Epidemiology and Infection

Original Papers

Human and animal viruses/Q fever

Investigation of a Q fever outbreak in a rural area of The Netherlands

I. KARAGIANNISa1a2, B. SCHIMMERa1 c1, A. VAN LIERa1, A. TIMENa1, P. SCHNEEBERGERa1a3, B. VAN ROTTERDAMa1, A. DE BRUINa1, C. WIJKMANSa4, A. RIETVELDa4 and Y. VAN DUYNHOVENa1

a1 National Institute for Public Health and the Environment, Bilthoven, The Netherlands

a2 European Program for Intervention Epidemiology Training (EPIET)

a3 ‘Jeroen Bosch Hospital’, ‘s-Hertogenbosch, The Netherlands

a4 Municipal Health Service ‘Hart voor Brabant’, ‘s-Hertogenbosch, The Netherlands

SUMMARY

A Q fever outbreak occurred in the southeast of The Netherlands in spring and summer 2007. Risk factors for the acquisition of a recent Coxiella burnetii infection were studied. In total, 696 inhabitants in the cluster area were invited to complete a questionnaire and provide a blood sample for serological testing of IgG and IgM phases I and II antibodies against C. burnetii, in order to recruit seronegative controls for a case-control study. Questionnaires were also sent to 35 previously identified clinical cases. Limited environmental sampling focused on two goat farms in the area. Living in the east of the cluster area, in which a positive goat farm, cattle and small ruminants were situated, smoking and contact with agricultural products were associated with a recent infection. Information leaflets were distributed on a large scale to ruminant farms, including hygiene measures to reduce the risk of spread between animals and to humans.

(Accepted December 05 2008)

(Online publication January 23 2009)

Correspondence:

c1 Author for correspondence: B. Schimmer, M.D., EPI/RIVM, PO Box 1, 3720 BA Bilthoven, The Netherlands. (Email: barbara.schimmer@rivm.nl)

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