{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T20:31:40Z","timestamp":1785529900613,"version":"3.56.0"},"reference-count":46,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2022,2,16]],"date-time":"2022-02-16T00:00:00Z","timestamp":1644969600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>Abattoir workers may contract Q fever by inhalation of Coxiella burnetii bacteria in aerosols generated by slaughtering livestock, or in contaminated dust. We estimated the seroprevalence of C. burnetii and examined the associated factors in a survey of South African abattoir workers. Coxiella burnetii seropositivity was determined by detection of IgG antibodies against C. burnetii phase II antigen. Logistic regression, adjusted for clustering and sampling fraction, was employed to analyze risk factors associated with C. burnetii seropositivity. Among 382 workers from 16 facilities, the overall seroprevalence was 33% (95% confidence interval (CI): 28\u201338%) and ranged from 8% to 62% at the facility level. Prolonged contact with carcasses or meat products (odds ratio (OR): 4.6, 95% CI: 1.51\u201314.41) and prior abattoir or butchery work experience (OR: 1.9, 95% CI: 1.13\u20133.17) were associated with C. burnetii seropositivity. In contrast, increasing age and livestock ownership were inversely associated. Precautions to protect abattoir personnel from Q fever are discussed.<\/jats:p>","DOI":"10.3390\/tropicalmed7020028","type":"journal-article","created":{"date-parts":[[2022,2,16]],"date-time":"2022-02-16T20:28:59Z","timestamp":1645043339000},"page":"28","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Exposure of South African Abattoir Workers to Coxiella burnetii"],"prefix":"10.3390","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7176-8699","authenticated-orcid":false,"given":"Liesl","family":"De Boni","sequence":"first","affiliation":[{"name":"South African Field Epidemiology Training Programme, Johannesburg 2192, South Africa"},{"name":"Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg 2193, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumaya","family":"Mall","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg 2193, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9929-4015","authenticated-orcid":false,"given":"Veerle","family":"Msimang","sequence":"additional","affiliation":[{"name":"National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg 2192, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9182-5598","authenticated-orcid":false,"given":"Alex","family":"de Voux","sequence":"additional","affiliation":[{"name":"South African Field Epidemiology Training Programme, Johannesburg 2192, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Rossouw","sequence":"additional","affiliation":[{"name":"National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg 2192, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3375-5760","authenticated-orcid":false,"given":"John","family":"Frean","sequence":"additional","affiliation":[{"name":"National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg 2192, South Africa"},{"name":"Wits Research Institute for Malaria, University of the Witwatersrand, Johannesburg 2193, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,2,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/S1473-3099(05)70052-9","article-title":"Natural History and Pathophysiology of Q Fever","volume":"5","author":"Raoult","year":"2005","journal-title":"Lancet Infect. Dis."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1128\/CMR.00045-16","article-title":"From Q Fever to Coxiella burnetii Infection: A Paradigm Change","volume":"30","author":"Eldin","year":"2017","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1016\/j.medmal.2014.02.006","article-title":"Q Fever in the Netherlands 2007\u20132010: What We Learned from the Largest Outbreak Ever","volume":"44","author":"Schneeberger","year":"2014","journal-title":"M\u00e9d. Mal. Infect."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/j.jinf.2006.10.048","article-title":"Q Fever","volume":"54","author":"Cutler","year":"2007","journal-title":"J. Infect."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2011\/248418","article-title":"Q Fever: Current State of Knowledge and Perspectives of Research of a Neglected Zoonosis","volume":"2011","author":"Porter","year":"2011","journal-title":"Int. J. Microbiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1128\/CMR.12.4.518","article-title":"Q Fever","volume":"12","author":"Maurin","year":"1999","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.epidem.2015.07.001","article-title":"Kinetics of Antibody Response to Coxiella burnetii Infection (Q Fever): Estimation of the Seroresponse Onset from Antibody Levels","volume":"13","author":"Wielders","year":"2015","journal-title":"Epidemics"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Wielders, C.C.H., Boerman, A.W., Schimmer, B., van den Brom, R., Notermans, D.W., van der Hoek, W., and Schneeberger, P.M. (2015). Persistent High IgG Phase I Antibody Levels against Coxiella burnetii among Veterinarians Compared to Patients Previously Diagnosed with Acute Q Fever after Three Years of Follow-Up. