THE INFECTION RATE OF COXIELLA BURNETII IN HUMANS IN THE AGE GROUP OVER 40 YEARS IN THE WESTERN PART OF NORTH MCEDONIA
THE INFECTION RATE OF COXIELLA BURNETII IN HUMANS IN THE AGE GROUP OVER 40 YEARS IN THE WESTERN PART OF NORTH MCEDONIA

Summary/Abstract: Coxiella burnetii is the causative agent of Q fever, a worldwide zoonosis, and can be misused as a biological warfare agent. C. burnetii is classically a strict intracellular, Gram-negative bacterium, that infects a wide range of animals, from arthropods to humans. Cattle, sheep, and goats are the most important source of human infections. Infection in nature is maintained and transmitted by ticks as the principal vector and reservoir. Humans contract C. burnetii infection mostly by aerosol in contact with contaminated environs, wind playing an important factor in spreading the infection. The wide distribution of C. burnetii contributes to a high resistance of its extracellular small cell variant to environmental conditions. Its intracellular large cell variant, adapted to survive under harsh conditions of phagolysosomes, enables long‐term survival and persistence of C. burnetii, namely in monocytes/macrophages. Host factors such as underlying disease and cell‐mediated immunity play a decisive role in the clinical expression of C. burnetii infection. Complete genome analysis of C. burnetii will certainly contribute to better understanding of the pathogenesis of C. burnetii infection and will improve Q fever diagnosis and immunoprophylaxis. Infection in animals (coxiellosis) is mostly persistent. Infection in humans is often asymptomatic, but it can manifest as an acute disease (usually a self‐limited flu‐like illness, pneumonia, or hepatitis) or as a chronic form (mainly endocarditis, but also hepatitis and chronic fatigue syndrome). C. burnetii infection in pregnant women may result in abortions, premature deliveries, and stillbirths. The objective of this seroepidemiological study was to estimate the prevalence of antibodies to C. burnetii and to examine the variation of infection in females and males aged over 40 years, in the western part of North Macedonia. The study was conducted in 274 random people with different symptoms from rural and urban regions of five areas. IgG antibodies against C. burnetii were assayed using the ELISA Test. Positive test was based on the Cut-off value, which in this case is over 0.5 optical density (OD). Of 142 female serums which were examined, 38 samples resulted positive (26.76%), and of 132 male serums which were examined, 39 resulted positive (29.54%). As to the percentage of infection in both sexes, there are variations in different regions. The lowest percentage is recorded in Gostivar with 7.5% for males and 13.3% for females, while the highest in Dibra which is 45.4% for males and 42.8% for females in Kercova. The infection percentage in total was high in both sexes and was different against the respective gender based on regions, as well and there is also a connection between the five regions when it comes to the distribution of the infection. The living conditions in the zones covered with the study are poor which represents a predisposing factor in the spread of the infection

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