Gert van der Hoek
In Memoriam - Editor, Senior Moderator
From ProMED
Q FEVER - NETHERLANDS (17): INTERNATIONAL RESPONSE
**************************************************
******
[1]
Date: Fri 26 Feb 2010
Source: Health Protection Agency (UK). Weekly Report 2010; 4(8), 26 Feb
[edited]
<http://www.hpa.org.uk/hpr/archives/2010/news0810.htm#qfnl>
Ongoing outbreak of Q fever in the Netherlands: HAIRS group considers risk
for UK
---------------------------------------------------------------------------------
Notifications of Q fever in the Netherlands *- that in earlier years
averaged 17 human cases annually [1] *- increased to 168 cases in 2007,
1000 in 2008, and over 2000 in 2009. The most affected area is the highly
agricultural southern province of Noord Brabant, but cases have also been
reported from neighbouring provinces. The disease has now been confirmed on
a total of 73 dairy goat farms [now 74; see commentary] and 2 sheep farms.
The specific epidemiology of Q fever in the Netherlands is most likely
related to intensive goat farming in the proximity of densely populated areas.
Control measures in the Netherlands
-----------------------------------
Dutch authorities have introduced a number of measures to try to control
the spread of the outbreak. These include mandatory vaccination of small
ruminants (initially in the affected regions but extended throughout the
country in 2010 to include holdings of more than 50 sheep or dairy goats,
and premises such as petting farms and zoos), a general ban on breeding,
and fortnightly Q fever bulk milk testing on all farms with 50 or more
dairy goats or dairy sheep. In December 2009 a cull commenced of all
pregnant dairy goats, whether vaccinated or unvaccinated, on infected
farms. Non-pregnant females were spared but are banned from use for
breeding purposes during their lifetime.
ECDC threat assessment
----------------------
In December 2009 the European Centre for Disease Prevention and Control
(ECDC) undertook a threat assessment concluding that "to date, there is no
evidence for a significant increase in the number of human cases of Q-fever
since 2007 in other European countries. In Belgium and Germany, goat
population density is much less than in the Netherlands and 'intensive'
farming is not practised in the same way. Therefore, sporadic occupational
cases and localised outbreaks could be expected in other countries,
including neighbouring Germany and Belgium, if infected animals reach the
farms. However, the spread to the general population is unlikely to reach
the extent it has in the Netherlands, as farms are not so often in the
proximity of densely populated areas and goats are not kept in the same way."
Implications for the UK
-----------------------
The Human Animal Infections Risk Surveillance (HAIRS) group is a
multi-agency and cross-disciplinary horizon scanning group with members
from the HPA, DEFRA, Veterinary Laboratories Agency, Department of Health,
Food Standards Agency, Animal Health, and the Devolved Administrations. The
HAIRS group met in January 2010 to discuss the implications of the Dutch
situation for the UK, considering evidence from the Dutch outbreak and the
ECDC threat assessment, together with UK Q fever surveillance data and
information on UK farming practices.
Current surveillance of Q fever in humans and animals does not indicate any
recent increase in numbers of cases in the UK. There are between 50-100
cases per year in humans in the UK, with no apparent increase seen in 2009.
Fewer than 10 cases in animals were identified in Great Britain annually
between 2006 and 2008, and none were diagnosed in 2009 to the end of
September. Further information on the background level of Q fever infection
in sheep and goats will be available from a Q fever seroprevalence study,
commissioned by DEFRA, that involves screening blood samples (from about
6000 sheep and 500 goats) collected during the 2008 routine Brucella
screening programme. Preliminary results are expected in early 2010.
There are significant differences in the pattern of husbandry and density
of stocking of goats between the UK and the Netherlands. The goat industry
in the UK is not intensive and there are very few large dairy goat farms,
most goat farming being small-scale and not concentrated in any one area.
The HAIRS group concluded that, due to these differences, it is highly
unlikely that the events in the Netherlands could be repeated in the UK. In
addition, current scientific evidence does not support the suggestion that
a hypervirulent strain may be contributing to the extent of the outbreak in
the Netherlands. HAIRS will continue to monitor the situation closely.
-
******
[2]
Date: Mon 22 Feb 2010
Source: Agrarisch Dagblad [trans. Mod.AS, edited]
<http://www.agd.nl/1095664/Nieuws/Veehouderij/Tankmelkonderzoek-bij-Duitse-melkveebedrijven.htm>
Bulk tank milk testing in German dairy plants
---------------------------------------------
The veterinary services of the German county Cleves [Kleve, northwest of
Dusseldorf, less than 8 km (5 miles) south of the Dutch border] have
announced measures to prevent Q fever. Plants applying direct milk
marketing are obliged to introduce bulk tank milk Q sampling for Q fever
testing. The direct marketing will be resumed once it is demonstrated that
the plant is not infected.
