettsii. Os carrapatos foram coletados em 18,6% (13/70) dos cavalos e foram identificados como A. sculptum e Dermacentor nitens. Embora seja uma área não endêmica, foram observados animais soropositivos, sugerindo a circulação de riquétsias na região estudada. Este é o primeiro estudo de levantamento sorológico desse agente em cavalos do Centro-Norte da Bahia. São necessários mais estudos para compreender a epidemiologia da FMB nesses locais.

Canine leishmaniasis in the semi-arid region of Pernambuco, northeastern Brazil: epidemiology, factors associated with seropositivity and spatial analysis.

This study aimed to determine the seroprevalence, factors associated with seropositivity to Leishmania infection in dogs and spatial analysis in six municipalities in the semiarid region of Pernambuco, Brazil. Blood samples were collected from 462 dogs, 77 in each municipality, and used for serological analysis [dual path platform (DPP®) and enzyme-linked immunosorbent assay (ELISA)]. Clinical signs of dogs were evaluated and associated factors for Leishmania infection were analyzed using robust Poisson regression model. A seroprevalence of 42.8% (198/462, IC: 95% = 38.6%-47.6%) was detected in dogs that tested positive in both tests, ranging from 29.8% to 55.8%, with higher prevalence in the municipality of Cabrobó (55.8%; P = 0.006). About 67% (132/198) of the seropositive dogs showed one or more clinical signs suggestive of canine leishmaniasis (CanL), such as lymphadenomegaly, skin lesions and conjunctivitis, which were associated with seropositivity. High seroprevalence levels were identified in urban and rural areas in all the municipalities, and the buffer for sand flies around cases covered almost these entire areas. Spatial analysis revealed a significant cluster, showing a relative risk of 1.88 in the urban area of Cabrobó. The higher density of seropositive dogs in urban areas indicates the need effective control measures against CanL to prevent the emergence of canine and human diseases.

Canine leishmaniasis in the semi-arid region of Pernambuco, northeastern Brazil: epidemiology, factors associated with seropositivity and spatial analysis / Leishmaniose visceral canina na região semiárida de Pernambuco, nordeste do Brasil: epidemiologia, fatores associados à soropositividade e análise espacial

Abstract This study aimed to determine the seroprevalence, factors associated with seropositivity to Leishmania infection in dogs and spatial analysis in six municipalities in the semiarid region of Pernambuco, Brazil. Blood samples were collected from 462 dogs, 77 in each municipality, and used for serological analysis [dual path platform (DPP®) and enzyme-linked immunosorbent assay (ELISA)]. Clinical signs of dogs were evaluated and associated factors for Leishmania infection were analyzed using robust Poisson regression model. A seroprevalence of 42.8% (198/462, IC: 95% = 38.6%-47.6%) was detected in dogs that tested positive in both tests, ranging from 29.8% to 55.8%, with higher prevalence in the municipality of Cabrobó (55.8%; P = 0.006). About 67% (132/198) of the seropositive dogs showed one or more clinical signs suggestive of canine leishmaniasis (CanL), such as lymphadenomegaly, skin lesions and conjunctivitis, which were associated with seropositivity. High seroprevalence levels were identified in urban and rural areas in all the municipalities, and the buffer for sand flies around cases covered almost these entire areas. Spatial analysis revealed a significant cluster, showing a relative risk of 1.88 in the urban area of Cabrobó. The higher density of seropositive dogs in urban areas indicates the need effective control measures against CanL to prevent the emergence of canine and human diseases.

Resumo Este estudo objetivou determinar a soroprevalência, fatores associados com a soropositividade da infecção por Leishmania em cães e análise espacial em seis municípios do semiárido de Pernambuco. Amostras de sangue foram coletadas de 462 cães, 77 em cada município, e utilizadas para análise sorológica [teste rápido imunocromatográfico (DPP®) e ensaio de imunoabsorção enzimática (ELISA)]. Os sinais clínicos dos cães foram avaliados, e os fatores associados à infecção por Leishmania foram analisados, ​​usando-se modelo robusto de regressão de Poisson. Foi detectada uma soroprevalência de 42,8% (198/462, IC: 95% = 38,6%-47,6%) em cães com resultados positivos em ambos os testes, variando de 29,8% a 55,8%, com maior prevalência no município de Cabrobó (55,8%; P = 0,006). Cerca de 67% (132/198) dos cães apresentaram um ou mais sinais clínicos sugestivos de CanL, como linfadenomegalia, lesões de pele e conjuntivite, os quais foram associados à soropositividade. Altos níveis de soroprevalência foram identificados nas áreas urbanas e rurais de todos os municípios, e os buffers da área de vôo do flebotomíneo em torno dos casos cobriam quase todas as áreas dos municípios. A análise espacial revelou um cluster significativo, mostrando um risco relativo de 1,88 na área urbana de Cabrobó. A maior densidade de casos em áreas urbanas indica a necessidade de medidas efetivas de controle contra o CanL, para evitar o surgimento da doença canina e humana.

