Seroepidemiologic evidence of Q fever and associated factors among workers in veterinary service laboratory in South Korea

초록

Author summaryThis study investigated the seroprevalence and seroreactivity of Q fever and determined the risk factors associated with seroprevalence of Q fever among the nationally representative sample of workers in the veterinary service laboratory (VSL) in South Korea. We found the seroprevalence and seroreactivity of C. burnetii infection among VSL staff were 7.9% and 16.0%, respectively. In addition, the work-specific tasks such as antemortem inspection of cattle, goats, or sheep, contact with animals having Q fever, and having animal blood splashed into or around eyes were found to be significantly associated with the seroprevalence of Q fever. Our findings suggest precautions be taken when contacting cattle, goats, or sheep, especially during the antemortem inspection, and dealing with C. burnetii infected animals, and when there is a risk of ocular contact with animal derivatives, such as the use of appropriate personal protective equipment, and compliance with other measures that prevent C. burnetii infections among VSL staff in South Korea. The incidence of Q fever has rapidly increased in South Korea since 2015. This study was undertaken to investigate the seroprevalence and seroreactivity of Q fever and the risk factors associated with its seroprevalence among workers in the veterinary service laboratory (VSL) in South Korea. This seroepidemiologic study was conducted in a total of 661 human subjects out of 1,328 subjects working in 50 VSL existing in South Korea between July 15 and July 29, 2019. Data were collected by administering survey questionnaires and by analyzing collected blood samples to determine the presence of antibodies against Coxiella burnetii. The seroprevalence and seroreactivity of C. burnetii infection were determined based on serum titers as (phase II IgG >= 1:256 and/or IgM >= 1:16) and (phase II IgG >= 1:16 and/or IgM >= 1:16) as determined by indirect immunofluorescent assay. Work, work environment, behavioral risk and protective factors associated with seroprevalence of Q fever were assessed by employing multivariable logistic regression analysis. Among the 661, the seroprevalence and seroreactivity of C. burnetii infection were 7.9% and 16.0%, respectively. Multivariate logistic regression analysis showed the risk factors significantly associated with seroprevalence were the antemortem inspection of cattle, goats, or sheep (APR (adjusted prevalence ratio), 2.52; 95% CI, 1.23-4.70)), animal blood splashed into or around eyes (APR, 2.24; 95% CI, 1.04-4.41), and contact with animals having Q fever (APR, 6.58; 95% CI, 3.39-10.85) during the previous year. This study suggests the need for precautions when contact with cattle, goats, or sheep is expected, especially during the antemortem inspection, when dealing with C. burnetii infected animals, or when there is a risk of ocular contact with animal derivatives. Therefore, we recommend the consistent use of appropriate personal protective equipment and other protective measures including PPE treatment and washing of body surfaces after work to prevent C. burnetii infections among VSL staff in South Korea.

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