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0116937"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Vanderburg, S., Rubach, M.P., Halliday, J.E.B., Cleaveland, S., Reddy, E.A., and Crump, J.A. (2014). Epidemiology of Coxiella burnetii Infection in Africa: A One Health Systematic Review. PLoS Negl. Trop. Dis., 8.","DOI":"10.1371\/journal.pntd.0002787"},{"key":"ref_10","first-page":"1198","article-title":"Tick Bite Fever and Q Fever: A South African Perspective","volume":"97","author":"Frean","year":"2007","journal-title":"S. Afr. Med. J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.actatropica.2019.02.032","article-title":"Current Perspectives on the Transmission of Q Fever: Highlighting the Need for a Systematic Molecular Approach for a Neglected Disease in Africa","volume":"193","author":"Salifu","year":"2019","journal-title":"Acta Trop."},{"key":"ref_12","first-page":"21","article-title":"Q Fever in Zimbabwe: A Review of the Disease and the Results of a Serosurvey of Humans, Cattle, Goats and Dogs","volume":"83","author":"Kelly","year":"1993","journal-title":"SA Med. J."},{"key":"ref_13","first-page":"409","article-title":"Q Fever: Serological Evidence of the Occurrence of a Case in South Africa","volume":"24","author":"Gear","year":"1950","journal-title":"SA Med. J."},{"key":"ref_14","first-page":"1006","article-title":"Q Fever: Serological Evidence of the Occurrence of Another Case in South Africa","volume":"24","author":"Ranking","year":"1950","journal-title":"SA Med. J."},{"key":"ref_15","unstructured":"Gear, J.H.S., Wolstenholme, B., Miller, B., Sher, B., and Schneider, J. (1977). Q Fever in South Africa. Medicine in a Tropical Environment, A.A. Balkema."},{"key":"ref_16","first-page":"129","article-title":"Q Fever in Cattle and Sheep in Southern Africa: A Preliminary Report","volume":"43","author":"Schutte","year":"1976","journal-title":"Onderstepoort J. Vet. Res."},{"key":"ref_17","first-page":"569","article-title":"The Incidence of Coxiella burnetii Antibodies in Cattle in the Transvaal","volume":"54","author":"Gummow","year":"1987","journal-title":"Onderstepoort J. Vet. Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1089\/vbz.2017.2158","article-title":"Prevalence of Selected Zoonotic Diseases and Risk Factors at a Human-Wildlife-Livestock Interface in Mpumalanga Province, South Africa","volume":"18","author":"Simpson","year":"2018","journal-title":"Vector Borne Zoonotic Dis."},{"key":"ref_19","first-page":"357","article-title":"The Epidemiology of Q Fever","volume":"43","author":"Derrick","year":"1944","journal-title":"J. Hyg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2037","DOI":"10.1016\/j.vaccine.2009.02.007","article-title":"Australia\u2019s National Q Fever Vaccination Program","volume":"27","author":"Gidding","year":"2009","journal-title":"Vaccine"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1111\/zph.12054","article-title":"The Effectiveness of Coxiella burnetii Vaccines in Occupationally Exposed Populations: A Systematic Review and Meta-Analysis","volume":"61","author":"Sargeant","year":"2014","journal-title":"Zoonoses Public Health"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Van den Brom, R., Schimmer, B., Schneeberger, P.M., Swart, W.A., van der Hoek, W., and Vellema, P. (2013). Seroepidemiological Survey for Coxiella burnetii Antibodies and Associated Risk Factors in Dutch Livestock Veterinarians. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0054021"},{"key":"ref_23","first-page":"41","article-title":"Enhanced Q Fever Risk Exposure Surveillance May Permit Better Informed Vaccination Policy","volume":"33","author":"Massey","year":"2009","journal-title":"CDI"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1136\/bmj.2.5506.148","article-title":"Occupational Infections in the Edinburgh Abattoir","volume":"2","author":"Schonell","year":"1966","journal-title":"Br. Med. J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1093\/oxfordjournals.aje.a112177","article-title":"Toxoplasma Gondii and Coxiella Burnetii Antibodies among Brazilian Slaughterhouse Employees","volume":"102","author":"Riemann","year":"1975","journal-title":"Am. J. Epidemiol."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Esmaeili, S., Naddaf, S.R., Pourhossein, B., Hashemi Shahraki, A., Bagheri Amiri, F., Gouya, M.M., and Mostafavi, E. (2016). Seroprevalence of Brucellosis, Leptospirosis, and Q Fever among Butchers and Slaughterhouse Workers in South-Eastern Iran. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0144953"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"195","DOI":"10.3961\/jpmph.17.017","article-title":"Seroreactivity to Q Fever among Slaughterhouse Workers in South Korea","volume":"50","author":"Chu","year":"2017","journal-title":"J. Prev. Med. Public Health"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Park, J.H., Hwang, S., Acharya, D., Lee, S., Hwang, K., Yoo, S.J., and Lee, K. (2018). Seroreactivity and Risk Factors Associated with Coxiella burnetii Infection among Cattle Slaughterhouse Workers in South Korea. Int. J. Environ. Res. Public Health, 15.","DOI":"10.3390\/ijerph15102264"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1128\/jcm.31.3.722-723.1993","article-title":"Prevalence of Antibodies to Coxiella burnetii in Japan","volume":"31","author":"Htwe","year":"1993","journal-title":"J. Clin. Microbiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"101322","DOI":"10.1016\/j.cimid.2019.06.003","article-title":"Seroepidemiological Study of Q Fever, Brucellosis and Tularemia in Butchers and Slaughterhouses Workers in Lorestan, Western of Iran","volume":"66","author":"Esmaeili","year":"2019","journal-title":"Comp. Immunol. Microbiol. Infect. Dis."