title: Absence of convincing evidence of Coxiella burnetii infection in Chile: a cross-sectional serosurvey among healthy adults in four different regions.
abstract: BACKGROUND
  Coxiella burnetii is an important zoonotic pathogen of global distribution. Still, in most parts of South America including Chile, systematic epidemiological data are lacking. The presented study aims to determine the seroprevalence of Coxiella burnetii antibodies in healthy adults of four different regions in Chile.
  
  
  METHODS
  A cross-sectional study was performed, which included healthy adults living in rural and urban areas of four cities located in different regions in northern, central, and southern Chile. In urban sectors, households were chosen by double stratified random sampling, while in rural areas convenience sampling was performed. Serum specimens were taken and screened for the presence of IgG antibodies against C. burnetii phase II antigen using a commercial ELISA kit. Positive and indeterminate results were confirmed by a reference laboratory using indirect immunofluorescence assay (IFA).
  
  
  RESULTS
  A total of 1112 individuals were included. Of those, 8 were positive by ELISA, but only one sample was confirmed using IFA. Statistical analysis for population freedom from disease revealed a high probability that C. burnetii was absent in our study population.
  
  
  CONCLUSIONS
  Our work provides the first epidemiological data on human Q fever in Chile indicating either a very low endemicity or the absence of this pathogen in the studied areas.
authors.affiliation: Laboratorio Clínico, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile. thomas.weitzel@gmail.com.
authors.forename: Thomas
authors.identifier: http://orcid.org/0000-0002-9804-2123
authors.initials: T
authors.lastname: Weitzel
authors.affiliation: Hospital Veterinario Puente Alto, Santiago, Chile.
authors.forename: Javier
authors.initials: J
authors.lastname: López
authors.affiliation: Instituto de Medicina Preventiva Veterinaria, Facultad de Ciencias Veterinarias, Universidad Austral de Chile, Valdivia, Chile.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Acosta-Jamett
authors.affiliation: Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, IHU Méditerranée-Infection, Aix-Marseille Université, Faculté de Médecine, Marseille, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Edouard
authors.affiliation: Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, IHU Méditerranée-Infection, Aix-Marseille Université, Faculté de Médecine, Marseille, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Parola
authors.affiliation: Departamento de Enfermedades Infecciosas e Inmunología Pediátrica, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. katia@med.puc.cl.
authors.forename: Katia
authors.initials: K
authors.lastname: Abarca
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000097:blood; D002677:Chile / Q000453:epidemiology; D002947:Cities; D016997:Coxiella burnetii / Q000472:pathogenicity*; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005191:Family Characteristics; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D011778:Q Fever / Q000453:epidemiology* / Q000382:microbiology; D012424:Rural Population; D016036:Seroepidemiologic Studies; D014505:Urban Population; D055815:Young Adult
chemical_list: D000907:Antibodies, Bacterial
keywords: Coxiella burnetii; Epidemiology; Q fever; Seroprevalence; South America; Zoonoses