Human Q fever in Spain (2016-2020)

Abstract

Introduction: Q fever is an anthropozoonosis caused by Coxiella burnetii. It is transmitted airborne from animals to humans and the agent can survive in the environment for long periods. The main reservoirs are domestic rumiants. Spain reports the highest number of cases in Europe.

Method: We conducted a descriptive study of Q fever cases notified to the Spanish National Network of Epidemiological Surveillance (RENAVE) between 2016 and 2020. We analyzed temporal and spatial variables. We performed a spatial analysis restricted to the areas with the highest incidence, estimating the smoothed relative risk (sRR per municipality.

Results: 1249 (71.2%) of the 1749 cases were men. Most cases happened between 35 and 55 years of age. The incidence rate is higher between March and June. Incidence is higher in the Canary Islands, Basque Country, La Rioja, Navarra, and Western Andalusia. In the most affected areas, the sRR seem to follow spatial patterns. In the Canary Islands, the sRR seem superior in the eastern islands. In the northern provinces, the sRR are higher in Vizcaya, Álava, and La Rioja. In Andalusia and Badajoz, the sRR are higher in the Southeast of Badajoz Province and the North of Sevilla Province.

Conclusions: The epidemiological situation of Q fever remains stable. The infection is more frequent in men between 35 and 55 years old. The rising of cases in spring may relate to the reproductive cycle of livestock. Spatial distribution is conditioned by environmental factors. Considering its zoonotic and geographical-seasonal character further One Health-multidisciplinary approach studies will be needed.