Serological detection and risk factors for equine piroplasmosis in the semiarid region of Pernambuco, Northeastern Brazil / Detecção sorológica e fatores de riscos para piroplasmose equina na região semiárida de Pernambuco, Nordeste do Brasil

Abstract Equine piroplasmosis, an economically important disease in horses, has so far not been reported in Pernambuco state, Brazil. This study aimed to evaluate the seroprevalence of anti-Babesia caballi and anti-Theileria equi antibodies based on the detection of these agents in equine blood and in ticks on horses in the municipality of Petrolina, Pernambuco, northeastern Brazil. Blood samples were drawn from 393 horses and sera were examined by ELISA. The presence of tick infestations was evaluated, and 101 ticks were subjected to DNA amplification for the detection of Babesia spp. by polymerase chain reaction (PCR). No parasites were detected in the blood smears. Anti-B. caballi and anti-T. equi antibodies were found in 27.2% (107/393) and 34.8% (137/393) horses, respectively. Infestation by Dermacentor nitens was detected in 4.3% (17/393) of the horses. There was no DNA amplification of the agents in ticks. The risk factors for the presence of anti-T. equi antibodies (P < 0.05) were: purebred (P < 0.001), animals older than 156 months (P = 0.014), and the presence of ticks (P = 0.001). No risk factors for B. caballi were identified. This study confirmed the circulation of agents of equine piroplasmosis in the municipality of Petrolina, state of Pernambuco, Brazil.

Resumo Piroplasmose equina é uma doença economicamente importante em equinos e não possui relatos no Estado de Pernambuco, Brasil. O objetivo deste estudo foi avaliar a soroprevalência de anticorpos anti-B. caballi e anti-T. equi pela detecção destes agentes no sangue e carrapatos de equinos no município de Petrolina, Pernambuco, Nordeste do Brasil. Amostras de sangue de 393 equinos foram coletadas e submetidas ao esfregaço sanguíneo e ELISA. A presença de infestação por carrapatos foi avaliada, e 71 carrapatos foram submetidos à Reação em Cadeia da Polimerase (PCR) para Babesia spp. Nenhum parasito foi detectado na análise de esfregaços de sangue. Anticorpos anti-B. caballi e anti-T. equi foram verificados em 27,2% (107/393) e 34,8% (137/393) dos equinos, respectivamente. A infestação por Dermacentor nitens foi verificada em 4,3% (17/393) dos equinos. Não houve amplificação do DNA dos agentes nos 71 carrapatos submetidos à PCR. Os fatores de risco para presença de anticorpos anti-T. equi (P < 0,05) foram: raça definida (P < 0,001), animais > de 156 meses (P = 0,014) e presença de carrapatos (P = 0,001). Nenhum fator de risco foi identificado para B. caballi. Esse estudo permitiu a confirmação da presença de agentes da piroplasmose equina no município de Petrolina, Pernambuco.

Serological detection and risk factors for equine piroplasmosis in the semiarid region of Pernambuco, Northeastern Brazil.

Equine piroplasmosis, an economically important disease in horses, has so far not been reported in Pernambuco state, Brazil. This study aimed to evaluate the seroprevalence of anti-Babesia caballi and anti-Theileria equi antibodies based on the detection of these agents in equine blood and in ticks on horses in the municipality of Petrolina, Pernambuco, northeastern Brazil. Blood samples were drawn from 393 horses and sera were examined by ELISA. The presence of tick infestations was evaluated, and 101 ticks were subjected to DNA amplification for the detection of Babesia spp. by polymerase chain reaction (PCR). No parasites were detected in the blood smears. Anti-B. caballi and anti-T. equi antibodies were found in 27.2% (107/393) and 34.8% (137/393) horses, respectively. Infestation by Dermacentor nitens was detected in 4.3% (17/393) of the horses. There was no DNA amplification of the agents in ticks. The risk factors for the presence of anti-T. equi antibodies (P < 0.05) were: purebred (P < 0.001), animals older than 156 months (P = 0.014), and the presence of ticks (P = 0.001). No risk factors for B. caballi were identified. This study confirmed the circulation of agents of equine piroplasmosis in the municipality of Petrolina, state of Pernambuco, Brazil.

