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Acta Trop. 2017 Aug;172:255-262. doi: 10.1016/j.actatropica.2017.05.013. Epub 2017 May 11.

Are brucellosis, Q fever and melioidosis potential causes of febrile illness in Madagascar?

Author information

1
German Federal Institute for Risk Assessment, Department of Biological Safety, Diedersdorfer Weg 1, 12277 Berlin, Germany. Electronic address: Idesbald.Boone@bfr.bund.de.
2
Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute of Bacterial Infections and Zoonoses, Naumburger Straße 96a, 07743 Jena, Germany. Electronic address: Klaus.Henning@fli.de.
3
Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute of Bacterial Infections and Zoonoses, Naumburger Straße 96a, 07743 Jena, Germany. Electronic address: angela.hilbert@havelland.de.
4
Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute of Bacterial Infections and Zoonoses, Naumburger Straße 96a, 07743 Jena, Germany. Electronic address: Heinrich.Neubauer@fli.de.
5
International Vaccine Institute, SNU Research Park, 1-Gwanak-ro, Gwanak-gu, Seoul 08226, Republic of Korea. Electronic address: vera.vkalckreuth@daad-alumni.de.
6
Bernhard Nocht Institute for Tropical Medicine, Bernhard Nocht-Straße 74, 20359 Hamburg, Germany. Electronic address: dekker@bni-hamburg.de.
7
Bernhard Nocht Institute for Tropical Medicine, Bernhard Nocht-Straße 74, 20359 Hamburg, Germany. Electronic address: schwarznorbert@bni-hamburg.de.
8
International Vaccine Institute, SNU Research Park, 1-Gwanak-ro, Gwanak-gu, Seoul 08226, Republic of Korea. Electronic address: gdpak@ivi.int.
9
Department of Tropical Medicine at the Bernhard Nocht Institute, Bundeswehr Hospital of Hamburg, Bernhard Nocht-Straße 74, 20359 Hamburg, Germany. Electronic address: krueger@bnitm.de.
10
Department of Tropical Medicine at the Bernhard Nocht Institute, Bundeswehr Hospital of Hamburg, Bernhard Nocht-Straße 74, 20359 Hamburg, Germany. Electronic address: hagen@bnitm.de.
11
Department of Tropical Medicine at the Bernhard Nocht Institute, Bundeswehr Hospital of Hamburg, Bernhard Nocht-Straße 74, 20359 Hamburg, Germany; University Medicine Rostock, Schillingallee 70, 18057 Rostock, Germany. Electronic address: frickmann@bnitm.de.
12
Department of Microbiology and Parasitology, University of Antananarivo, B.P.175, Antananarivo, Madagascar. Electronic address: herijean007@yahoo.fr.
13
Department of Microbiology and Parasitology, University of Antananarivo, B.P.175, Antananarivo, Madagascar. Electronic address: rakrapha13@yahoo.fr.
14
Department of Microbiology and Parasitology, University of Antananarivo, B.P.175, Antananarivo, Madagascar. Electronic address: rakotophilibert@yahoo.fr.
15
Department of Microbiology and Parasitology, University of Antananarivo, B.P.175, Antananarivo, Madagascar. Electronic address: rakouttsa@yahoo.fr.
16
Bernhard Nocht Institute for Tropical Medicine, Bernhard Nocht-Straße 74, 20359 Hamburg, Germany. Electronic address: hogan@bnitm.de.
17
Bernhard Nocht Institute for Tropical Medicine, Bernhard Nocht-Straße 74, 20359 Hamburg, Germany. Electronic address: may@bnitm.de.
18
International Vaccine Institute, SNU Research Park, 1-Gwanak-ro, Gwanak-gu, Seoul 08226, Republic of Korea. Electronic address: fmarks@ivi.int.
19
Bernhard Nocht Institute for Tropical Medicine, Bernhard Nocht-Straße 74, 20359 Hamburg, Germany; University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany. Electronic address: sven@poppert.eu.
20
German Federal Institute for Risk Assessment, Department of Biological Safety, Diedersdorfer Weg 1, 12277 Berlin, Germany; RWTH Aachen University Hospital, Pauwelsstraße 30, 52074 Aachen, Germany. Electronic address: Sascha.Al-Dahouk@gmx.de.

Abstract

Brucellosis, Q fever and melioidosis are zoonoses, which can lead to pyrexia. These diseases are often under-ascertained and underreported because of their unspecific clinical signs and symptoms, insufficient awareness by physicians and public health officers and limited diagnostic capabilities, especially in low-resource countries. Therefore, the presence of Brucella spp., Coxiella burnetii and Burkholderia pseudomallei was investigated in Malagasy patients exhibiting febrile illness. In addition, we analyzed zebu cattle and their ticks as potential reservoirs for Brucella and C. burnetii, respectively. Specific quantitative real-time PCR assays (qPCRs) were performed on 1020 blood samples drawn from febrile patients. In total, 15 samples (1.5%) were Brucella-positive, mainly originating from patients without travel history, while DNA from C. burnetii and Bu. pseudomallei was not detected. Anti-C. burnetii antibodies were found in four out of 201 zebu serum samples (2%), whereas anti-Brucella antibodies could not be detected. Brucella DNA was detected in a single zebu sample. Three out of 330 ticks analyzed (1%) were positively tested for C. burnetii DNA but with high Ct values in the qPCR assay. Our data suggest that zebus as well as Amblyomma and Boophilus ticks have to be considered as a natural reservoir or vector for C. burnetii, but the risk of cattle-to-human transmission is low. Since bovine brucellosis does not seem to contribute to human infections in Madagascar, other transmission routes have to be assumed.

KEYWORDS:

Brucellosis; Febrile illness; Madagascar; Melioidosis; Q fever; Zoonoses

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