One health behind bars: Seroincidence of Coxiella burnetii in women inmates, correctional officers, and feral cats.

Although the Q fever causative agent Coxiella burnetii has presented a variety of infection sources, its epidemiology remains to be fully established in vulnerable populations. Accordingly, the aim of this study was to investigate the presence and dynamics of anti- C. burnetii antibodies and associated risk factors in incarcerated women, correctional officers and in-prison feral cats of a major Brazilian penitentiary complex in a one-year interval. Overall, 139/413 (33.7 %) inmates in 2020 and 68/166 (41.0 %) in 2021 were seropositive to C. burnetii by the indirect immunofluorescence assay (IFA). A statistical association was observed between seropositivity and inmate ethnicity (p = 0.0173), with Black individuals 2-fold more likely seropositive. No feral cat sample was seropositive. The one-year seroincidence was 14.5. The seroincidence and associated risk factors herein have been the first to C. burnetii during incarceration worldwide, serving as a One Health approach warning of Q Fever behind bars.