Active surveillance of Q fever in human and animal population of Cyprus

BACKGROUND: A long-term active surveillance of Q fever was conducted in Cyprus organized in two phases. METHODS: Following serological tests and identification of seropositive humans and animals for C. burnetii in two villages (VIL1 and VIL2), all seronegative individuals were followed up for one year on a monthly basis by trained physicians to detect possible seroconversion for Q fever. In the second phase of the study, active surveillance for one year was conducted in the entire Cyprus. Physicians were following specific case definition criteria for Q fever. Standardized questionnaires, a geographical information system on a regional level, Immunofluorescence Assay (IFA) examinations and shell vial technique were used. RESULTS: Eighty-one seronegative humans and 239 seronegative animals from both villages participated in the first phase surveillance period of Q fever. Despite the small number of confirmed clinical cases (2 humans and 1 goat), a significant percentage of new seropositives for C. burnetii (44.4% of human participants and 13.8% of animals) was detected at the end of the year. During the second phase of surveillance, 82 humans, 100 goats, and 76 sheep were considered suspected cases of Q fever. However, only 9 human, 8 goat, and 4 sheep cases were serologically confirmed, while C. burnetii was isolated from three human and two animal samples. The human incidence rate was estimated at 1.2 per 100,000 population per year. CONCLUSION: A small number of confirmed clinical cases of Q fever were observed despite the high seroprevalence for C. burnetii in human and animal population of Cyprus. Most of the cases in the local population of Cyprus appear to be subclinical. Moreover further studies should investigate the role of ticks in the epidemiology of Q fever and their relation to human seropositivity

Legionella spp. and legionellosis in southeastern Italy: disease epidemiology and environmental surveillance in community and health care facilities

<p>Abstract</p> <p>Background</p> <p>Following the publication of the Italian Guidelines for the control and prevention of legionellosis an environmental and clinical surveillance has been carried out in Southeastern Italy. The aim of the study is to identify the risk factors for the disease, so allowing better programming of the necessary prevention measures.</p> <p>Methods</p> <p>During the period January 2000 - December 2009 the environmental surveillance was carried out by water sampling of 129 health care facilities (73 public and 56 private hospitals) and 533 buildings within the community (63 private apartments, 305 hotels, 19 offices, 4 churches, 116 gyms, 3 swimming pools and 23 schools). Water sampling and microbiological analysis were carried out following the Italian Guidelines. From January 2005, all facilities were subject to risk analysis through the use of a standardized report; the results were classified as <it>good </it>(G), <it>medium </it>(M) and <it>bad </it>(B). As well, all the clinical surveillance forms for legionellosis, which must be compiled by physicians and sent to the Regional Centre for Epidemiology (OER), were analyzed.</p> <p>Results</p> <p><it>Legionella </it>spp. was found in 102 (79.1%) health care facilities and in 238 (44.7%) community buildings. The percentages for the contamination levels < 1,000, 1,000-10,000, > 10,000 cfu/L were respectively 33.1%, 53.4% and 13.5% for samples from health care facilities and 33.5%, 43.3% and 23.2% for samples from the community. Both in hospital and community environments, <it>Legionella pneumophila </it>serogroup (<it>L. pn </it>sg) 2-14 was the most frequently isolate (respectively 54.8% and 40.8% of positive samples), followed by <it>L. pn </it>sg 1 (respectively 31.3% and 33%). The study showed a significant association between M or B score at the risk analysis and <it>Legionella </it>spp. positive microbiological test results (p < 0.001). From clinical surveillance, during the period January 2001 - August 2009, 97 cases of legionellosis were reported to the OER: 88 of community origin and 9 nosocomial. The most frequent symptoms were: fever (93.8%), cough (70.1%), dyspnea (58.8%), shivering (56.7%). Radiological evidence of pneumonia was reported in 68%. The laboratory diagnostic methods used were: urinary antigen (54.3%), single antibody titer (19.8%), only seroconversion (11.1%), other diagnostic methods (14.8%).</p> <p>Conclusions</p> <p>Our experience suggests that risk analysis and environmental microbiological surveillance should be carried out more frequently to control the environmental spread of <it>Legionella </it>spp. Furthermore, the laboratory diagnosis of legionellosis cannot be excluded only on the basis of a single negative test: some patients were positive to only one of the diagnostic tests.</p

Evaluation of standardized scored inspections for Legionnaires' disease prevention, during the Athens 2004 Olympics

The study was designed to determine the contribution of standardized scored inspections implemented during the Athens 2004 Pre-Olympic and Olympic period, in assessing the presence of Legionella spp. in water sites. Inspection grading scores of 477 water supply systems, 127 cooling towers and 134 decorative fountains were associated with the corresponding microbiological test results of 2514 samples for Legionella spp. Nine violations of water supply systems and nine of cooling towers significantly associated with positive microbiological test results, and four violations of water supply systems and one of cooling towers were among those designated as ‘critical’ water safety hazards in the inspection reports. The study documents a strong correlation [water supply systems (RR 1·92), cooling towers (RR 1·94)] between unsatisfactory inspection scoring results and Legionella-positive microbiological test results (in excess of 10 000 c.f.u./l) and suggests the utility of inspection scoring systems in predicting Legionella proliferation of water systems and in preventing Legionnaires' disease

Relationship between production conditions and milk gross composition in ewe's and goat's organic and conventional farms in central Greece

Organic milk and dairy products are widely consumed lately, with the belief they are of higher nutritional quality than conventional, while researchers report contradictory views on this issue. This study aimed to compare the fat, protein, and lactose content of organic and conventional raw ewe's and goat's milk in Greece and to further associate the impact of the farming practices on these parameters. Two hundred thirty-four bulk milk samples were collected from 62 goat and 16 sheep organic and conventional farms with similar farming characteristics. A standardized detailed survey and a sampling report were used in order to record the farming practices implemented in the participating farms. The chemical composition of all samples was determined by Fourier transformed infrared analysis. Statistical associations of farming practices with the milk chemical gross composition results were explored using linear mixed-model analysis. Linear mixed-model analysis revealed several factors in farming practices such as the feeding regime, the season, and the breed to be associated with ewe's and goat's milk composition, while organic or conventional farm system was not identified as an associated factor. Organic and conventional goat and sheep farming in Greece does not substantially differ, and consequently, there were no significant differences found in the examined chemical composition parameters of organic and conventional goat's and ewe's milk