Q fever: single-point source outbreak with high attack rates and massive numbers of undetected infections across an entire region.
Identifieur interne : 000384 ( Ncbi/Merge ); précédent : 000383; suivant : 000385Q fever: single-point source outbreak with high attack rates and massive numbers of undetected infections across an entire region.
Auteurs : Volker H. Hackert [Pays-Bas] ; Wim Van Der Hoek ; Nicole Dukers-Muijrers ; Arnout De Bruin ; Sascha Al Dahouk ; Heinrich Neubauer ; Cathrien A. Bruggeman ; Christian J P A. HoebeSource :
- Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [ 1537-6591 ] ; 2012.
Descripteurs français
- Wicri :
- geographic : Pays-Bas.
English descriptors
- KwdEn :
- Adult, Aged, Agriculture, Animals, Antibodies, Bacterial (blood), Contact Tracing, Coxiella burnetii (isolation & purification), Disease Outbreaks (veterinary), Female, Goat Diseases (epidemiology), Goat Diseases (microbiology), Goats, Humans, Incidence, Male, Middle Aged, Netherlands (epidemiology), Pregnancy, Q Fever (epidemiology), Q Fever (veterinary), Sheep, Sheep Diseases (epidemiology), Sheep Diseases (microbiology), Zoonoses (epidemiology), Zoonoses (microbiology).
- MESH :
- chemical , blood : Antibodies, Bacterial.
- geographic , epidemiology : Netherlands.
- epidemiology : Goat Diseases, Q Fever, Sheep Diseases, Zoonoses.
- isolation & purification : Coxiella burnetii.
- microbiology : Goat Diseases, Sheep Diseases, Zoonoses.
- veterinary : Disease Outbreaks, Q Fever.
- Adult, Aged, Agriculture, Animals, Contact Tracing, Female, Goats, Humans, Incidence, Male, Middle Aged, Pregnancy, Sheep.
Abstract
In early 2009, a dairy-goat annex care farm in South Limburg, the Netherlands, reported 220 Coxiella burnetii-related abortions in 450 pregnant goats. These preceded human cases and occurred in a region that was Q-fever free before 2009, providing a unique quasi-experimental setting for investigating regional transmission patterns associated with a Q-fever point source.
DOI: 10.1093/cid/cis734
PubMed: 22918992
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pubmed:22918992Le document en format XML
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Hackert</name><affiliation wicri:level="1"><nlm:affiliation>Department of Sexual Health, Infectious Diseases, and Environmental Health, South Limburg Public Health Service, Geleen, The Netherlands. volker.hackert@ggdzl.nl</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Sexual Health, Infectious Diseases, and Environmental Health, South Limburg Public Health Service, Geleen</wicri:regionArea><wicri:noRegion>Geleen</wicri:noRegion></affiliation></author><author><name sortKey="Van Der Hoek, Wim" sort="Van Der Hoek, Wim" uniqKey="Van Der Hoek W" first="Wim" last="Van Der Hoek">Wim Van Der Hoek</name></author><author><name sortKey="Dukers Muijrers, Nicole" sort="Dukers Muijrers, Nicole" uniqKey="Dukers Muijrers N" first="Nicole" last="Dukers-Muijrers">Nicole Dukers-Muijrers</name></author><author><name sortKey="De Bruin, Arnout" sort="De Bruin, Arnout" uniqKey="De Bruin A" first="Arnout" last="De Bruin">Arnout De Bruin</name></author><author><name sortKey="Al Dahouk, Sascha" sort="Al Dahouk, Sascha" uniqKey="Al Dahouk S" first="Sascha" last="Al Dahouk">Sascha Al Dahouk</name></author><author><name sortKey="Neubauer, Heinrich" sort="Neubauer, Heinrich" uniqKey="Neubauer H" first="Heinrich" last="Neubauer">Heinrich Neubauer</name></author><author><name sortKey="Bruggeman, Cathrien A" sort="Bruggeman, Cathrien A" uniqKey="Bruggeman C" first="Cathrien A" last="Bruggeman">Cathrien A. Bruggeman</name></author><author><name sortKey="Hoebe, Christian J P A" sort="Hoebe, Christian J P A" uniqKey="Hoebe C" first="Christian J P A" last="Hoebe">Christian J P A. 