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Environmental sampling coupled with real-time PCR and genotyping to investigate the source of a Q fever outbreak in a work setting.

Environmental sampling coupled with real-time PCR and genotyping to investigate the source of a Q fever outbreak in a work setting.
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Hurtado A, Alonso E, Aspiritxaga I, López Etxaniz I, Ocabo B, Barandika JF, Fernández-Ortiz DE Murúa JI, Urbaneja F, Álvarez-Alonso R, Jado I, García-Pérez AL,


Hurtado A, Alonso E, Aspiritxaga I, López Etxaniz I, Ocabo B, Barandika JF, Fernández-Ortiz DE Murúa JI, Urbaneja F, Álvarez-Alonso R, Jado I, García-Pérez AL, (click to view)

Hurtado A, Alonso E, Aspiritxaga I, López Etxaniz I, Ocabo B, Barandika JF, Fernández-Ortiz DE Murúa JI, Urbaneja F, Álvarez-Alonso R, Jado I, García-Pérez AL,

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Epidemiology and infection 2017 04 24145(9) 1834-1842 doi 10.1017/S0950268817000796
Abstract

A Q fever outbreak was declared in February 2016 in a company that manufactures hoists and chains and therefore with no apparent occupational-associated risk. Coxiella burnetii infection was diagnosed by serology in eight of the 29 workers of the company; seven of them had fever or flu-like signs and five had pneumonia, one requiring hospitalisation. A further case of C. burnetii pneumonia was diagnosed in a local resident. Real-time PCR (RTi-PCR) showed a widespread distribution of C. burnetii DNA in dust samples collected from the plant facilities, thus confirming the exposure of workers to the infection inside the factory. Epidemiological investigations identified a goat flock with high C. burnetii seroprevalence and active shedding which was owned and managed by one of the workers of the company as possible source of infection. Genotyping by multispacer sequence typing (MST) and a 10-loci single-nucleotide polymorphism (SNP) discrimination using RTi-PCR identified the same genotype (MST18 and SNP type 8, respectively) in the farm and the factory. These results confirmed the link between the goat farm and the outbreak and allowed the identification of the source of infection. The circumstances and possible vehicles for the bacteria entering the factory are discussed.

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