Abstract:
Zoonotic diseases, such as brucellosis, Q fever and Rift Valley fever (RVF) caused by
Brucella spp., Coxiella burnetii and RVF virus, respectively, can have devastating effects
on human, livestock, and wildlife health and cause economic hardship due to morbidity
and
mortality
in
livestock.
Coinfection
with
multiple
pathogens
can
lead
to
more
severe
disease
outcomes
and
altered
transmission
dynamics.
These
three
pathogens
can
alter
host
immune
responses
likely
leading
to
increased
morbidity,
mortality
and
pathogen
transmission
during
coinfection.
Developing
countries,
such
as
those
commonly
afflicted
by
outbreaks
of
brucellosis,
Q fever
and
RVF,
have
high
disease
burden
and
thus
common
coinfections.
A literature
survey
provided
information
on
case
reports
and
studies
investigating
coinfections
involving
the
three
focal
diseases.
Fifty
five
studies
were
collected
demonstrating
coinfections
of
Brucella
spp.,
C.
burnetii
or
RVFV
with
50
different
pathogens,
of
which
64%
were
zoonotic.
While
the
literature
search
criteria
involved
‘coinfection’,
only
24/55
studies
showed
coinfections
with
direct
pathogen
detection
methods
(microbiology,
PCR
and
antigen
test),
while
the
rest
only
reported
detection
of
antibodies
against
multiple
pathogens,
which
only
indicate
a
history
of
co-
exposure,
not
concurrent
infection.
These
studies
lack
the
ability
to
test
whether
coinfection
leads
to
changes
in
morbidity,
mortality
or
transmission
dynamics.
We
describe
considerations
and
methods
for
identifying
ongoing
coinfections
to
address
this
critical
blind
spot
in
disease
risk
management.