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Hackert</name><affiliation wicri:level="1"><nlm:affiliation>Department of Sexual Health, Infectious Diseases, and Environmental Health, South Limburg Public Health Service, Geleen, The Netherlands. volker.hackert@ggdzl.nl</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Sexual Health, Infectious Diseases, and Environmental Health, South Limburg Public Health Service, Geleen</wicri:regionArea><wicri:noRegion>Geleen</wicri:noRegion></affiliation></author><author><name sortKey="Van Der Hoek, Wim" sort="Van Der Hoek, Wim" uniqKey="Van Der Hoek W" first="Wim" last="Van Der Hoek">Wim Van Der Hoek</name></author><author><name sortKey="Dukers Muijrers, Nicole" sort="Dukers Muijrers, Nicole" uniqKey="Dukers Muijrers N" first="Nicole" last="Dukers-Muijrers">Nicole Dukers-Muijrers</name></author><author><name sortKey="De Bruin, Arnout" sort="De Bruin, Arnout" uniqKey="De Bruin A" first="Arnout" last="De Bruin">Arnout De Bruin</name></author><author><name sortKey="Al Dahouk, Sascha" sort="Al Dahouk, Sascha" uniqKey="Al Dahouk S" first="Sascha" last="Al Dahouk">Sascha Al Dahouk</name></author><author><name sortKey="Neubauer, Heinrich" sort="Neubauer, Heinrich" uniqKey="Neubauer H" first="Heinrich" last="Neubauer">Heinrich Neubauer</name></author><author><name sortKey="Bruggeman, Cathrien A" sort="Bruggeman, Cathrien A" uniqKey="Bruggeman C" first="Cathrien A" last="Bruggeman">Cathrien A. Bruggeman</name></author><author><name sortKey="Hoebe, Christian J P A" sort="Hoebe, Christian J P A" uniqKey="Hoebe C" first="Christian J P A" last="Hoebe">Christian J P A. Hoebe</name></author></analytic><series><title level="j">Clinical infectious diseases : an official publication of the Infectious Diseases Society of America</title><idno type="eISSN">1537-6591</idno><imprint><date when="2012" type="published">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Agriculture</term><term>Animals</term><term>Antibodies, Bacterial (blood)</term><term>Contact Tracing</term><term>Coxiella burnetii (isolation & purification)</term><term>Disease Outbreaks (veterinary)</term><term>Female</term><term>Goat Diseases (epidemiology)</term><term>Goat Diseases (microbiology)</term><term>Goats</term><term>Humans</term><term>Incidence</term><term>Male</term><term>Middle Aged</term><term>Netherlands (epidemiology)</term><term>Pregnancy</term><term>Q Fever (epidemiology)</term><term>Q Fever (veterinary)</term><term>Sheep</term><term>Sheep Diseases (epidemiology)</term><term>Sheep Diseases (microbiology)</term><term>Zoonoses (epidemiology)</term><term>Zoonoses (microbiology)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="blood" xml:lang="en"><term>Antibodies, Bacterial</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Netherlands</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Goat Diseases</term><term>Q Fever</term><term>Sheep Diseases</term><term>Zoonoses</term></keywords><keywords scheme="MESH" qualifier="isolation & purification" xml:lang="en"><term>Coxiella burnetii</term></keywords><keywords scheme="MESH" qualifier="microbiology" xml:lang="en"><term>Goat Diseases</term><term>Sheep Diseases</term><term>Zoonoses</term></keywords><keywords scheme="MESH" qualifier="veterinary" xml:lang="en"><term>Disease Outbreaks</term><term>Q Fever</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Agriculture</term><term>Animals</term><term>Contact Tracing</term><term>Female</term><term>Goats</term><term>Humans</term><term>Incidence</term><term>Male</term><term>Middle Aged</term><term>Pregnancy</term><term>Sheep</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Pays-Bas</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">In early 2009, a dairy-goat annex care farm in South Limburg, the Netherlands, reported 220 Coxiella burnetii-related abortions in 450 pregnant goats. These preceded human cases and occurred in a region that was Q-fever free before 2009, providing a unique quasi-experimental setting for investigating regional transmission patterns associated with a Q-fever point source.