Fenga Concettina, Gangemi Silvia, De Luca Annamaria, Calimeri Sebastiano, Lo Giudice Daniela, Pugliese Michela, Licitra Francesca, Alibrandi Angela, Costa Chiara
University of Messina, Messina, Italy (Occupational Medicine Section - Department of the Environment, Security, Territory, Food and Health Sciences).
University of Messina, Messina, Italy (Department of Biomedical Sciences and Morphological and Functional Images).
Int J Occup Med Environ Health. 2015;28(5):901-7. doi: 10.13075/ijomeh.1896.00448.
The aim of this survey was to assess the seroprevalence of antibodies against Coxiella burnetii (C. burnetii) in subjects at risk of exposure in Sicily, Southern Italy.
Prevalence of IgG antibodies to C. burnetii phase II antigens was evaluated by ELISA in a group of 140 workers at risk of exposure (38 veterinarians, 38 slaughterhouse workers, 44 livestock handlers, 20 laboratory and technical personnel) included in a medical surveillance program and in 42 control subjects. Positive samples were classified as suggestive of prior exposure to C. burnetii.
Antibodies against C. burnetii were detected in 88 out of 140 (62.9%) exposed workers and in 6 out of 42 (14.3%) subjects of the control group. The variables evaluated did not seem to have a significant effect on seropositivity to Coxiella with the exception of symptoms in the last 6 months preceding the survey.
Our study demonstrated a high seroprevalence of C. burnetii in the group of exposed workers in comparison to non-exposed subjects of the control group. Clinical illness appears to be rare; nevertheless, physicians should consider Q fever in patients with compatible symptoms and occupational exposure to animals and their products. As aerosols represent the main route of infection in animals and humans, these workers are strongly advised to wear respiratory masks. In addition, occupational physicians should consider routine serologic evaluation and vaccination of occupationally exposed workers.
本次调查旨在评估意大利南部西西里岛有暴露风险人群中抗伯氏考克斯体（C. burnetii）抗体的血清阳性率。
采用酶联免疫吸附测定法（ELISA）评估纳入医学监测项目的140名有暴露风险的工作人员（38名兽医、38名屠宰场工人、44名畜牧工人、20名实验室及技术人员）以及42名对照受试者中针对C. burnetii II期抗原的IgG抗体阳性率。阳性样本被归类为提示既往曾暴露于C. burnetii。
140名暴露工人中有88名（62.9%）检测到抗C. burnetii抗体，对照组42名受试者中有6名（14.3%）检测到该抗体。除调查前最后6个月出现的症状外，所评估的变量似乎对伯氏考克斯体血清阳性率无显著影响。
我们的研究表明，与对照组未暴露受试者相比，暴露工人群体中C. burnetii的血清阳性率较高。临床疾病似乎罕见；然而，医生应考虑在有相关症状且职业性接触动物及其产品的患者中诊断Q热。由于气溶胶是动物和人类的主要感染途径，强烈建议这些工人佩戴呼吸面罩。此外，职业医生应考虑对职业暴露工人进行常规血清学评估和接种疫苗。
