影响新南威尔士州偏远农村小镇低风险居民的非典型Q热暴发。

IF 1.6 Q4 INFECTIOUS DISEASES
Communicable Diseases Intelligence Pub Date : 2017-06-30
Brett N Archer, Cathie Hallahan, Priscilla Stanley, Kathy Seward, Margaret Lesjak, Kirsty Hope, Anthony Brown
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引用次数: 0

摘要

我们调查了澳大利亚新南威尔士州一个偏远农村城镇爆发的Q热。通过主动和被动病例查找活动以及回顾性实验室记录审查确定的病例使用标准问卷进行访谈。完成了两组个案分析,以对暴发期间与感染相关的临床、流行病学和暴露风险因素提出假设。将实验室确诊的暴发病例(n=14)与排除病例组(n=16)和该地区历史Q热病例组(n=106)进行比较。与历史病例组相比,爆发病例明显更有可能是女性(43%对18%的男性,P = 0.04)和原住民(29%对7%的非原住民,P = 0.03)。同样,在高风险职业中工作的病例很少(21%比84%,P < 0.01)。大多数暴发病例(64%)报告在发病前一个月没有高危接触活动。与排除病例组相比,与狗接触的暴发病例比例显著增加(100%对63%,P = 0.02)或在其住宅物业上看到袋鼠(100%对60%,P = 0.02)。蜱虫接触率也很高(92%),尽管这与被排除的病例组没有显著差异。虽然此次暴发的来源尚未得到确认,但我们的研究结果表明,感染可能是通过吸入被伯纳氏克希菌污染的气溶胶或粉尘发生的,这些气溶胶或粉尘从一个不明动物设施或从本地野生动物或野生动物的排泄物中散布到该镇。另外,也可能通过伴侣动物或蜱虫媒介传播。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Atypical outbreak of Q fever affecting low-risk residents of a remote rural town in New South Wales.

We investigated an outbreak of Q fever in a remote rural town in New South Wales, Australia. Cases identified through active and passive case finding activities, and retrospective laboratory record review were interviewed using a standard questionnaire. Two sets of case-case analyses were completed to generate hypotheses regarding clinical, epidemiological and exposure risk factors associated with infection during the outbreak. Laboratory-confirmed outbreak cases (n=14) were compared with an excluded case group (n=16) and a group of historic Q fever cases from the region (n=106). In comparison with the historic case group, outbreak cases were significantly more likely to be female (43% vs. 18% males, P = 0.04) and identify as Aboriginal (29% vs. 7% non-Aboriginal, P = 0.03). Similarly, very few cases worked in high-risk occupations (21% vs. 84%, P < 0.01). Most outbreak cases (64%) reported no high-risk exposure activities in the month prior to onset. In comparison with the excluded case group, a significantly increased proportion of outbreak cases had contact with dogs (100% vs. 63%, P = 0.02) or sighted kangaroos on their residential property (100% vs. 60%, P = 0.02). High rates of tick exposure (92%) were also reported, although this was not significantly different from the excluded case group. While a source of this outbreak could not be confirmed, our findings suggest infections likely occurred via inhalation of aerosols or dust contaminated by Coxiella burnetii, dispersed through the town from either an unidentified animal facility or from excreta of native wildlife or feral animals. Alternatively transmission may have occurred via companion animals or tick vectors.

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Communicable Diseases Intelligence
Communicable Diseases Intelligence INFECTIOUS DISEASES-
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