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">22918992</PMID><DateCreated><Year>2012</Year><Month>11</Month><Day>20</Day></DateCreated><DateCompleted><Year>2013</Year><Month>07</Month><Day>10</Day></DateCompleted><DateRevised><Year>2012</Year><Month>11</Month><Day>20</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1537-6591</ISSN><JournalIssue CitedMedium="Internet"><Volume>55</Volume><Issue>12</Issue><PubDate><Year>2012</Year><Month>Dec</Month></PubDate></JournalIssue><Title>Clinical infectious diseases : an official publication of the Infectious Diseases Society of America</Title><ISOAbbreviation>Clin. Infect. Dis.</ISOAbbreviation></Journal><ArticleTitle>Q fever: single-point source outbreak with high attack rates and massive numbers of undetected infections across an entire region.</ArticleTitle><Pagination><MedlinePgn>1591-9</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1093/cid/cis734</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">In early 2009, a dairy-goat annex care farm in South Limburg, the Netherlands, reported 220 Coxiella burnetii-related abortions in 450 pregnant goats. These preceded human cases and occurred in a region that was Q-fever free before 2009, providing a unique quasi-experimental setting for investigating regional transmission patterns associated with a Q-fever point source.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">Index-farm residents/employees, visitors, and their household contacts were traced and screened for C. burnetii. Distribution of community cases was analysed using a geographic information system. True incidence, including undetected infections, was estimated regionwide by seroprevalence in a pre- versus postoutbreak sample, and near-farm by immunoglobulin M seroprevalence in a municipal population sample. Environmental bacterial load was repeatedly measured in surface and aerosol samples.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Serological attack rate was 92% (24/26) in index-farm residents/employees, 56% (28/50) in visitors, and 50% (7/14) in household contacts, and the clinical attack rate (ie, the proportion of persons seropositive for acute infection who also had clinical illness) was ≥ 80%. Notified symptomatic community cases (n = 253) were scattered downwind from the index farm, following a significant exposure-response gradient. Observed incidence ranged from 6.3% (0-1 km) to 0.1% (4-5 km), and remained high beyond. True incidence of infections was estimated at 2.9% regionwide, extrapolating to 8941 infections; estimated near-farm incidence was 12%. Coxiella burnetii load was high on-farm (2009), and lower off-farm (2009-2010).</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Linking a single dairy-goat farm to a human Q-fever cluster, we show widespread transmission, massive numbers of undetected infections, and high attack rates on- and off-farm, even beyond a 5-km high-risk zone. Our investigation may serve as an essential case study for risk assessment in public health and related fields such as bioterrorism response and preparedness.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Hackert</LastName><ForeName>Volker H</ForeName><Initials>VH</Initials><AffiliationInfo><Affiliation>Department of Sexual Health, Infectious Diseases, and Environmental Health, South Limburg Public Health Service, Geleen, The Netherlands. volker.hackert@ggdzl.nl</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>van der Hoek</LastName><ForeName>Wim</ForeName><Initials>W</Initials></Author><Author ValidYN="Y"><LastName>Dukers-Muijrers</LastName><ForeName>Nicole</ForeName><Initials>N</Initials></Author><Author ValidYN="Y"><LastName>de Bruin</LastName><ForeName>Arnout</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Al Dahouk</LastName><ForeName>Sascha</ForeName><Initials>S</Initials></Author><Author ValidYN="Y"><LastName>Neubauer</LastName><ForeName>Heinrich</ForeName><Initials>H</Initials></Author><Author ValidYN="Y"><LastName>Bruggeman</LastName><ForeName>Cathrien A</ForeName><Initials>CA</Initials></Author><Author ValidYN="Y"><LastName>Hoebe</LastName><ForeName>Christian J P A</ForeName><Initials>CJ</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2012</Year><Month>08</Month><Day>23</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Clin