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- A Nationwide Seroepidemiologic Study on Q Fever Antibodies in Sheep of PortugalPublication . Cruz, Rita; Esteves, Fernando; Nóbrega, Carmen; Santos, Carla; Ferreira, Ana S.; Mega, Cristina; Coelho, Ana C.; Vala, Helena; Mesquita, JoãoIntroduction: Q fever is an almost global zoonotic disease caused by Coxiella burnetii. Human infections can produce acute and chronic disease that can lead to abortions and stillbirths in pregnant women, usually infected by the inhalation of C. burnetii-contaminated aerosols or through consumption of contaminated products. Sheep are one of the primary animal reservoirs with disease being associated with vast shedding of bacteria in placentas, feces, milk, and birth fluids. Although almost neglected in the past, recent outbreaks of sheep origin have alerted the public and the scientific community. Materials and Methods: An epidemiologic survey to estimate the seroprevalence of Q fever antibodies was performed in a representative number of sheep of all regions of continental Portugal (n = 1068), using a commercial ELISA (ID Screen Q Fever Indirect Multi-species Kit; IDvet, Montpellier, France). Results and Discussion: An anti-C. burnetii seroprevalence of 11.4% (95% confidence interval 9.6–13.5) was found, with a clear distinction between the Center region with highest seroprevalence, and the rest of the territory. Sheep traditional farming is widely present in Portugal and is part of the cultural and gastronomical background of the country. This close proximity to small ruminants may contribute to the zoonotic transfer to humans.
- Outbreaks of abortions byCoxiella burnetiiin small ruminant flocks and a longitudinal serological approach on archived bulk tank milk suggest Q fever emergence in Central PortugalPublication . Cruz, Rita; Esteves, Fernando; Vasconcelos-Nóbrega, Carmen; Santos, Carla; Ferreira, Ana S.; Mega, Cristina; Coelho, Ana C.; H, Vala; Mesquita, João R.Q fever is a worldwide zoonotic infectious disease caused by Coxiella burnetii and sheep and goats are known to be the main reservoir for human infection. This study describes the epidemiological and laboratory findings of C. burnetii outbreaks affecting sheep and goat flocks and also provides the results of a prospective serosurvey in bulk tank milk samples to assess C. burnetii circulation in a population of sheep living in close contact to the human population in Central Portugal. In the epizooties, C. burnetii was identified in tissues of the resulting abortions by qPCR. As for the serological survey, 10.2% (95%CI: 4.5‐19.2) of the 78 bulk tank milk samples collected in 2015 presented IgG antibodies against C. burnetii. The same farms were visited and sampled in 2016 and 25.6% (95%CI: 16.4‐36.8) were positive. This steep increase in the number of anti‐C. burnetii farms between the 2015 and 2016 collections showed to be statistically significant (p = 0.020) and is strongly suggestive of Q fever emergence in Central Portugal. Measures on animal health and on disease spread control to the human population should be considered.
- A 2-Year Longitudinal Seroepidemiological Evaluation of Toxoplasma gondii Antibodies in a Cohort of Autochthonous Sheep from Central PortugalPublication . Almeida, Daniela; Quirino, João; Barradas, Patrícia Ferreira; da Silva, Priscilla Gomes; Pereira, Maria; Cruz, Rita; Santos, Carla; Mega, Cristina; Esteves, Fernando; Nóbrega, Carmen; Vala, Helena; Gärtner, Fátima; Amorim, Irina; Mesquita, João R.Background: Toxoplasma gondii is an important zoonosis and one of the major causes of abortion in sheep worldwide. (2) Methods: We performed a 2-year longitudinal serological antiT. gondii IgG screening on a cohort of a spatially confined population of a Portuguese autochthonous sheep breed in central Portugal. (3) Results: From the screening of the 2015 and 2016 sera, an increase of seroprevalence was observed (57.7% (95% CI: 49.9–65.3%) versus 69.1% (95% CI: 61.5–75.9), from 2015 and 2016, respectively) (p = 0.031). (4) Conclusions The present study is the first to provide prospective data on the anti-T. gondii serological status of a sheep cohort in Portugal, showing an increase in the occurrence of T. gondii. There is a need to provide a clearer understanding of T. gondii epidemiology in Portugal, ideally by implementing monitoring programs on sentinel herds, not only due to the high impact of T. gondii on animal health but also for it being a zoonosis.
