Laboratory methods for case finding in human psittacosis outbreaks: a systematic review

Area of Science:

• Infectious Diseases
• Microbiology
• Public Health

Background:

• Psittacosis outbreak investigations are crucial for source tracing and risk assessment.
• Current laboratory testing methods for human Chlamydia psittaci infections lack specificity, hindering investigations.

Purpose of the Study:

• To identify best practices for laboratory testing methods in psittacosis outbreaks.
• To evaluate existing diagnostic strategies for human Chlamydia psittaci infections.

Main Methods:

• Systematic literature search of PubMed and Scopus (1986-2017).
• Hand-searching reference lists of identified articles.
• Analysis of laboratory tests used in 44 human psittacosis outbreaks across 12 countries.

Main Results:

• Thirty-seven articles described 44 psittacosis outbreaks.
• Various PCR and serologic tests were used, but no 'gold standard' was identified.
• Many cases could not be confirmed or excluded, and no strategy achieved full case finding.

Conclusions:

• PCR offers rapid identification and genotyping but has limited sensitivity outside the acute phase.
• There is a need for new, sensitive, and specific serologic tests for psittacosis diagnosis.
• Improved serologic tests could enhance case finding, source tracing, and disease burden assessment.