Three-Toed Sloth as Putative Reservoir of Coxiella burnetii, Cayenne, French Guiana

To the Editor: Q fever is an emerging zoonosis and a major public health concern in French Guiana, a French overseas region located on the northeastern coast of South America (1,2). Most cases occur in the city of Cayenne (3), specifically in the suburbs , where houses are near wooded hills (4). Genotyping performed by using multispacer sequence typing showed that MST17, a unique genotype of C. burnetii, circulates in Cay-enne and is responsible for epidemics of Q fever (5). C. burnetii transmission peaks during the rainy season, and the incidence of Q fever usually increases 1–3 months later (6). The animal reservoir of C. burnetii in French Guiana is unknown; previous studies have excluded domestic ruminants, which are known to be C. burnetii reservoirs elsewhere in the world (6). Four sero-logic surveys showed few C. burnetii– positive opossums, dogs, rodents (Proechimys spp.), bovines, or birds in French Guiana (7). In 2013, using real-time PCR (qPCR) analysis of vaginal swab samples, we showed that 6/158 (3.8%) dogs from Cayenne and 0/206 bats from the coastal area of French Guiana were positive for C. burnetii (Cycle threshhold [C t ]<35). One of the positive samples was identified as genotype MST17 (5). A case–control study among humans identified several risk factors for Q fever, including living near a forest and the presence of wild animals near the house (6). During January–April 2013, a Q fever outbreak occurred in Tiger Camp, a military residential area located at the top of a wooded hill in Cay-enne. Vaginal swab samples were collected from animals living in the area (13 goats, 8 sheep, 7 bats, 34 birds, 2 opossums, 4 iguanas, and 17 geckos); all samples were negative for C. bur-netii by qPCR. In addition, serologic tests for C. burnetii were negative for samples from all 37 small ruminants maintained near the outbreak area. In January 2014, a dead (accidental death) female 3-toed sloth (Brad-ypus tridactylus) (Figure, panel A) was found on the road near the residence of a Q fever patient. We retrieved the sloth and collected feces, spleen, liver, kidney, lung, and uterus samples and a vaginal swab sample. A total of 16 ticks were removed from the sloth and stored in 70% alcohol. DNA was extracted from the fe-ces, organs, and ticks by using the BioRobot EZ1 Workstation (QIA-GEN, Courtaboeuf, France). qPCR targeting the repeated insertion sequence IS1111 was performed by using a …