Is there a higher risk of exposure to Coxiella burnetii for pre-clinical veterinary students?
Authors: Conan Anne , Gallagher Christa , Erskine Nicole , Howland Michael , Smith-Anthony Marshalette , Marchi Silvia , Magouras Ioannis , Muller Ananda , Becker Anne AMJ 
Published: April 2022

Coxiella burnetii is globally distributed but evidence of zoonotic transmission in the Caribbean region is scarce. The presence of the bacterium is suspected on the Caribbean island of St. Kitts. The risk of exposure of veterinary students was reported in other regions of the world but is not documented in the Caribbean region. The present study aimed to evaluate the risk of exposure to C. burnetii for pre-clinical veterinary students attending an island-based veterinary school. A cross-sectional study was conducted to compare incoming and outgoing veterinary students’ seroprevalence. Serology was performed using indirect immunofluorescence assay to test Coxiella burnetii Phase I and Phase II immunoglobulins M and G. Background data were gathered using a standardized questionnaire.

Of the 98 participants (48 incomings and 50 outgoings), 41 (41.8 %, 95 %CI: 31.9-52.2) were seropositive to C. burnetii. There was no significant difference between the two groups (45.8% for incoming vs. 38.0% for outgoing) (p=0.4). No risk factors were significantly more reported in the seropositive group. U.S. state of origin of the students was not associated with seropositivity either.

Pre-clinical veterinary students do not have a higher risk of exposure to C. burnetii by attending the veterinary school in St. Kitts, but they are highly exposed before arrival on the island. Most of these participants had experience with animals either through farming or previous veterinary technician employment. This indicates a high exposure in the U.S. young population aiming to become veterinarians. There is an urgent need to increase C. burnetii surveillance in animals and humans to apply relevant prevention and control measures, including recommendations for vaccination of students and professionals at risk.

Author Summary

Q fever is a zoonosis present worldwide. Risk of exposure is higher in livestock farmers and other animal-related professions, including veterinary students. The presence of the bacterium is suspected on the Caribbean island of St. Kitts. We aimed to evaluate the risk of exposure to C. burnetii for students attending an American veterinary school based in St. Kitts. By comparing seroprevalence in incoming and outgoing students, we observed no risk of exposure by attending the school. These findings are different from studies in other veterinary schools. Future studies could explain these geographical differences and inform veterinary schools worldwide on appropriate measures to protect students from exposure to C. burnetii. Moreover, we detected a high seroprevalence in the incoming population, proving an anterior exposure. This indicates a high exposure in the U.S. young population aiming to become veterinarians. There is an urgent need to increase C. burnetii surveillance in animals and humans to apply relevant prevention and control measures, including recommendations of vaccination of students and professionals at risk.