Published Date: 2009-12-09 23:50:00
Subject: PRO/AH/EDR> Q fever - Netherlands (13): control measures
Archive Number: 20091209.4198
Q FEVER - NETHERLANDS (13): CONTROL MEASURES
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Wed 9 Dec 2009
Source: RNW - Radio Netherlands Worldwide [edited]
An estimated 15 000 to 20 000 goats and sheep in the Netherlands are
to be slaughtered in connection with Q-fever.
Minister of Health Ab Klink and Minister of Agriculture Gerda Verburg
have agreed that on infected farms where animals have not been
vaccinated, all pregnant animals must be slaughtered, whether or not
they have the virus [sic; the agent is a bacterium].
Q-fever is caused by bacteria (_Coxiella burnetii_) released when
pregnant goats or sheep have spontaneous abortions. The disease is
prevalent in areas in the southern Netherlands with large-scale goat
farms and a relatively dense population. This year  alone, 2200
[in fact, 2293 cases as of 25 Nov 2009] people have contracted it,
most of them in the southern rural province of Brabant. At least 6
people have died.
Date: Wed 9 Dec 2009
Source: NRC-Handelsblad, Daily, Netherlands [edited]
To stop the spread of Q-fever, which has killed 6 people so far, the
Dutch authorities are ordering all pregnant goats on contaminated
Health minister Gerda Verburg and agriculture minister Ab Klink
agreed Wednesday [9 Dec 2009] to take drastic measures to prevent the
spread of Q-fever. Following a recommendation by the National
Institute for Public Health and the Environment (RIVM), they decided
to order all pregnant goats slaughtered on contaminated farms.
Q-fever first appeared in the Netherlands in 2007. It is caused by
infection with the _Coxiella burnetti_ bacterium, which can be found
in cattle, sheep, goats or domestic animals. It is easily released
when a pregnant infected animal miscarries because of the disease.
In humans, Q-fever can cause permanent heart problems. Close to 2330
people in the Netherlands have been infected so far. Six patients
with an underlying illness died as a result.
Last week, the RIVM advised the government to slaughter all pregnant
goats on contaminated farms, regardless of whether the animals are
infected. Even if this would result in the slaughter of "tens of
thousands" of animals, it would be "the most effective measure," the RIVM said.
There has been increasing criticism of the government's handling of
Q-fever lately. Doctors from North Brabant, the area where the
disease is the most widespread, have accused the government of giving
in to the farming industry.
On Tuesday [8 Dec 2009], the association of Dutch municipalities
asked the government to "let the public health interest be the
guiding principle" in setting policy on Q-fever.
[While small ruminants, namely goats and sheep are traditionally
regarded as the main potential source of human infection, other
animals, such as cattle, dogs and cats, are not to be disregarded. In
urban areas, littering cats have been seriously suspected as a
significant source of human infection. In the Dutch context, the
earlier (1997) review "Q fever in Europe" is of interest. It included
the following text: "In some human cases, no relation with
"classical" sources can be found, and possible new sources must be
sought. In a serological study of dogs and cats [in central
Netherlands, 1992], 13.2 percent (91/688) of dogs and 10.4 percent
(46/441) of cats were found to be positive for specific antibodies
against _C. burnetii_. This implies that cats and dogs may be a
source of infection. Special attention to hygiene during parturition
may be needed." See "Q fever in Europe" in Eurosurveillance, Volume
2, Issue 2, 01 February 1997 at
<http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=138>. - Mod.AS]