Are brucellosis, Q fever and melioidosis potential causes of febrile illness in Madagascar?

다국어 초록 (Multilingual Abstract)

<P><B>Abstract</B></P> <P>Brucellosis, Q fever and melioidosis are zoonoses, which can lead to pyrexia. These diseases are often under-ascertained and underreported because of their unspecific clinical signs and symptoms, insufficient awareness by physicians and public health officers and limited diagnostic capabilities, especially in low-resource countries. Therefore, the presence of <I>Brucella</I> spp., <I>Coxiella burnetii</I> and <I>Burkholderia pseudomallei</I> was investigated in Malagasy patients exhibiting febrile illness. In addition, we analyzed zebu cattle and their ticks as potential reservoirs for <I>Brucella</I> and <I>C. burnetii</I>, respectively. Specific quantitative real-time PCR assays (qPCRs) were performed on 1020 blood samples drawn from febrile patients. In total, 15 samples (1.5%) were <I>Brucella-</I>positive, mainly originating from patients without travel history, while DNA from <I>C. burnetii</I> and <I>Bu. pseudomallei</I> was not detected.</P> <P>Anti-<I>C. burnetii</I> antibodies were found in four out of 201 zebu serum samples (2%), whereas anti-<I>Brucella</I> antibodies could not be detected. <I>Brucella</I> DNA was detected in a single zebu sample. Three out of 330 ticks analyzed (1%) were positively tested for <I>C. burnetii</I> DNA but with high Ct values in the qPCR assay. Our data suggest that zebus as well as <I>Amblyomma</I> and <I>Boophilus</I> ticks have to be considered as a natural reservoir or vector for <I>C. burnetii</I>, but the risk of cattle-to-human transmission is low. Since bovine brucellosis does not seem to contribute to human infections in Madagascar, other transmission routes have to be assumed.</P>