Outbreak of hepatitis A in Flemish Belgium, July-August 2004 (original) (raw)
Related papers
Spread of Q fever in Bulgaria and risk assessment for animal health and public health in 2023
Deleted Journal, 2024
Q fever, first described among slaughterhouse staff in Australia in 1937, is now recognized as an endemic disease throughout the world, except New Zealand. Since this first description, knowledge of this pathogen and its associated infections has increased dramatically. From the public health point of view and economic consequences, Q fever is a zoonotic disease of high public importance, the etiological agent of which, Coxiella burnetii, is included in group B of the list of potential biological weapons of the World Organization for Animal Health (WOAH, founded as OIE). The 14 positive cases of Q fever in humans in the Gabrovo Region (including 4 veterinarians and staff working on the farms) and the positive herds found in three cow farms and one sheep farm also raised concern. For this reason, it is important to recall the importance of this disease and the risks it poses to human and animal health, as well as to outline the necessary measures for surveillance and prevention of new cases. In relation with the detected positive cases of Q fever in humans (among them, farm owners and staff, veterinarians) and positive herds of large and small ruminants in the last five years in a number of regions of Bulgaria, we tracked and analyzed the spread of Coxiella burnetii and the possibilities for the control and eradication of the Q fever disease, as well as with the aim of establishing the trends in the prevalence of the disease and especially the relationship between the morbidity in humans and animals.
Eurosurveillance
Background: Q fever is a zoonosis, included in category B of particularly dangerous infectious agents and as such merits careful surveillance and regular updating of the information about its distribution. Aim: This observational retrospective study aimed to provide an overview of Q fever incidence in Bulgaria in the period 2011 to 2017. Methods: Aggregated surveillance data from Bulgaria's mandatory surveillance system, laboratory data on individual samples received at the National Reference Laboratory Rickettsiae and Cell Cultures and outbreak reports sent by the regional health authorities to the National Centre of Infectious and Parasitic Diseases, were used in this analysis. Cases were described by year, region, age group and most commonly identified risk behaviours. Results: A total of 139 confirmed cases were reported in the study period (average annual incidence: 0.27 cases/100,000 inhabitants). No seasonality or trend in reported cases was observed. Cases were mostly sporadic, with two small outbreaks in 2017. Identified risk behaviours among cases were occupational exposure and consumption of milk and dairy products, although exposure data were incomplete. The male/female ratio was 1.4. The identification and resolution of the two rural outbreaks in 2017 with a total of 18 cases involved good practices: active case finding and collaboration between public health and veterinary authorities. Conclusion: Between 2011 and 2017, Bulgaria retained low Q fever incidence, mostly sporadic cases and two small outbreaks. Occupational exposure and consumption of milk and dairy products were the most often reported likely exposures among cases. The outbreak investigations demonstrate the application of good control practices.
FEMS Immunology & Medical Microbiology, 2012
We describe the Q fever epidemic in the Netherlands with emphasis on the epidemiological characteristics of acute Q fever patients and the association with veterinary factors. Data from 3264 notifications for acute Q fever in the period from 2007 through 2009 were analysed. The patients most affected were men, smokers and persons aged 40-60 years. Pneumonia was the most common clinical presentation (62% in 2007 and 2008). Only 3.2% of the patients were working in the agriculture sector and 0.5% in the meat-processing industry including abattoirs. Dairy goat farms with Coxiella burnetii-induced abortion waves were mainly located in the same area where human cases occurred. Airborne transmission of contaminated dust particles from commercial dairy goat farms in densely populated areas has probably caused this epidemic. In 2010, there was a sharp decline in the number of notified cases following the implementation of control measures on dairy goat and sheep farms such as vaccination, hygiene measures and culling of pregnant animals on infected farms. In combination with a rise in the human population with antibodies against C. burnetii, these have most likely ended the outbreak. Development of chronic Q fever in infected patients remains an important problem for years to come.
An outbreak of Q fever in Bulgaria
2000
Summary. Q fever is an acute febrile illness due to Coxiella burnetii. In the Balkans, Q fever in humans has been reported since World War II, and in countries such as Bulgaria the number of cases has increased since the early 1990s. We report an investigation of an outbreak in the town of Botevgrad, Western Bulgaria. Overall, 220 cases were
Investigation of a Q-fever outbreak in Northern Italy
European Journal of Epidemiology, 1996
Objectives: A study was conducted to evaluate the extent of a Q-fever epidemic through active case finding in the area of Vicenza (northeastern Italy), and to identify risk factors for Q-fever in this outbreak. Methods: 1) Descriptive epidemiology; 2) Seroepidemiological survey; 3) Case-control study. 1) Epidemic curve and maps with the location of cases. Identification of the road followed by the flocks of sheep. 2) Cross-sectional study on humans and flocks of sheep tested for anti-Coxiella burnetii antibodies. 3) Cases were defined by the presence of fever > 38 °C plus serological confirmation. Controls were 94 apparently healthy individuals attending outpatient facilities for control visits or certification, group-matched by geographical area, age and gender. A standardized questionnaire was administered by trained interviewers. Odds ratio and 95% confidence intervals (CI) were used to evaluate risk factors for Q-fever. Results: A total of 58 cases were identified in a 5-month period. Male to female ratio was 2.8:1; mean age was 42 years (range: 20–65 years). Twenty-eight patients (48%) were hospitalized. Fever was accompanied by asthenia (81%), headache (76%), chills (72%), and myalgia and arthralgia (53%); cough was present in 47% of patients. Rx abnormalities were found in 81 % of the patients undergoing chest X-ray. Among 111 apparently healthy family members who underwent serological testing, four (3.6%) had antibodies to Coxiella burnetii. Three flocks which passed through the outbreak area between late May and early June were shown to be infected, with prevalence of antibodies ranging between 45 and 53%. The case-control study showed a significant association with exposure to flocks of sheep (Odds ratio = 6.1; 95% CI 2.5, 16.3). Other potential risk factors were not more commonly reported by cases with respect to controls. Conclusions: Indirect exposure to flocks of sheep was a determinant of this outbreak of Q-fever. This finding suggests that transmission occurred through inhalation of contaminated airborne particles. The importance of control measures should be stressed in areas traversed by flocks of sheep.
