Q fever outbreak in southeastern Netherlands

Abstract number: O251

Nabuurs-Franssen M.H., Weers-Pothoff G., Groot C.A.R., Besselink R., Steenberger P., Morrow G., Dijkstra F., Horrevorts A.

Objectives: Q fever is a worldwide zoonosis caused by Coxiella burnetii. Goats, sheep and cattle have been described as the most common animal reservoir and birth products from infected animals are an important source of environmental contamination. Transmission to humans occurs by the aerosol route or by ingestion of non pasteurised milk products. In the late spring of 2007 there was an outbreak of Q fever in the South East of the Netherlands.

Results: From January until November there were 150 confirmed (and 23 probable) cases of Q fever in the South East of the Netherlands whereas normally 5–20 cases would be expected annually in the whole country. The area has a population of 90.000 and is primarily rural.

Patients reported a sudden onset of high fever, sweats, cough, headaches and muscle pain. There were 3 to every 2 females, their median age was 51 years and 71% had a history of smoking. Forty-nine percent of the patients were admitted to the hospital all with pneumonia except two patients who had hepatitis and one patient who had endocarditis. Most patients were treated with moxifloxacin 400 mg once daily for 7 days and recovered within 24–48 hours. However, 15% of the patients still had complaints, mainly fatigue and may develop chronic Q fever. Of the 18 pregnant women who were screened 2 (11%) had an active infection and were treated with co-trimoxazole for the rest of their pregnancy.

There was a long dry and hot spell during the spring of this year and Coxiella burnetii is highly resistant to chemicals and heat and can survive for long periods in the environment which may have contributed to this outbreak. The source of the outbreak is still under investigation but transmission was almost certainly by way of aerosols.

Conclusion: There was a large outbreak of Q fever in the South East of the Netherlands. Most patients suffered from a pneumonia implicating that the transmission is probably causes by the aerosol route and climate change may have contributed to this exceptionally large outbreak of Q fever in the Netherlands.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Location: Barcelona, Spain
Presentation type:
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