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Airborne geographical dispersal of Q fever from livestock holdings to human
communities: a systematic review and critical appraisal of evidence
#MMPMID29764368
Clark NJ
; Soares Magalhães RJ
BMC Infect Dis
2018[May]; 18
(1
): 218
PMID29764368
show ga
BACKGROUND: Q fever is a zoonotic disease caused by Coxiella burnetii. This
bacterium survives harsh conditions and attaches to dust, suggesting
environmental dispersal is a risk factor for outbreaks. Spatial epidemiology
studies collating evidence on Q fever geographical contamination gradients are
needed, as human cases without occupational exposure are increasing worldwide.
METHODS: We used a systematic literature search to assess the role of distance
from ruminant holdings as a risk factor for human Q fever outbreaks. We also
collated evidence for other putative drivers of C. burnetii geographical
dispersal. RESULTS: In all documented outbreaks, infective sheep or goats, not
cattle, was the likely source. Evidence suggests a prominent role of airborne
dispersal; Coxiella burnetii travels up to 18 km on gale force winds. In rural
areas, highest infection risk occurs within 5 km of sources. Urban outbreaks
generally occur over smaller distances, though evidence on attack rate gradients
is limited. Wind speed / direction, spreading of animal products, and stocking
density may all contribute to C. burnetii environmental gradients. CONCLUSIONS: Q
fever environmental gradients depend on urbanization level, ruminant species,
stocking density and wind speed. While more research is needed, evidence suggests
that residential exclusion zones around holdings may be inadequate to contain
this zoonotic disease, and should be species-specific.
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