Risk of seropositivity to Coxiella burnetii in humans living in areas with endemically infected cattle: No way for specific prevention

International audienceQ fever, a zoonotic disease caused by Coxiella burnetii, is endemic among cattle in Western France. However, studies assessing the risk of human infection in such areas are lacking to date, while they may provide information about key specific preventive actions which could be advised to the human populations living with or close to cattle. Therefore, we conducted a cross‐sectional study in two departments of Western France during the 2017/18 winter in order to explore possible risk factors for seropositivity among two distinct populations, i) an occupational risk group, that is, the cattle farmers, and ii) the general adult population (approached by blood donors). Sera were collected in 176 cattle farmers and 347 blood donors respectively, and tested for phase I and II antibodies using an indirect immunofluorescence antibody assay. Each participant was asked to fill in a questionnaire containing socio‐demographic characteristics, occupational and non‐occupational risk exposure. Identified risk factors were: in the general population, working in contact with ruminants, comparatively to any other activity (OR = 4.41; 95% CI: [1.59–6.55]); among farmers, managing an itself infected cattle herd (OR = 3.20; 95% CI: [1.59–6.55]). No other controllable risk factor (lifestyle, outdoor activities, proximity to pets and livestock animals, occupational practices) was here evidenced. In areas with endemically infected cattle, human exposure to Coxiella burnetii is to some extent unavoidable. This strengthens the need for physicians' awareness of the symptoms of Q fever and the appropriateness of general biosecurity measures, especially among at‐risk groups living there

Fièvre Q : la contribution des bovins en tant que réservoir des infections humaines ne doit pas être négligée

International audienceLa fièvre Q, causée par Coxiella burnetii, est une zoonose dont les principaux réservoirs sont les ruminants domestiques (bovins, ovins, caprins). Pour autant, la contribution spécifique des bovins au risque de transmission à l'homme reste incertaine. En effet, les études de séroprévalence et de facteurs de risque chez l'homme ont pour la plupart été réalisées dans des zones comprenant à la fois des bovins et des petits ruminants, ces derniers étant systématiquement impliqués dans les épidémies de fièvre Q. Dans deux départements de l'ouest de la France, caractérisés par une fréquence élevée d'infection chez les bovins et une très faible densité de petits ruminants, la prévalence et les facteurs de risque de séropositivité ont été explorés chez des éleveurs de bovins laitiers, des vétérinaires et dans la population générale adulte. Dans ces trois groupes, la prévalence de porteurs d'anticorps était respectivement de 56, 89 et 13%, attestant de la circulation C. burnetii y compris en l'absence de petits ruminants, et confirmant ainsi la contribution spécifique des bovins au risque d'infection humaine. Ce risque était d'abord professionnel, lié à une activité au contact avec des bovins pour la population générale et à la détention d'un troupeau infecté pour les éleveurs, à l'exclusion de tout autre facteur. Il est donc nécessaire de sensibiliser les médecins aux symptômes de la fièvre Q et à l'importance des mesures générales de biosécurité, en particulier pour les groupes à risqu

Coxiella burnetii infection in humans: to what extent do cattle in infected areas free from small ruminants play a role?

International audienceDomestic ruminants (cattle, goats and sheep) are considered to be the main reservoirs for human Coxiella burnetii infection. However, there is still a need to assess the specific contribution of cattle. Indeed, most seroprevalence studies in humans were carried out in areas comprising both cattle and small ruminants, the latter being systematically implicated in human Q fever outbreaks. Therefore, we conducted a cross-sectional study in areas where C. burnetii infection in cattle was endemic, where the density of cattle and small ruminant farms were respectively high and very low. The aim was to estimate the seroprevalence rates among two occupational (cattle farmers and livestock veterinarians), and one non-occupational (general adult population) risk groups. Sera were collected in 176 cattle farmers, 45 veterinarians and 347 blood donors, and tested for phase I and II antibodies using immunofluorescence assay. Seroprevalence rates were 56.3% among cattle farmers, 88.9% among veterinarians and 12.7% among blood donors. This suggests that a specific risk for acquiring C. burnetii infection from cattle in endemically infected areas exists, mainly for occupational risk groups, but also for the general population. Further research is needed to identify risk factors for C. burnetii infection in humans in such areas

Prévention du suicide : comment agir ?

