Expanding the diagnostic scope of paleopathology: Identification of Q fever (Coxiella burnetii) using a One Paleopathology approach.

Objectives: This project is an application of the One Paleopathology approach to the study of Q fever (C. burnetii infection), a disease which is underdiagnosed and largely unknown in paleopathology.

Materials: Clinical and veterinary pathological case reports and reviews, bioarcheological and zooarchaeological data, veterinary and environmental studies of wild and domestic animal pathology, clinical molecular pathogen data METHODS: One Paleopathology approach which combines data from people, animals, and their environment to understand disease in the past.

Results: Q fever in animals presents as reproductive failure, with no typical skeletal manifestations seen in animals. Persistent Q fever (C. burnetii) focalized infection affects the human skeleton in predictable ways, including spondylodiscitis and extravertebral osteomyelitis or osteitis which can occur more commonly in children. Evidence of skeletal involvement suggests C. burnetii infection in the past is underestimated and underdiagnosed in humans.

Conclusion: Using the One Paleopathology approach can improve the study of C. burnetii infection in the past, where both animal and human paleopathology and environmental factors are assessed in developing potential diagnoses.

Significance: This project is the first paleopathological study to specifically focus awareness on identification of C. burnetii in past skeletal samples, both animal and human.

Limitations: Lack of paleopathological studies and existing reference literature identifying skeletal involvement associated with C. burnetii infection.

Suggestions For Future Research: Future paleopathological genomic studies should focus on identification of C. burnetii genotypes.