title: Epidemiological study of Q fever in humans, ruminant animals, and ticks in Cyprus using a geographical information system.
abstract: A cross-sectional study of Q fever was conducted in a representative sample of the human and animal population in Cyprus in order to assess the seroprevalence of Q fever and the prevalence of related risk factors. A total of 583 human and 974 ruminant animal serum samples were collected and tested for the detection of antibodies against Coxiella burnetii phase II antigen using an indirect immunofluorescent assay. One hundred forty-one ticks were collected from the infested animals examined; the polymerase chain reaction and the shell-vial technique were used to detect and isolate C. burnetii. Standardized questionnaires were used to obtain information concerning inhabitants and their animals. A geographical information system was used to identify high-risk regions. The prevalence of IgG antibodies against C. burnetii phase II antigen was estimated at 52.7% for humans, 48.2% for goats, 18.9% for sheep, and 24% for bovines. C. burnetii was detected in 11 (7.8%) ticks. Using the geographical information system, two villages were identified as high-risk regions on the basis of high seroprevalence rates of IgG antibodies in humans and animals. Risk factors related to Q fever seropositivity were identified by logistic regression analysis and included age, residence, occupation, use of manure in the garden, ownership of animals (especially goats), and the presence of tick-infested or aborting animals. Q fever poses an occupational hazard to humans living in close contact with sheep and/or goats. In parallel, ticks should be considered an important aspect in the epidemiology of Q fever and should be further studied to better elucidate their role.
authors.affiliation: Laboratory of Clinical Bacteriology, Parasitology, and Geographical Medicine, Collaborating Center of WHO, Faculty of Medicine, University of Crete, PO Box 1393, TK 71409 Heraklion, Crete, Greece. annapsa@med.uoc.gr
authors.forename: A
authors.initials: A
authors.lastname: Psaroulaki
authors.forename: C
authors.initials: C
authors.lastname: Hadjichristodoulou
authors.forename: F
authors.initials: F
authors.lastname: Loukaides
authors.forename: E
authors.initials: E
authors.lastname: Soteriades
authors.forename: A
authors.initials: A
authors.lastname: Konstantinidis
authors.forename: P
authors.initials: P
authors.lastname: Papastergiou
authors.forename: M C
authors.initials: MC
authors.lastname: Ioannidou
authors.forename: Y
authors.initials: Y
authors.lastname: Tselentis
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D000829:Animals, Domestic / Q000382:microbiology*; D002648:Child; D016997:Coxiella burnetii / Q000276:immunology / Q000302:isolation & purification; D003430:Cross-Sectional Studies; D003535:Cyprus / Q000453:epidemiology; D005260:Female; D040362:Geographic Information Systems; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D011778:Q Fever / Q000453:epidemiology*; D012418:Ruminants / Q000382:microbiology*; D016036:Seroepidemiologic Studies; D013987:Ticks / Q000382:microbiology*