Coxielose em ruminantes e a febre Q na saúde pública no Brasil

Abstract

Q fever is a zoonosis of worldwide distribution caused by Coxiella burnetii, a gram-negative obligate intracellular bacterium of the order Legionellales, which has been classified as a potential bioterrorism agent. Thus, the present study aims to perform a literature review on Q fever and coxiellosis, with emphasis on its close relationship to public health, due to its zoonotic nature, in addition to its economic importance for national livestock. Cattle and small ruminants represent the most frequent sources of infection in humans, with inhalation of contaminated aerosols from infected animal products being the main form of transmission. The high occupational risk is related mainly to cattle and small ruminant breeders and veterinarians, even people with sporadic contact with animals, such as employees in veterinary clinics. Infections in humans are usually asymptomatic, but can evolve into serious complications such as endocarditis, which can be fatal if not treated appropriately. In ruminants the most important clinical manifestations are reproductive disorders such as abortion, stillbirth fetus, endometritis, infertility and mastitis, but the agent has also been identified in cattle with endocarditis. The clinical diagnosis is difficult, due to the nonspecificity of the clinical signs. Specific indirect diagnostic tools such as the indirect microimmunofluorescence test is considered a reference technique for humans, however for ruminants the molecular method of polymerase chain reaction (PCR) is a reliable method to detect the elimination of the agent in body fluids (feces, milk and vaginal mucus) that may be intermittent. The prophylactic combination of doxycycline and hydroxychloroquine has been shown to be effective in preventing endocarditis and is indicated in the presence of risk factors in humans. In animals, the use of antimicrobials has not been effective. In recent years, several cases of C. burnetii infection in humans and animals have been reported in Brazil, with evidence of Q fever circulating in humans in the southeast and northeast regions, and in animals in the southeast, central-west and northeast regions. The Ministry of Agriculture, Livestock and Supply classifies the disease in category 3 (three) of the list of diseases of mandatory notification to the Veterinary Service, however, it is not recognized by the Brazilian Ministry of Health as of mandatory notification in humans. With all zoonotic diseases, the control of the disease in animals and the interdisciplinary following the principles of One Health, will directly influence the results observed in humans.