Serological diagnosis and risk factors for Coxiella burnetii in goats and sheep in a semi-arid region of Northeastern Brazil.

Coxiella burnetii is a zoonotic agent transmitted mainly by small ruminants. In Brazil the disease has been classified as a notifiable disease since 2013, when human cases were reported. This study aimed to identify risk factors associated with the presence of anti- Coxiella burnetii antibodies in goats and sheep in a semiarid region of Northeastern Brazil. Sera of 412 goats and 403 sheep from municipality of Petrolina, Pernambuco, were examined by the Indirect Fluorescent Antibody Test (IFAT) against antigens of C. burnetii. Information about management variables (independent variables) that could be associated with the presence of the microorganism (dependent variables) were obtained from the supervisor of each farm. It was determined that 2.2% (9/412) of the goats and 2.1% (9/403) of the sheep had antibodies reactive to C. burnetii. The presence of anti-C. burnetii antibodies was associated with the dry area of the Sequeiro (a region in the northern part of the municipality of Petrolina) (P = 0.025), male sheep (P = 0.020), and intensive goat breeding (P = 0.005). This study therefore showed the presence of anti-C. burnetii antibodies in goat and sheep, confirming for the first time that this agent is likely circulating among goat herds in the Caatinga Biome, semi-arid of Brazil.

Serological diagnosis and risk factors for Coxiella burnetii in goats and sheep in a semi-arid region of Northeastern Brazil / Diagnóstico sorológico e fatores de risco para Coxiella burnetii em caprinos e ovinos da região semiárida do nordeste do Brasil

Abstract Coxiella burnetii is a zoonotic agent transmitted mainly by small ruminants. In Brazil the disease has been classified as a notifiable disease since 2013, when human cases were reported. This study aimed to identify risk factors associated with the presence of anti- Coxiella burnetii antibodies in goats and sheep in a semiarid region of Northeastern Brazil. Sera of 412 goats and 403 sheep from municipality of Petrolina, Pernambuco, were examined by the Indirect Fluorescent Antibody Test (IFAT) against antigens of C. burnetii. Information about management variables (independent variables) that could be associated with the presence of the microorganism (dependent variables) were obtained from the supervisor of each farm. It was determined that 2.2% (9/412) of the goats and 2.1% (9/403) of the sheep had antibodies reactive to C. burnetii. The presence of anti-C. burnetii antibodies was associated with the dry area of the Sequeiro (a region in the northern part of the municipality of Petrolina) (P = 0.025), male sheep (P = 0.020), and intensive goat breeding (P = 0.005). This study therefore showed the presence of anti-C. burnetii antibodies in goat and sheep, confirming for the first time that this agent is likely circulating among goat herds in the Caatinga Biome, semi-arid of Brazil.

Resumo Coxiella burnetii é um agente zoonótico transmitido principalmente por pequenos ruminantes. No Brasil, a doença foi classificada como de notificação compulsória desde 2013, quando casos humanos foram relatados. O objetivo deste estudo foi identificar os fatores de risco associados à presença de anticorpos anti-Coxiella burnetii em caprinos e ovinos em uma região semiárida do Nordeste do Brasil. Este estudo envolveu um inquérito sorológico de 412 caprinos e 403 ovinos em fazendas do município de Petrolina, no estado de Pernambuco. Os soros foram examinados pela Reação de Imunofluorescência Indireta (RIFI) contra antígenos de C. burnetii . Informações sobre variáveis ​​de manejo (variáveis ​​independentes) que poderiam estar associadas à presença do microrganismo (variáveis ​​dependentes) foram obtidas do proprietário de cada fazenda. Foi determinado que 2,2% (9/412) dos caprinos e 2,1% (9/403) dos ovinos tinham anticorpos reativos a C. burnetii. A presença de anticorpos anti-C. burnetii foram associados com a área seca do Sequeiro (região no norte do município de Petrolina) (P = 0,025), ovinos machos (P = 0,020) e criação intensiva de caprinos (P = 0,005). Este estudo, portanto, observou a presença de anticorpos anti-C. burnetii em pequenos ruminantes, confirmando pela primeira vez que este agente pode estar circulando em rebanhos caprinos no bioma Caatinga, semiárido do Brasil.