Q Fever Update: Ill Winds Blowing from Livestock Farms as Airborne Disease Spreads / Predicted to Get Worse

Q FEVER - NETHERLANDS (05)
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Date: Sat 27 Jun 2009
From: Jim van Steenbergen


[ProMED-mail thanks Dr Jim van Steenbergen for the following commentary
regarding this outbreak in humans and goats in the Netherlands and why
Belgium and Germany have not been likewise affected. - Mod.LL]

There is Q fever in Belgium and Germany, but just as modest as we in the
Netherlands used to have, with occasional milder outbreaks. The difference
is the way we keep our goats with herds of 5000 in open stables, concrete
floor, where the farmer adds a little straw every day and removes
everything (including previously deposited placentas) 2 or 3 times a year.
The open stables assist the wind in blowing _Coxiella_ into the outside
environment. In a herd of 5000 you can easily miss a few abortions. The
typical abortion storm is regularly seen (10-20 per cent of pregnancies
ending in abortion), and reported. But we miss hundreds of abortions that
occur in less than 5 per cent of pregnancies (reportable if abortion rate
is over 5 per cent). In a herd of 5000 no obligation to report 1 to 259
abortions.

The vaccination started in 2008 with, at that time, all available vaccine
(40 000 doses). In 2009, there is still a shortage but now over 190 000
doses have been bought and are being administered now by the public health
vets. This is still not enough for the 350 000 goats in the country.
Amazingly enough, the 1.1 million sheep are not (as yet) suffering any
abortions (and no problems at all are seen in cattle).

The area is covered by a thin layer of _Coxiella_ built up in 3 years,
which will undoubtedly infect humans again next year [2009] under certain
weather conditions. We'll see large numbers of human cases next year, even
if the abortion rate were lowered substantially.
--
Jim van Steenbergen
Coordinator, Communicable Disease Control
Netherlands National Institute for Public Health and the Environment
Dutch: Rijksinstituut voor Volksgezondheid en Milieu (RIVM)
Bilthoven, Netherlands


[see also:
Q fever - Netherlands (04): fatalities 20090626.2330
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
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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]

.................jw/ll/mj/sh


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