Though there is, so far, no evidence of Q fever in Cleves, the German
authorities are worried about the risk that the bacterium will cross the
border from the nneighboring Dutch teritory, where the disease is raging.
--
c
******
[3]
Date: Sat 27 Feb 2010 [accessed]
Source: Letter to the Editor, Vaccine 2009; 27: 3801 [edited]
Q fever vaccination ? unfinished business in Australia
------------------------------------------------------
We celebrate with Gidding et al [1] the achievements of the short-lived
national Q fever vaccination program in Australia. The data presented
suggest a significant impact on Q fever in certain at-risk populations at
the time of the program, particularly abattoir workers. Similar benefits
may accrue in other countries with a Q fever burden, if a national program
was conducted.
However, Australia's Q fever immunisation challenge is not yet completed.
More than 400 cases of Q fever were reported in Australia for 2006 and in
New South Wales, Australia's most populous state, during 2007 the crude
rate of notification was 3.15 per 100 000 population (n=215). These cases
occurred despite an effective vaccine being available. The national Q fever
vaccination program in Australia was a short-term intervention and public
health history clearly demonstrates that intensive time-limited
interventions that are not accompanied by system change are unlikely to be
sustainable.
There has been a shift in the epidemiology of Q fever notifications in NSW.
Recent data suggest that the ongoing burden is being borne by rural people
who live and work in close contact with farm animals. Human infection
commonly occurs through inhaling contaminated aerosols or dust, such as
when people work and live around livestock.
It is clear that while advocating international application of Q fever
vaccination in at-risk populations, there is a need for a sustainable
systematic program in Australia that ensures that non-abattoir workers who
remain at risk from this serious disease can access the protection offered
by the available vaccine.
Reference
---------
1. Gidding HF, Wallace C, Lawrence G, McIntyre PB. (). Australia's national
Q fever vaccination program. Vaccine 2009; 27: 2037*41.
[byline: Peter D Massey, David N Durrheim, Andrew Way. Hunter New England
Health, Population Health]
-
[The 76th infected goat farm was declared as "Q fever infected" on 26 Feb
2010 in Zegveld, Utrecht province. The farm, with 1251 dairy goats, has
been added to the Dutch Q fever distribution map, available at
<http://www.vwa.nl/portal/page?_pageid=119,1639827&_dad=portal&_schema=PORTAL&p_file_id=46922>.
During 25-26 Feb 2010, an international conference, entitled "One Health in
relation to Q fever, in humans and animals", was held in Breda, south
Netherlands. The following presentations were scheduled:
- Christianne Bruschke *- actual veterinary situation and developments in
the Netherlands
- Yvonne van Duynhoven -- actual situation from the human side in the
Netherlands
- Francisco Reviriego Gordejo (DG SANCO) -- the EU public and animal health
legislative context
- Pia Makela (EFSA) *- current Q-fever monitoring practices in the EU
- Denis Coulombier (ECDC) -- implications for public health in the EU
- Mark Paauw -- the meaning and consequences of Q-fever for farmers in
general and especially the situation of the goat farming
- Annie Rodolakis (France) *- history and developments in France, effects
of vaccination, diagnostics, virulency, cooperation between human and
veterinary medicine, notification, intervention methods
- Stephen Graves (Australia) -- history and developments in Australia,
effects of vaccination diagnostics (humane), role of non-ruminants,
cooperation between human and veterinary medicine, notification,
intervention methods
- Martin Ganter (Germany) -- history and developments in Germany, effects
of vaccination, cooperation between human and veterinary medicine, notification
- Paula Menzies (Canada) -- history and developments in Canada, role of
non-ruminants, cooperation between human and veterinary medicine,
notification, intervention methods
- Piet Vellema (Netherlands) *- research in the relation to the approach of
Q fever
- Hendrik Jan Roest (Netherlands) -- diagnosis, genotype differences,
virulence, culture of _C. burnetii_
- Richard Thiery (EFSA) -- results of EFSA's grant on improving harmonised
Q fever monitoring in the EU
- Dimitrios Frangoulidis (Germany) -- pasteurization, genotype differences,
virulence, culture of _C. burnetii_
- Benaouda Kadra ( CEVA) -- Q fever: vaccine production and control.
