Human q fever

Q fever is a ubiquitous zoonosis due to Coxiella burnetii, a strict intracellular bacterium. Transmission to man occurs mainly through the inhalation of infected aerosols, arising mostly from livestock deliveries. The main characteristic of Q fever is its clinical variability, acute forms being associated with primary infection (flu-like syndrome, pneumopathy, hepatitis). The clinical expression also varies with age and sex. Chronic Q fever (mainly associated with endocarditis) may develop in people at risk (patients with valvular disease or immunosuppression or pregnant women), hence the importance of serological screening for Q fever in people at risk, and of the detection of valvular anomalies in patients with acute Q fever.La fièvre Q est une zoonose ubiquitaire due à Coxiella burnetii, bactérie intracellulaire stricte. La transmission à l'Homme se fait principalement par inhalation d'aérosols infectés, en particulier lors de la mise bas des mammifères. La principale caractéristique de la fièvre Q est la variabilité de son expression clinique, avec des formes aiguës lors de la primo-infection (syndrome pseudo-grippal, pneumopathie, hépatite). L'expression clinique varie également selon et le sexe. Chez les sujets à risque (patients atteints d'une valvulopathie ou immunodéprimés, femmes enceintes), la fièvre Q peut évoluer vers une forme chronique (provoquant généralement une endocardite), d'où l'importance du dépistage sérologique de la fièvre Q chez les sujets à risque et de la recherche de toute anomalie valvulaire devant un cas de fièvre Q aiguë

Q Fever in France, 1985–2009

To assess Q fever in France, we analyzed data for 1985–2009 from the French National Reference Center. A total of 179,794 serum samples were analyzed; 3,723 patients (one third female patients) had acute Q fever. Yearly distribution of acute Q fever showed a continuous increase. Periodic variations were observed in monthly distribution during January 2000–December 2009; cases peaked during April–September. Q fever was diagnosed more often in patients in southeastern France, where our laboratory is situated, than in other areas. Reevaluation of the current positive predictive value of serologic analysis for endocarditis was performed. We propose a change in the phase I (virulent bacteria) immunoglobulin G cutoff titer to >1,600. Annual incidences of acute Q fever and endocarditis were 2.5/100,000 persons and 0.1/100,000 persons, respectively. Cases and outbreaks of Q fever have increased in France

Wind in November, Q Fever in December

An investigation in southern France confirms the role of wind in Coxiella burnetii transmissio

Aspects épidémiologiques de la fièvre Q

AIX-MARSEILLE2-BU Méd/Odontol. (130552103) / SudocPARIS-BIUP (751062107) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Fièvre Q et grossesse (hétérogénéité de prise en charge et suivi à moyen terme de femmes enceintes traitées et non traitées lors de l'épidémie de Chamonix (74) en 2002)

La recherche d'atteinte par la fièvre Q sur le moyen terme après l'épidémie de Chamonix chez des femmes traitées lors de leur grossesse de 2002 (atteintes de fièvre Q aiguë ou cicatricielle) et de femmes non traitées (atteintes de fièvre Q cicatricielle ou séronégatives) a été réalisée par un questionnaire spécifique à chaque groupe. La comparaison des groupes grâce au test exact de Fisher n'a révélé aucune différence significative (p=0.1) entre les groupes, donc aucune certitude quant à l'efficacité de la prise en charge ou la nécessité de traiter les femmes atteintes de fièvre Q cicatricielle pendant leur grossesse ; ni aucun cas suspect d'atteinte par la fièvre Q, sauf deux femmes victimes d'avortements spontanés. L'arbre décisionnel basé sur la sérologie chez la femme enceinte établi ici, affiche la différence entre population standard (sérologie en cas de fièvre inexpliquée, d'issue anormale de la grossesse, d'infécondité) et population à risque (sérologie mensuelle systématique), insiste sur l'inutilité de traiter les formes cicatricielles, et la place primordiale du sérodiagnostic de phase I.GRENOBLE1-BU Médecine pharm. (385162101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Autochthonous infection with hepatitis E virus related to subtype 3a, France: a case report

