In search of hidden Q-fever outbreaks: linking syndromic hospital clusters to infected goat farms

Epidemiol Infect. 2011 Jan;139(1):19-26. doi: 10.1017/S0950268810001032. Epub 2010 May 18.

Abstract

Large Q-fever outbreaks were reported in The Netherlands from May 2007 to 2009, with dairy-goat farms as the putative source. Since Q-fever outbreaks at such farms were first reported in 2005, we explored whether there was evidence of human outbreaks before May 2007. Space-time scan statistics were used to look for clusters of lower-respiratory infections (LRIs), hepatitis, and/or endocarditis in hospitalizations, 2005-2007. We assessed whether these were plausibly caused by Q fever, using patients' age, discharge diagnoses, indications for other causes, and overlap with reported Q fever in goats/humans. For seven detected LRI clusters and one hepatitis cluster, we considered Q fever a plausible cause. One of these clusters reflected the recognized May 2007 outbreak. Real-time syndromic surveillance would have detected four of the other clusters in 2007, one in 2006 and two in 2005, which might have resulted in detection of Q-fever outbreaks up to 2 years earlier.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Animals
  • Child
  • Child, Preschool
  • Cluster Analysis
  • Goat Diseases / epidemiology*
  • Goat Diseases / microbiology
  • Goat Diseases / transmission
  • Goats
  • Hospitals
  • Humans
  • Infant
  • Infant, Newborn
  • Middle Aged
  • Netherlands / epidemiology
  • Population Surveillance
  • Q Fever / epidemiology
  • Q Fever / transmission
  • Q Fever / veterinary*
  • Retrospective Studies
  • Time Factors
  • Young Adult
  • Zoonoses