The 2007–2010 Q fever epidemic in the Netherlands: characteristics of notified acute Q fever patients and the association with dairy goat farming

Abstract

We describe the Q fever epidemic in the Netherlands with emphasis on the epidemiological characteristics of acute Q fever patients and the association with veterinary factors. Data from 3264 notifications for acute Q fever in the period from 2007 through 2009 were analysed. The patients most affected were men, smokers and persons aged 40–60 years. Pneumonia was the most common clinical presentation (62% in 2007 and 2008). Only 3.2% of the patients were working in the agriculture sector and 0.5% in the meat-processing industry including abattoirs. Dairy goat farms with Coxiella burnetii-induced abortion waves were mainly located in the same area where human cases occurred. Airborne transmission of contaminated dust particles from commercial dairy goat farms in densely populated areas has probably caused this epidemic. In 2010, there was a sharp decline in the number of notified cases following the implementation of control measures on dairy goat and sheep farms such as vaccination, hygiene measures and culling of pregnant animals on infected farms. In combination with a rise in the human population with antibodies against C. burnetii, these have most likely ended the outbreak. Development of chronic Q fever in infected patients remains an important problem for years to come.

Q Fever in the United States: Summary of Case Reports from Two National Surveillance Systems, 2000–2012

“…3,4,8 The largest documented epidemic of Q fever was primarily caused by airborne transmission of C. burnetii from infected goat farms to more highly populated areas in the Netherlands from 2007 through 2010. 43 A similar increase in incidence of Q fever during spring, attributed to windborne transmission following lambing season, has also been documented in France. 4 Clinicians should consider Q fever when appropriate despite an absence of direct exposure to livestock, including cases of community acquired pneumonia and other flu-like illnesses, especially when a potential risk factor for chronic Q fever is present.…”

Comparison between Emerging Q Fever in French Guiana and Endemic Q fever in Marseille, France

“…The clinical manifestations of acute Q fever reportedly vary from one geographic area to another. 2 For example, the main manifestation of acute Q fever in the Spanish Basque region, 17 in an outbreak in the Netherlands, 18 in southeast Canada, 19 and in Switzerland 20 is pneumonia, in contrast to metropolitan France and southern Spain, where the predominant presentation of Q fever is transaminitis. 7,21 We hypothesized that exposure to higher inocula by aerosol or to a particularly virulent strain of C. burnetii circulating in Cayenne could explain the observed manifestation of Q fever and severity of the pneumonia in Cayenne.…”

Galleria mellonella as an alternative model of Coxiella burnetii infection

“…cattle, sheep and goats), wildlife and arthropods (McQuiston & Childs, 2002). Between 2007 and 2010, the largest described outbreak of Q fever occurred in the Netherlands, resulting in .4000 human cases, and .50 000 goats were culled in order to control the spread of the disease (Whelan et al, 2011;Dijkstra et al, 2012). In addition, there are several recent reports of outbreaks amongst military personnel serving in Iraq and Afghanistan, and C. burnetii is listed as a category B agent by the US Centers for Disease Control and Prevention (Moodie et al, 2008;Faix et al, 2008;Bailey et al, 2011).…”