- A Questionnaire-Based Survey on the Long-Term Management of Canine Leishmaniosis by Veterinary PractitionersPublication . Pereira, Maria; Santos, Rute; Nóbrega, Carmen; Mega, Cristina; Cruz, Rita; Esteves, Fernando; Santos, Carla; Mesquita, João R.; Vala, Helena; Santos-Gomes, GabrielaCanine Leishmaniosis (CanL) is a chronic and potentially fatal disease. In economically disadvantaged regions, costs associated with long-term patient monitoring may determine that some owners decline veterinary follow-up of their dogs. This online, questionnaire-based survey aimed to assess how Portuguese veterinary practitioners perform long-term patient monitoring and recognize relapses. More than 50% of respondents reported that 50–100% of dog owners declared financial restraints. Hence, in these circumstances, most veterinary practitioners only performed clinical examination and serology. However, when owners did not declare financial restriction, other tests were additionally performed, such as renal and hepatic profiles, hemogram, serum protein electrophoresis and urine protein creatinine ratio. The mean number of exams performed when owners presented financial restraints was significantly lower than the number of exams performed without economic limitations. Most veterinary practitioners prescribed allopurinol ad aeternum oruntil disease remission and domperidone. CanL relapses were recognized by more than half of respondents “Always”, through the reappearance or worsening of clinical signs, whereas about a quarter detected an increase in anti-Leishmania antibody levels and identified abnormalities in the serum protein electrophoresis profile. The relapse rate was higher in the Lisbon Metropolitan Area and north, the most economically favored regions of Portugal. This study confirms that owner financial restraints negatively influence veterinary follow-up and relapse recognition, ultimately compromising clinical decision making and favoring the maintenance of Leishmania infantum infection endemicity.
- Crimean-Congo hemorrhagic fever virus circulating among sheep of Portugal: a nationwide serosurvey assessmentPublication . Mesquita, João; Cruz, Rita; Esteves, Fernando; Santos, Carla; Pousa, Humberto; Coelho, Catarina; Mega, Cristina; Nóbrega, Carmen; Vala, Helena; Peyrefitte, Christophe Nicolas; Nascimento, Maria São José; Barradas, Patrícia FerreiraCrimean-Congo hemorrhagic fever virus (CCHFV) is a widespread zoonotic pathogen that can cause mild to severe hemorrhagic disease in humans. CCHFV may be transmitted through direct contact with tissue or blood of viremic animals; however, the primary transmission route is through infected tick bites. CCHFV RNA has been detected in ticks feeding on domestic and wild animals in western Spain, suggesting an established circulation of CCHFV in Western Europe. Ruminants have been recognized as important CCHFV reservoirs and have been linked to human cases in endemic regions. Given the emergence of CCHF in neighboring Spain, and a report of two CCHFV seropositive humans in southern Portugal in 1985, we investigated the potential circulation of this virus in the country by performing a nationwide anti-CCHFV IgG serosurvey in sentinel sheep of Portugal. Sera (n = 459) randomly selected from widely distributed farms (n = 20) of Portugal were tested using a commercial double-antigen enzyme-linked immunosorbent assay, yielding an overall seroprevalence of 0.4% (95% confidence interval [CI] 0.04-1.56%). Positive sheep were from the southern region of Portugal (Alentejo region), which raise the seroprevalence of this region to 0.74% (95% CI 0.09-2.66%). This is the first study reporting the presence of CCHFV antibodies in sheep of Portugal, thus suggesting a geographical expansion of CCHFV to this country. It seems likely that CCHFV may exist focally in southern Portugal.
