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: 2.54). 10/2010; 139(1):1-12. DOI: 10.1017/S0950268810002268
Source: PubMed


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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    • "Control measures on dairy goat farms which were implemented in 2008 were a breeding ban on bulk tank milk positive goat farms and culling of pregnant does. Table 1provides a chronological overview of the control measures applied in the Netherlands (VWZ, 2010;Roest et al., 2011c). Eventually the human Q fever incidence decreased, indicating that the combined control measures had an effect. "
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    ABSTRACT: Between 2006 and 2009 the largest human Q fever epidemic ever described occurred in the Netherlands. The source of infection was traced back to dairy goat herds with abortion problems due to Q fever. The first aim of control measures taken in these herds was the reduction of human exposure. To analyze Q fever dynamics in goat herds and to study the effect of control measures, a within-herd model of Coxiella burnetii transmission in dairy goat herds was developed. With this individual-based stochastic model we evaluated six control strategies and three herd management styles and studied which strategy leads to a lower Q fever prevalence and/or to disease extinction in a goat herd. Parameter values were based on literature and on experimental work. The model could not be validated with independent data.
    Full-text · Article · Nov 2015 · Preventive Veterinary Medicine
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    • "The risk for humans to become infected by zoonotic agents from small ruminants is very variable and depends on the agent as well as human behaviour. Changes in animals housing and management of animals in combination with reduction of human exposure to zoonotic agents increase risk of outbreaks, as seen in the Q fever outbreak in the Netherlands (Roest et al., 2011). Changes in human habits, e.g., in food purchases or in meal preparation, can increase risk to acquire zoonotic infections (Nougairede et al., 2013). "
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    ABSTRACT: Zoonoses are infections that spread naturally between species (sometimes by a vector) from animals to other animal species or to humans or from humans to animals. Most of the zoonoses diagnosed in sheep and goats are transmitted by close contact of man with these animals and are, more often, occupational diseases that principally affect breeders, veterinarians and/or slaughterhouse workers. Some other diseases have an airborne transmission and affect the population in the vicinity of sheep/goat farms. Due to the fact that small ruminants are almost the only remaining animals which are migrating in industrialised countries, there is a severe risk for transmitting the diseases. Some other zoonotic diseases are foodborne diseases, which are mainly transmitted from animals to humans and to other animal species by contaminated food and water. Within the last decade central Europe was threatened by some new infections, e.g., bluetongue disease and schmallenberg disease, which although not of zoonotic interest, are caused by pathogens transmitted by vectors. Causal agents of both diseases have found highly effective indigenous vectors. In the future, climate change may possibly modify conditions for the vectors and influence their distribution and competence. By this, other vector-borne zoonotic infections may propagate into former disease free countries. Changes in human behaviour in consummation and processing of food, in animal housing and management may also influence future risks for zoonosis. Monitoring, prevention and control measures are proposed to limit further epidemics and to enable the containment of outbreaks. Measures depend mainly on the damage evoked or anticipated by the disease, the local situation, and the epidemiology of the zoonoses, the presence of the infective agent in wild and other animals, as well as the resistance of the causal microorganisms in the environment and the possibility to breed sheep and goats which are resistant to specific infections. In this review, the clinical signs in animals and humans of the main sheep and goat zoonoses, as well as the transmission route and the control measures are reported. Brucellosis, chlamydophilosis, Q fever, Orf, Rift valley fever and Bovine Spongiform Encephalopathy are described in greater detail, in order to determine factors that contribute to the choice of the control strategies. Copyright © 2015 Elsevier B.V. All rights reserved.
    Full-text · Article · Jul 2015 · Veterinary Microbiology
    • "Inhalation of aerosolised C. burnetii bacteria is the most probable route of introduction of the organism in a farm (Welsh et al., 1958; Berri et al., 2005; Roest et al., 2012). Depending on factors as immune status of the animals, flock/herd size and virulence of C. burnetii, eventually, introduction of C. burnetii in a farm leads to spreading of the infection within the flock/herd and, possibly, results in abortion storms, as has occurred in the Netherlands between 2005 and 2009 (Wouda and Dercksen, 2007; Van den Brom and Vellema, 2009; Roest et al., 2011). "
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    ABSTRACT: Q fever is an almost ubiquitous zoonosis caused by Coxiella burnetii, which is able to infect several animal species, as well as humans. Cattle, sheep and goats are the primary animal reservoirs. In small ruminants, infections are mostly without clinical symptoms, however, abortions and stillbirths can occur, mainly during late pregnancy. Shedding of C. burnetii occurs in feces, milk and, mostly, in placental membranes and birth fluids. During parturition of infected small ruminants, bacteria from birth products become aerosolized. Transmission to humans mainly happens through inhalation of contaminated aerosols. In the last decade, there have been several, sometimes large, human Q fever outbreaks related to sheep and goats. In this review, we describe C. burnetii infections in sheep and goats, including both advantages and disadvantages of available laboratory techniques, as pathology, different serological tests, PCR and culture to detect C. burnetii. Moreover, worldwide prevalences of C. burnetii in small ruminants are described, as well as possibilities for treatment and prevention. Prevention of shedding and subsequent environmental contamination by vaccination of sheep and goats with a phase I vaccine are possible. In addition, compulsory surveillance of C. burnetii in small ruminant farms raises awareness and hygiene measures in farms help to decrease exposure of people to the organism. Finally, this review challenges how to contain an infection of C. burnetii in small ruminants, bearing in mind possible consequences for the human population and probable interference of veterinary strategies, human risk perception and political considerations. Copyright © 2015 Elsevier B.V. All rights reserved.
    No preview · Article · Jul 2015 · Veterinary Microbiology
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