Coxiella burnetii in Small Ruminants and Humans: Evidence-based Control and Prevention Strategies with a Model to Assess Financial Impact of Coxiellosis to the Ontario Goat Industry

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Coxiella burnetii in Small Ruminants and Humans: Evidence-based Control and Prevention Strategies with a Model to Assess Financial Impact of Coxiellosis to the Ontario Goat Industry

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Title: Coxiella burnetii in Small Ruminants and Humans: Evidence-based Control and Prevention Strategies with a Model to Assess Financial Impact of Coxiellosis to the Ontario Goat Industry
Author: O'Neill, Tyler J.
Department: Population Medicine
Program: Population Medicine
Advisor: Sargeant, Jan M.
Abstract: Infection with zoonotic Coxiella burnetii, the causative agent of Q fever, poses significant challenges for control and prevention in both human and small ruminant hosts. In this context, the research objectives were to systematically identify, assess the risk of systematic bias, and quantitatively synthesize available data reported on interventions to control the development of acute clinical Q fever in high-risk occupationally exposed humans and to prevent bacterial shedding from sheep and goats from routes of public health importance (e.g. vaginal, uterine, and placental secretions, urine, and feces). This study was the first to systematically synthesize and analytically describe vaccination effects in humans and small ruminants. Vaccination in humans had the potential to prevent Q fever in abattoir employees but significant heterogeneity existed in the data. In contrast, vaccination significantly reduced the prevalence of shedding from vaginal and uterine secretions in previously sensitized goats, and milk, vaginal secretions, and feces from naïve goats. The mean levels shed from placental and vaginal routes were significantly decreased in vaccinated naïve goats. No effect of vaccination was found on the prevalence of shedding or mean level of shedding in vaccinated sheep compared to control sheep. The threat to public health remains despite vaccination of livestock. Substantial herd-level financial cost was described through stochastic simulation of direct production losses and expenditures in dairy and meat-producing goat farms in Ontario. Both high and low levels of C. burnetii exposure were modeled. The results of the systematic reviews, meta-analyses, and financial analysis are critical to inform evidence-based decision-making regarding future Q fever policy on prevention and control.
URI: http://hdl.handle.net/10214/3993
Date: 2012-09-13


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http://creativecommons.org/licenses/by-nd/2.5/ca/ Except where otherwise noted, this item's license is described as http://creativecommons.org/licenses/by-nd/2.5/ca/

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