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.onehlt.2018.09.002","article-title":"Seroprevalance of Coxiella burnetii among Abattoir and Slaughterhouse Workers: A Meta-Analysis","volume":"6","author":"Woldeyohannes","year":"2018","journal-title":"One Health"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Wolter, K. (2007). Introduction to Variance Estimation. Statistics for Social and Behavioral Sciences, Springer.","DOI":"10.1007\/978-0-387-35099-8_15"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1093\/oxfordjournals.aje.a112510","article-title":"Estimating prevalence from the results of a screening test","volume":"107","author":"Rogan","year":"1978","journal-title":"Am. J. Epidemiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1177\/1536867X0600600106","article-title":"Goodness-of-Fit Test for a Logistic Regression Model Fitted Using Survey Sample Data","volume":"6","author":"Archer","year":"2006","journal-title":"Stata J."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1111\/j.1863-2378.2009.01251.x","article-title":"Investigation of a Q Fever Outbreak in a Scottish Co-Located Slaughterhouse and Cutting Plant: Scottish Outbreak of Q Fever","volume":"57","author":"Wilson","year":"2010","journal-title":"Zoonoses Public Health"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1007\/s10096-001-0645-5","article-title":"Investigation of a Slaughterhouse-Related Outbreak of Q Fever in the French Alps","volume":"21","author":"Carrieri","year":"2002","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"21","DOI":"10.5365\/wpsar.2016.7.2.012","article-title":"A Q Fever Cluster among Workers at an Abattoir in South-Western Sydney, Australia, 2015","volume":"7","author":"Lord","year":"2016","journal-title":"WPSAR"},{"key":"ref_38","first-page":"181","article-title":"Prevalence of Antibodies to Coxiella burnetii among Veterinarians and Slaughterhouse Workers in Nova Scotia","volume":"26","author":"Marrie","year":"1985","journal-title":"Can. Vet. J."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1089\/vbz.2013.1379","article-title":"Seroepidemiological Survey of Q Fever and Brucellosis in Kurdistan Province, Western Iran","volume":"14","author":"Esmaeili","year":"2014","journal-title":"Vector Borne Zoonotic Dis."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Mostafavi, E., Molaeipoor, L., Esmaeili, S., Ghasemi, A., Kamalizad, M., Yousefi Behzadi, M., Naserifar, R., Rohani, M., and Hashemi Shahraki, A. (2019). Seroprevalence of Q Fever among High-Risk Occupations in the Ilam Province, the West of Iran. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0211781"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"De Rooij, M.M.T., Borl\u00e9e, F., Smit, L.A.M., de Bruin, A., Janse, I., Heederik, D.J.J., and Wouters, I.M. (2016). Detection of Coxiella burnetii in Ambient Air after a Large Q Fever Outbreak. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0151281"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1017\/S0950268816002843","article-title":"Trends and Risk Factors for Human Q Fever in Australia, 1991\u20132014","volume":"145","author":"Massey","year":"2017","journal-title":"Epidemiol. Infect."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e181580","DOI":"10.1001\/jamanetworkopen.2018.1580","article-title":"Clinical Features and Complications of Coxiella burnetii Infections from the French National Reference Center for Q Fever","volume":"1","author":"Melenotte","year":"2018","journal-title":"JAMA Netw. Open"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"e245","DOI":"10.3346\/jkms.2018.33.e245","article-title":"Serologic Survey and Risk Factors for Coxiella burnetii Infection among Dairy Cattle Farmers in Korea","volume":"33","author":"Park","year":"2018","journal-title":"J. Korean Med. Sci."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"417","DOI":"10.3201\/eid2003.131111","article-title":"Coxiella burnetii Seroprevalence and Risk for Humans on Dairy Cattle Farms, the Netherlands, 2010\u20132011","volume":"20","author":"Schimmer","year":"2014","journal-title":"Emerg. Infect. Dis."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Alonso, E., Lopez-Etxaniz, I., Hurtado, A., Liendo, P., Urbaneja, F., Aspiritxaga, I., Olaizola, J.I., Pi\u00f1ero, A., Arrazola, I., and Barandika, J.F. (2015). Q Fever Outbreak among Workers at a Waste-Sorting Plant. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0138817"}],"container-title":["Tropical Medicine and Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2414-6366\/7\/2\/28\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:20:43Z","timestamp":1760134843000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2414-6366\/7\/2\/28"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,16]]},"references-count":46,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,2]]}},"alternative-id":["tropicalmed7020028"],"URL":"https:\/\/doi.org\/10.3390\/tropicalmed7020028","relation":{},"ISSN":["2414-6366"],"issn-type":[{"value":"2414-6366","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,16]]}}}