The Q fever epidemic in The Netherlands: history, onset, response and reflection. Epidemiol Infect

Department of Bacteriology and TSEs, Central Veterinary Institute of Wageningen UR, Lelystad, The Netherlands.
Epidemiology and Infection (Impact Factor: 2.49). 10/2010; 139(1):1-12. DOI: 10.1017/S0950268810002268
Source: PubMed

ABSTRACT The 2007-2009 human Q fever epidemic in The Netherlands attracted attention due to its magnitude and duration. The current epidemic and the historical background of Q fever in The Netherlands are reviewed according to national and international publications. Seroprevalence studies suggest that Q fever was endemic in The Netherlands several decades before the disease was diagnosed in dairy goats and dairy sheep. This was in 2005 and the increase in humans started in 2007. Q fever abortions were registered on 30 dairy goat and dairy sheep farms between 2005 and 2009. A total of 3523 human cases were notified between 2007 and 2009. Proximity to aborting small ruminants and high numbers of susceptible humans are probably the main causes of the human Q fever outbreak in The Netherlands. In general good monitoring and surveillance systems are necessary to assess the real magnitude of Q fever.

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Available from: Hendrik-Jan Roest, Aug 08, 2014
    • "The partly closed status of some herds to prevent infectious diseases like paratuberculosis and caseous lymphadenitis could have made a herd more susceptible for C. burnetii or new strains of this bacterium. Secondly the new introduction of a more virulent strain or a genetic shift to a more virulent strain could have contributed to the cause of the outbreak (Roest et al. 2011b). "
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    ABSTRACT: About 80 years ago, Q fever research began due to human outbreaks of unknown origin, associated with domestic animals. Since then, some but not all characteristics of this “query” disease, caused by the intracellular bacterium Coxiella burnetii were revealed. In this chapter the bacteriology of the bacterium, clinical presentation, epidemiology and transmission of the disease in humans and animals are presented. Domestic small ruminants are the main source of human Q fever. Although Q fever is considered to be an occupational disease, outbreaks have a major public health impact and attract most attention. The Dutch Q fever outbreak, involving 4000 human cases over the years 2007–2010, is an example of how Q fever can re-emerge from an endemic state into an outbreak of unforeseen dimension. In this outbreak the epidemiological link between dairy goats and human cases was confirmed by genotyping for the first time. This was possible due to the previous development of genotyping assays that are applicable on clinical material. Although Q fever seems to be a blue print for outbreaks it is not known yet what factors are essential to cause outbreaks and how they interact. To prevent outbreaks, a better understanding of these factors and their interaction is necessary and research should therefore focus on this.
    Zoonoses - Infections Affecting Humans and Animals, 01/2015: pages 317-334; , ISBN: 978-94-017-9456-5
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    • "Numbers of chronic Q fever increased thereafter, amounting to over 200 cases identified until 2011 with a 13% lethality [10] [11]. From 2009 onwards, consecutive measures to curtail the livestock epidemic included mandatory vaccination and culling of carrying animals on infected farms [8]. Some preventive measures, like avoiding human proximity to infected farms, were not feasible due to the dense population. "
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    ABSTRACT: Following a large Q fever outbreak in the Netherlands, patients at risk for chronic Q fever received a whole-cell Q fever vaccine. Sensitized people were excluded based on pre-vaccination screening with skin test (ST) and serology. An investigational IFN-γ-production assay was added. No previous experience existed for Q fever vaccination in this patient risk-group with predefined cardiac valvular anomalies or aortic aneurysm/prosthesis and many co-morbidities. We studied the adverse events (AE) and their association with patient characteristics and immunological parameters.
    Vaccine 10/2014; 32(49). DOI:10.1016/j.vaccine.2014.09.061 · 3.49 Impact Factor
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    • "After shedding, C. burnetii can be transmitted to humans or to animals on the same farm or on other farms. For humans, the main infection route is by inhalation of infected aerosols (Cutler et al., 2007; Roest et al., 2011a). It has been described previously that in 2007 the seroprevalence and DNA prevalence of C. burnetii in bovine herds in the Netherlands were 79% and 28%, respectively (Muskens et al., 2011) which was comparable to that in other western European countries (Agger et al., 2010; Ryan et al., 2011). "
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    ABSTRACT: Despite cattle herds can harbor Coxiella burnetii, risk factors for C. burnetii presence in dairy cattle herds are largely unknown. Therefore, C. burnetii herd prevalence and risk factors for bulk tank milk (BTM) positivity were investigated. In this cross-sectional study, a questionnaire was filled out by the farmer and BTM from 301 farms was tested by ELISA for presence of C. burnetii antibodies and PCR for presence of C. burnetii DNA. Risk factors were identified by univariable and multivariable logistic regression analyses. Antibodies to C. burnetii were detected in 81.6% (CI: 77.2-85.9) and C. burnetii DNA in 18.8% (CI: 14.4-23.1) of the BTM samples. Herd size (OR = 1.1 per 10 cows), cleaning the bedding of the cubicles at most every other day (OR = 2.8) and purchase of cattle from at least two addresses (OR = 3.1) showed a significant and positive association with ELISA positivity and use of an automatic milking system a negative association (OR = 0.3). Risk factors for PCR positivity were purchase of cattle from at least two delivery addresses (OR = 3.2), presence of cows with ticks (OR = 2.0), use of an automatic milking system (OR = 0.2) and presence of goats or sheep on the farm (OR = 0.4). Biosecurity and general hygiene seem associated with introduction and spread of C. burnetii in dairy herds.
    Preventive Veterinary Medicine 09/2014; 117(1). DOI:10.1016/j.prevetmed.2014.08.016 · 2.51 Impact Factor
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