International audienceAlthough being complex, suicide is a phenomenon considered as preventable, and its prevention has been made as a public health priority. Some interventions to prevent suicide have been evaluated, such as the education of the healthcare workers, especially in the suicidal assessment (suicidal risk and suicidal emergency/dangerousness), the diagnosis and management of common mental disorders, the care provided after a suicide attempt, the restriction access to common means of suicide, the use of websites to educate the public, or the appropriate reports of suicide in media. Other interventions, even not rigorously evaluated, are implemented in France as in many parts of the world. It is the case of interventions among identified high-risk groups. To be efficient, prevention programs should simultaneously include different strategies targeting several known risk factors for suicide. Clinicians play a crucial role in the suicide prevention strategies

Trends and characteristics of attempted and completed suicides reported to general practitioners before vs during the COVID-19 pandemic in France: Data from a nationwide monitoring system, 2010-2022

International audienceBackground Most studies published to date have investigated the impact of the COVID-19 pandemic on suicidal acts using hospital data. Trends from primary care in a country such as France are crucial, as individuals may not consult hospital services after suicide attempts (SAs) but rather see their general practitioner (GP). Objectives We aimed to evaluate whether the incidence and characteristics of SAs and completed suicides (CSs) reported to French GPs were different during the COVID-19 pandemic than those of before. Methods and findings We conducted a retrospective observational study using data from a nationwide monitoring system, the French Sentinel Network (FSN). All SAs and CSs reported by GPs to the FSN from January 1, 2010, to March 10, 2022 were included. The annual incidence rates (IRs) and the characteristics of SAs and CSs during the pandemic (March 11, 2020, to March 10, 2022) were compared to those of before. In total, 687 SAs and 169 CSs were included. The IRs remained stable for SAs and CSs before and during the pandemic (overlap in confidence intervals). The mean IRs were 52 (95%CI = 44; 57) per 100,000 inhabitants for SAs during the pandemic versus 47 [36; 57] during the pre-pandemic period (p = 0.49), and 5 (95%CI = 2; 9) for CSs versus 11 [6; 16] (p = 0.30). During the pandemic, SA were slightly different from those before in terms of age and occupational status (young/students and older/retirees over-represented), history of consultation and expression of suicidal ideas to GP (more frequent), and CS in terms of occupational status (students over-represented) (p<0.05). Conclusion The COVID-19 pandemic had no major effect on the overall incidence of SAs and CSs reported to French GPs. However, more suicidal acts were reported among younger and older individuals. Suicidal patients and GPs have adapted by improving the expression of suicidal ideas

A Cross-Sectional Study of Exposure Factors Associated with Seropositivity for SARS-CoV-2 Antibodies during the Second Epidemic Wave among a Sample of the University of Corsica (France)

This study aimed to estimate the seroprevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection within the staff and student populations of the University of Corsica (France) during the second wave of the epidemic. Methods: A cross-sectional survey was conducted from 23 November 2020 to 31 January 2021. The participants underwent blood sampling using a fingerstick procedure and completed an anonymized questionnaire. Sera were tested for the presence of anti-SARS-CoV-2 IgG (ELISA-S) and, if positive, with an in-house virus neutralization test (VNT). Results: A total of 418 persons were included in the study. The overall seroprevalence was 12.8% (95% confidence interval (CI), 9.8\textendash 16.6%). A total of 15 (31%) of the 49 individuals who had a positive ELISA-S also had a positive VNT. Seropositivity was associated with living at the city campus during the week and on weekends (OR = 3.74 [1.40\textendash 12.00]), using public transportation/carpooling (OR = 2.00 [1.01\textendash 4.02]), and being in contact with a person who tested positive for SARS-CoV-2 (OR = 2.32 [1.20\textendash 4.40]). The main symptoms associated with seropositivity were ``having had an acute respiratory infection'' (OR = 3.05 [1.43\textendash 6.43]) and ``experiencing loss of smell'' (OR = 16.4 [5.87\textendash 50.7]). Conclusion: These results could be useful for SARS-CoV-2 prevention and control on university campuses

Characteristics of suicide completers and suicide attempters during the first year of COVID-19 pandemic (from March 11, 2020, to March 10, 2021) and the second year (from March 11, 2021, to March 10, 2022) in the French General Practice Sentinel Network.

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Comparison of the mean annual incidence rates (per 100,000) of attempted and completed suicide reported to the French GPs during the COVID-19 pandemic (March 11, 2020, to March 10, 2022) and before (March 11, 2010 to March 10, 2020), French General Practice Sentinel Network.

Comparison of the mean annual incidence rates (per 100,000) of attempted and completed suicide reported to the French GPs during the COVID-19 pandemic (March 11, 2020, to March 10, 2022) and before (March 11, 2010 to March 10, 2020), French General Practice Sentinel Network.</p

Annual incidence rates (per 100,000) of attempted and completed suicide reported to the French GPs between 2010 and 2021.

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Comparison of GP in the French General Practice Sentinel Network in the COVID-19 pandemic (from March 11, 2020, to March 10, 2022) and in the preceding period (from March 11, 2010, to March 10, 2020), and in the first year of the pandemic (from March 11, 2020, to March 10, 2021) and the second year (from March 11, 2021, to March 10, 2022).

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