Hepatitis E virus (HEV) recently emerged in Europe as a cause of autochthonous acute hepatitis and a porcine zoonosis. European autochthonous cases almost exclusively involved viruses of genotype 3, subtype 3a being only recently reported in France, from farm pigs. We report an autochthonous human infection with a HEV related to subtype 3a in Southeastern France. A 55-year-old human immunodeficiency virus-infected man presented liver cytolysis in June 2014. HEV RNA was detected in serum and three months later, anti-HEV IgM and IgG were positive whereas HEV RNA was no more detectable in serum. No biological or clinical complication did occur. HEV phylogeny based on two capsid gene fragments showed clustering of sequences obtained from the case-patient with HEV-3a, mean nucleotide identity being 91.7 and 91.3% with their 10 best GenBank matches that were obtained in Japan, South Korea, USA, Canada, Germany and Hungria from humans, pigs and a mongoose. Identity between HEV sequence obtained here and HEV-3a sequences obtained at our laboratory from farm pigs sampled in 2012 in Southeastern France was only 90.2-91.4%. Apart from these pig sequences, best hits from France were of subtypes 3i, 3f, or undefined. The patient consumed barely cooked wild-boar meat; no other risk factor for HEV infection was documented. In Europe, HEV-3a has been described in humans in England and Portugal, in wild boars in Germany, and in pigs in Germany, the Netherlands, and, recently, France. These findings suggest to gain a better knowledge of HEV-3a circulation in France

Rapid diagnosis of periodontitis, a feasibility study using MALDI-TOF mass spectrometry

International audienceAim The aim of the present study was to assess the feasibility and diagnostic contribution of protein profiling using MALDI-TOF mass spectrometry applied to saliva, gingival crevicular fluid (GCF) and dental plaque from periodontitis and healthy subjects. We hypothesized that rapid routine and blinded MALDI-TOF analysis could accurately classify these three types of samples according to periodontal state. Materials and methods Unstimulated saliva, GCF and dental plaque, collected from periodontitis subjects and healthy controls, were analyzed by MALDI-TOF MS. Based on the differentially expressed peaks between the two groups, diagnostic decision trees were built for each sample. Results Among 141 patients (67 periodontitis and 74 healthy controls), the decision trees diagnosed periodontitis with a sensitivity = 70.3% (± 0.211) and a specificity = 77.8% (± 0.165) for saliva, a sensitivity = 79.6% (± 0.188) and a specificity = 75.7% (± 0.195) for GCF, and a sensitivity = 72.1% (± 0.202) and a specificity = 72.2% (± 0.195) for dental plaque. The sensitivity and specificity of the tests were improved to 100% (CI 95% = [0.91;1]) and 100% (CI 95% = [0.92;1]), respectively, when two samples were tested

Development and validation of a multiplex qPCR assay for detection and relative quantification of HPV16 and HPV18 E6 and E7 oncogenes

International audienceHuman papillomaviruses (HPV) play a key role in promoting human anogenital cancers. Current high-risk HPV screening or diagnosis tests involve cytological or molecular techniques mostly based on qualitative HPV DNA detection. Here, we describe the development of a rapid quantitative polymerase chain reaction (qPCR) detection test of HPV16 and HPV18 oncogenes (E6 and E7) normalized on human gene encoding GAPDH. Optimized qPCR parameters were defined, and analytical specificities were validated. The limit of detection was 10 1 for all genes tested. Assay performances were evaluated on clinical samples (n = 96). Concordance between the Xpert HPV assay and the triplex assay developed here was 93.44% for HPV16 and 73.58% for HPV18. HPV co-infections were detected in 15 samples. The systems developed in the present study can be used in complement to traditional HPV tests for specifically validating the presence of HPV16 and/or HPV18. It can also be used for the follow-up of patients with confirmed infection and at risk of developing lesions, through the quantification of E6 and E7 oncogene expression (mRNA) normalized on the GAPDH expression levels