- Pulmonary and Gastrointestinal Parasitic Infections in Small Ruminant Autochthonous Breeds from Centre Region of Portugal—A Cross Sectional StudyPublication . Pereira, Maria; Vila-Viçosa, Maria; Coelho, Catarina; Santos, Carla; Esteves, Fernando; Cruz, Rita; Gomes, Liliana; Henriques, Diogo; Vala, Helena; Nóbrega, Carmen; Mega, Cristina; Melo, Carolina de; Malva, Madalena; Braguez, Joana; Mateus, Teresa LetraThe production of small ruminant autochthonous breeds in the Centre region of Portugal is practiced in a semi-extensive husbandry system, exposing animals to parasitic infections. The main objective of this study was to estimate the prevalence of lungworm infection and identify risk factors. Fecal samples of 203 goats and 208 sheep from 30 herds were collected per rectum and subjected to the modified Baermann test. The overall prevalence of infection was 57.7%, significantly higher in goats (95.6%) than in sheep (20.7%) (p < 0.001). According to the binary logistic regression model, sheep dewormed with albendazole, mebendazole plus closantel, or ivermectin plus clorsulon presented a risk of Protostrongylidae infection 29.702, 7.426, or 8.720 times higher, respectively, than those dewormed with eprinomectin. Additionally, the presence of gastrointestinal parasites was investigated in 307 fecal samples using Mini-FLOTAC®. The overall prevalence of infection was 86.3%, also significantly higher in goats (93.2%) than in sheep (79.9%) (p < 0.001). Strongyle-type eggs were the most frequently identified, both in sheep (69.8%) and goats (87.8%), followed by Eimeria oocysts (40.3% in sheep and 68.9% in goats). Considering the high prevalence and the burden of lungworm parasitic infection, it is urgent to determine its economic impact and the repercussions in animal health in the Centre region of Portugal to establish appropriate therapeutic guidelines.
- Occupationally Acquired Q Fever in Shepherds and Sheep Milk CheesemakersPublication . Cruz, Rita; Santos, Carla; Esteves, Fernando; Ferreira, Ana Sofia; Nóbrega, Carmen; Mega, Cristina; Albuquerque, Carlos; Teixeira-de-Lemos, Edite; Coelho, Ana Cláudia; Vala, Helena; Mesquita, JoãoQ fever is a zoonosis caused byCoxiella burnetii, and transmission to humans is often associatedwith contact with ovine and caprine livestock. Those exposed to sheep are particularly at high risk of infection.Recent studies show that Q fever is increasing in sheep farms in Portugal raising alerts on spillover to humans.We detected anti-C. burnetiiIgG in shepherds and sheep milk cheesemakers (27 [28.1%] in a total of 96; 95%confidence interval [CI] 19.4–38.2%) and in controls (21 [8.1%] in a total of 260; 95% CI 5.1–12.1%), pointingto an increased risk ofC. burnetiiinfection (P= 0.0001), with an odds ratio foranti-C. burnetiiof 4.45 (95% CI2.4–8.4%;P= 0.0001), in individuals with occupational contact with sheep in Portugal.