Epidemiological characteristics of Q fever in Vojvodina Province, Serbia, 1985-2009.pdf
Due to the atypical symptoms and signs of Q fever, the high incidence of mild infections and the fact that in our region the appearance of this anthropozoonosis is linked to the lambing season (the end of winter and beginning of spring), when the greatest frequency of respiratory infections is manifested, Q fever is not recognized very often. The possible lethal complications, the fact that Coxiella burnetii can survive for years in the environment and be transferred by airstream in great breathing spaces, the small infectious dose necessary to cause the disease and speculation as to its possible use in bioterrorism, make it a significant public health problem. The aim of our study was to give some data on Q fever in the Autonomous Province of Vojvodina, Serbia, an area with a high degree of agricultural activity.
A Narrative Review of Q Fever in Europe
Cureus, 2023
Coxiella burnetii, the causative agent of Q fever, causes abortions in animals. Its effects on humans and the management of Q fever in certain conditions like pregnancy are undetermined. The World Health Organization has estimated that zoonotic diseases cause around one billion cases of infections and millions of deaths globally each year. It is worth noting that many emerging infectious diseases currently being reported worldwide are zoonoses. We reviewed studies reporting on Q fever prevalence and incidence in Europe. Articles from 1937 to 2023 with the following terms "Coxiella burnetii and Europe and Q fever, and seroprevalence studies" were identified in the PubMed database and reports by organizations such as the European Centre for Disease Prevention and Control (ECDC). We included randomized and observational studies, seroprevalence studies, case series, and case reports. According to the ECDC in 2019, 23 countries reported 1069 cases, the majority of which were classified as confirmed cases. The number of reports per 100,000 inhabitants in the EU/EEA was 0.2 for 2019, the same as the previous four years. The highest report rate (0.7 cases per 100,000 population) was observed in Spain, followed by Romania (0.6), Bulgaria (0.5), and Hungary. Considering the typically asymptomatic nature of Q fever infection, it is imperative to strengthen the existing systems to promote the rapid identification and reporting of Q fever outbreaks in animals, particularly in cases of abortion. It is also essential to consider the facilitation of early information exchange between veterinarians and public health counterparts to ensure the timely detection and prevention of potential zoonotic events, including Q fever.
Epidemiological characteristics of Q fever in Vojvodina province, Serbia, 1985-2009
Archives of Biological Sciences, 2012
Due to the atypical symptoms and signs of Q fever, the high incidence of mild infections and the fact that in our region the appearance of this anthropozoonosis is linked to the lambing season (the end of winter and beginning of spring), when the greatest frequency of respiratory infections is manifested, Q fever is not recognized very often. The possible lethal complications, the fact that Coxiella burnetii can survive for years in the environment and be transferred by airstream in great breathing spaces, the small infectious dose necessary to cause the disease and speculation as to its possible use in bioterrorism, make it a significant public health problem. The aim of our study was to give some data on Q fever in the Autonomous Province of Vojvodina, Serbia, an area with a high degree of agricultural activity.
Investigation of a Q fever outbreak in a rural area of The Netherlands
Epidemiology and Infection, 2009
SUMMARYA Q fever outbreak occurred in the southeast of The Netherlands in spring and summer 2007. Risk factors for the acquisition of a recent Coxiella burnetii infection were studied. In total, 696 inhabitants in the cluster area were invited to complete a questionnaire and provide a blood sample for serological testing of IgG and IgM phases I and II antibodies against C. burnetii, in order to recruit seronegative controls for a case-control study. Questionnaires were also sent to 35 previously identified clinical cases. Limited environmental sampling focused on two goat farms in the area. Living in the east of the cluster area, in which a positive goat farm, cattle and small ruminants were situated, smoking and contact with agricultural products were associated with a recent infection. Information leaflets were distributed on a large scale to ruminant farms, including hygiene measures to reduce the risk of spread between animals and to humans.
The Journal of Infection in Developing Countries, 2018
Introduction: Q fever is a zoonosis which commonly manifests as an acute febrile disease accompanied by pneumonia or hepatitis. The aim of this study was to reveal the reservoirs, sources and routes of infection relevant for the Q fever outbreak that occurred in the border region between Serbia and Montenegro. Methodology: A prospective study was conducted from 3rd to 23rd March, 2016 in Brodarevo, village near the Serbian-Montenegro border. The EU case definition for Q fever was applied and serological evidence of IgM and/or IgG antibody for phase II antigen Coxiella burnetii used for laboratory confirmation. Animal infection was proven by detection of specific biomarkers for Q fever by ELISA and Real-Time PCR. Results: In total, ten patients were registered with Q fever, giving an attack rate of 0.5% in the village. A severe form of disease with atypical pneumonia ended up with hospitalization of eight patients. Serological surveillance was conducted in 30 herds of the receptive a...