Infect Dis</MedlineTA><NlmUniqueID>9203213</NlmUniqueID><ISSNLinking>1058-4838</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000907">Antibodies, Bacterial</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000383" MajorTopicYN="N">Agriculture</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000818" MajorTopicYN="N">Animals</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000907" MajorTopicYN="N">Antibodies, Bacterial</DescriptorName><QualifierName UI="Q000097" MajorTopicYN="N">blood</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016358" MajorTopicYN="N">Contact Tracing</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016997" MajorTopicYN="N">Coxiella burnetii</DescriptorName><QualifierName UI="Q000302" MajorTopicYN="N">isolation & purification</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004196" MajorTopicYN="N">Disease Outbreaks</DescriptorName><QualifierName UI="Q000662" MajorTopicYN="Y">veterinary</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015511" MajorTopicYN="N">Goat Diseases</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName><QualifierName UI="Q000382" MajorTopicYN="N">microbiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006041" MajorTopicYN="N">Goats</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015994" MajorTopicYN="N">Incidence</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009426" MajorTopicYN="N" Type="Geographic">Netherlands</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011247" MajorTopicYN="N">Pregnancy</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011778" MajorTopicYN="N">Q Fever</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName><QualifierName UI="Q000662" MajorTopicYN="Y">veterinary</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012756" MajorTopicYN="N">Sheep</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012757" MajorTopicYN="N">Sheep Diseases</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName><QualifierName UI="Q000382" MajorTopicYN="N">microbiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015047" MajorTopicYN="N">Zoonoses</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName><QualifierName UI="Q000382" MajorTopicYN="N">microbiology</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2012</Year><Month>8</Month><Day>25</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2012</Year><Month>8</Month><Day>25</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2013</Year><Month>7</Month><Day>11</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">22918992</ArticleId><ArticleId IdType="pii">cis734</ArticleId><ArticleId IdType="doi">10.1093/cid/cis734</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Pays-Bas</li></country></list><tree><noCountry><name sortKey="Al Dahouk, Sascha" sort="Al Dahouk, Sascha" uniqKey="Al Dahouk S" first="Sascha" last="Al Dahouk">Sascha Al Dahouk</name><name sortKey="Bruggeman, Cathrien A" sort="Bruggeman, Cathrien A" uniqKey="Bruggeman C" first="Cathrien A" last="Bruggeman">Cathrien A. Bruggeman</name><name sortKey="De Bruin, Arnout" sort="De Bruin, Arnout" uniqKey="De Bruin A" first="Arnout" last="De Bruin">Arnout De Bruin</name><name sortKey="Dukers Muijrers, Nicole" sort="Dukers Muijrers, Nicole" uniqKey="Dukers Muijrers N" first="Nicole" last="Dukers-Muijrers">Nicole Dukers-Muijrers</name><name sortKey="Hoebe, Christian J P A" sort="Hoebe, Christian J P A" uniqKey="Hoebe C" first="Christian J P A" last="Hoebe">Christian J P A. Hoebe</name><name sortKey="Neubauer, Heinrich" sort="Neubauer, Heinrich" uniqKey="Neubauer H" first="Heinrich" last="Neubauer">Heinrich Neubauer</name><name sortKey="Van Der Hoek, Wim" sort="Van Der Hoek, Wim" uniqKey="Van Der Hoek W" first="Wim" last="Van Der Hoek">Wim Van Der Hoek</name></noCountry><country name="Pays-Bas"><noRegion><name sortKey="Hackert, Volker H" sort="Hackert, Volker H" uniqKey="Hackert V" first="Volker H" last="Hackert">Volker H. 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