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A ProMED-mail post
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International Society for Infectious Diseases
[1]
Date: Thu 25 Jun 2009
Source: Dutch News [edited]
At least 2 people have died suffering from the flu-like Q fever in the
Den Bosch area, microbiologist Peter Wever told news agency ANP on
Thursday [25 Jun 2009].
Both had been admitted to hospital after the diagnosis, but they may
have died of complications or other factors, Wever, from the Jeroen
Bosch hospital in Den Bosch, told ANP. Given that between 1 and 2
percent of people admitted to hospital with the disease die, more
deaths should be expected, he said. Some 600 people have been
hospitalized with Q fever, ANP said, without giving a time frame.
Q fever was rarely known among humans in the Netherlands until 2007,
when 168 cases were reported. In 2008, there were more than 1000
cases. The disease is spread by livestock, which shed the bacteria in
urine, feces, birth products, and milk. Q fever, which leads to
spontaneous abortion in sheep and goats, causes flu-like symptoms in
humans but can lead to lung infections.
--
Communicated by:
ProMED-mail Rapporteur Brent Barrett
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[2]
Date: Fri 26 Jun 2009
Source: Expatica [edited]
So far in 2009, 3 people in the Netherlands have died after
contracting so-called Q fever, according to the national institute for
public health and the environment.
Roel Coutinho, director of the institute, said one patient died in
2008 and then 3 in 2009. All of the patients were suffering from
additional serious medical conditions.
Some 1429 infected patients have been reported by general
practitioners since the beginning of 2009. To limit the spread of the
disease, 130 000 goats in the provinces of [North]-Brabant, Limburg,
and Gelderland will be vaccinated.
--
Communicated by:
ProMED-mail
[The pathogenic organism of Q fever, often acquired by close exposure
to animals, is infectious with a very low inoculum and may be
aerosolized over a distance. It is not clear what contact the infected
people had with animals or how close they were to farms.
_Coxiella burnetii_, the causative agent, was discovered in 1937. This
organism is an agent that can be resistant to heat and desiccation,
and is highly infectious by the aerosol route. A single inhaled
organism may produce clinical illness. Indeed, in [non-human]
primates, the dose to kill 50 percent of the primates was found to be
1.7 organisms (1).
The organisms can be resistant to heat, drying, and many common
disinfectants. These features enable the bacteria to survive for long
periods in the environment. This very stable form of _C. burnetii_ is
associated with compact small cell variants of the organism that are
produced during standard replication along with the less resistant
large cell form, metabolically dormant, and spore-like (2).
Infection of humans usually occurs by inhalation of these organisms
from air that contains airborne barnyard dust contaminated by dried
placental material, birth fluids, and excreta of infected herd
animals. Humans are often very susceptible to the disease, and very
few organisms may be required to cause infection.
Ingestion of contaminated milk, followed by regurgitation and
inspiration of the contaminated food, is a less common mode of
transmission. Other modes of transmission to humans, including tick
bites and human-to-human transmission, are rare.
References
----------
1. Lille RD, Perrin TL, Armstrong C: An institutional outbreak of
pneumonitis. III. Histopathology in man and rhesus monkeys in the
pneumonitis due to the virus of "Q fever." Pub Hlth Rep 1941; 56:
1419-25.
2. Norlander L: Q fever epidemiology and pathogenesis. Microbes Infect
2000; 2: 417-24 [abstract available at
The HealthMap/ProMED-mail interactive map of the Netherlands is available at
[see also:
Q Fever - Netherlands (03): update, animal vaccination 20090510.1744
Q Fever - Netherlands (02): (NB) 20090508.1721
Q fever, caprine - Netherlands: (LI) 20090331.1230
Q fever - Netherlands: sheep & goat vaccination 20090228.0841
2008
----
Q fever - Netherlands (04): sheep & goat vaccination 20081023.3352
Q fever - Netherlands (03): (NBR, GEL) 20080802.2367
Q fever - Netherlands (02): (NBR) 20080728.2306
Q fever - Netherlands: (NBR) 20080725.2267
2007
----
Q fever - Netherlands (Noord-Brabant, Gelderland) 20070809.2592]
........................................ll/mj/jw
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