- Mammary neoplasms in dogs and cats. Contribution for promotion of well-beingPublication . Soares, Marta; Almeida, Rui Gomes; Esteves, Fernando; Cruz, Rita; Santos, Carla; Mega, Cristina; Nóbrega, Carmen; Mesquita, João; Vala, HelenaIntrodução: Nos últimos anos tem-se verificado um crescimento significativo da incidência de neoplasias humanas a nível mundial, sendo esta também uma das principais causas de morbilidade e mortalidade nos animais de companhia, destacando-se as neoplasias mamárias como processo neoplásico que mais acomete os nossos animais. Objetivos: Analisar o paradigma atual das neoplasias em animais de companhia; Intervir na sensibilização de tutores e profissionais da equipa de saúde animal para uma gestão mais assertiva, nomeadamente no que respeita à sua deteção e exérese precoce. Métodos: estudo retrospetivo contemplando uma amostragem de canídeos (n=20) e felídeos (n=12) com massas mamárias submetidas a excisão cirúrgica e diagnóstico histopatológico. Resultados: Na amostra analisada foi observada uma maior frequência de neoplasias mamárias em cadelas de raça Indeterminada e em gatas de raça Europeu Comum, sendo a idade média, para ambas as espécies, próxima dos 10 anos de idade. Foi ainda registada uma maior frequência de neoplasias mamárias malignas, 75% em cadelas e 66,7% nas gatas, em relação às benignas. Conclusões: Foi possível verificar que na região do país contemplada neste estudo foram diagnosticadas mais neoplasias mamárias malignas do que benignas, provavelmente motivado pela excisão cirúrgica tardia de massas mamárias grandes, por vezes ulceradas.
- A One Health Perspective on Q Fever: Part 2Publication . Cruz, Rita; C, Vasconcelos-Nóbrega; Esteves, Fernando; Coelho, Catarina; Ferreira, Ana Sofia; Santos, Carla; Mega, Cristina; Coelho, Ana C.; Vala, Helena; Mesquita, JoãoQ fever, a widespread zoonotic disease caused by Coxiella burnetiid, produces a complex and polymorphic disease in humans. As a zoonotic disease, control in animals will influence the level of disease seen in humans, thus resulting in interesting one health perspectives for disease control. Here the authors describe the clinical manifestations in animals and humans, as well as the current diagnostic methods available and the strategies for disease control. A review on the published information regarding Q fever as a disease with impact for veterinary public health and public health is presented.
- Prevalence of Toxoplasma gondii Antibodies and Risk Factor Investigation in Portuguese Veterinarians: A Matched Case Control StudyPublication . Almeida, Daniela; Santos-Silva, Sérgio; Pereira, Maria; Santos, Carla; Mega, Cristina; Coelho, Catarina; Nóbrega, Carmen; Esteves, Fernando; Cruz, Rita; Vala, Helena; Mesquita, João R.Background: Toxoplasma gondii is a widespread zoonotic agent that greatly impacts Public Health, being responsible for one of the most important parasitic zoonosis worldwide. T. gondii has a heteroxenous life cycle, with cats being the definitive hosts and all warm-blooded animals, including humans, being intermediate hosts. Veterinary practitioners (VP) may be at a higher risk than the general population for T. gondii infection, as they have direct and daily contact with many animal species. The aim of the present study was to ascertain if VP were more likely to be anti-T. gondii IgG seropositive than the general population, as well as to understand if age, accidents with blood-contaminated sharps (cross-blood contamination), gender, working years, and geographic regions play a role as risk factors for T. gondii infection. For this purpose, a case–control study using archived samples was performed. (2) Methods: A total of 350 veterinary practitioners were tested using a commercial semiquantitative enzyme immunoassay for anti-T. gondii IgG. From the general population, 175 anonymous volunteers (matched with cases by region, age, and gender) were studied for anti-T. gondii IgG. (3) Results: There was no statistical difference found between the presence of anti-T. gondii IgG in practitioners (26%; CI = 21.40–30.60%) and the general population (33.14%; CI = 26.17–40.12%) (p = 0.108). Univariate and multivariate analysis showed that only age (older groups) was found to be associated with a higher prevalence of anti-T. gondii IgG, with significant p values (p < 0.05) for both univariate and multivariate analysis. (4) Conclusions: To the best of our knowledge, this is the first case–control study fully focused on the prevalence of anti-T. gondii IgG in VP in Portugal, showing that there was no significant risk for T. gondii infection in veterinarians exposed daily and repeatedly to different species of animals.