Abstracts of the papers and results of the groups' discussions will be
posted when available. - Mod.AS]
http://www.promedmail.org/pls/otn/f..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,81550
Q FEVER - NETHERLANDS (17): INTERNATIONAL RESPONSE
**************************************************
******
[1]
Date: Fri 26 Feb 2010
Source: Health Protection Agency (UK). Weekly Report 2010; 4(8), 26 Feb
[edited]
<http://www.hpa.org.uk/hpr/archives/2010/news0810.htm#qfnl>
Ongoing outbreak of Q fever in the Netherlands: HAIRS group considers risk
for UK
---------------------------------------------------------------------------------
Notifications of Q fever in the Netherlands *- that in earlier years
averaged 17 human cases annually [1] *- increased to 168 cases in 2007,
1000 in 2008, and over 2000 in 2009. The most affected area is the highly
agricultural southern province of Noord Brabant, but cases have also been
reported from neighbouring provinces. The disease has now been confirmed on
a total of 73 dairy goat farms [now 74; see commentary] and 2 sheep farms.
The specific epidemiology of Q fever in the Netherlands is most likely
related to intensive goat farming in the proximity of densely populated areas.
Control measures in the Netherlands
-----------------------------------
Dutch authorities have introduced a number of measures to try to control
the spread of the outbreak. These include mandatory vaccination of small
ruminants (initially in the affected regions but extended throughout the
country in 2010 to include holdings of more than 50 sheep or dairy goats,
and premises such as petting farms and zoos), a general ban on breeding,
and fortnightly Q fever bulk milk testing on all farms with 50 or more
dairy goats or dairy sheep. In December 2009 a cull commenced of all
pregnant dairy goats, whether vaccinated or unvaccinated, on infected
farms. Non-pregnant females were spared but are banned from use for
breeding purposes during their lifetime.
ECDC threat assessment
----------------------
In December 2009 the European Centre for Disease Prevention and Control
(ECDC) undertook a threat assessment concluding that "to date, there is no
evidence for a significant increase in the number of human cases of Q-fever
since 2007 in other European countries. In Belgium and Germany, goat
population density is much less than in the Netherlands and 'intensive'
farming is not practised in the same way. Therefore, sporadic occupational
cases and localised outbreaks could be expected in other countries,
including neighbouring Germany and Belgium, if infected animals reach the
farms. However, the spread to the general population is unlikely to reach
the extent it has in the Netherlands, as farms are not so often in the
proximity of densely populated areas and goats are not kept in the same way."
Implications for the UK
-----------------------
The Human Animal Infections Risk Surveillance (HAIRS) group is a
multi-agency and cross-disciplinary horizon scanning group with members
from the HPA, DEFRA, Veterinary Laboratories Agency, Department of Health,
Food Standards Agency, Animal Health, and the Devolved Administrations. The
HAIRS group met in January 2010 to discuss the implications of the Dutch
situation for the UK, considering evidence from the Dutch outbreak and the
ECDC threat assessment, together with UK Q fever surveillance data and
information on UK farming practices.
Current surveillance of Q fever in humans and animals does not indicate any
recent increase in numbers of cases in the UK. There are between 50-100
cases per year in humans in the UK, with no apparent increase seen in 2009.
Fewer than 10 cases in animals were identified in Great Britain annually
between 2006 and 2008, and none were diagnosed in 2009 to the end of
September. Further information on the background level of Q fever infection
in sheep and goats will be available from a Q fever seroprevalence study,
commissioned by DEFRA, that involves screening blood samples (from about
6000 sheep and 500 goats) collected during the 2008 routine Brucella
screening programme. Preliminary results are expected in early 2010.
There are significant differences in the pattern of husbandry and density
of stocking of goats between the UK and the Netherlands. The goat industry
in the UK is not intensive and there are very few large dairy goat farms,
most goat farming being small-scale and not concentrated in any one area.
The HAIRS group concluded that, due to these differences, it is highly
unlikely that the events in the Netherlands could be repeated in the UK. In
addition, current scientific evidence does not support the suggestion that
a hypervirulent strain may be contributing to the extent of the outbreak in
the Netherlands. HAIRS will continue to monitor the situation closely.
-
******
[2]
Date: Mon 22 Feb 2010
Source: Agrarisch Dagblad [trans. Mod.AS, edited]
<http://www.agd.nl/1095664/Nieuws/Veehouderij/Tankmelkonderzoek-bij-Duitse-melkveebedrijven.htm>
Bulk tank milk testing in German dairy plants
---------------------------------------------
The veterinary services of the German county Cleves [Kleve, northwest of
Dusseldorf, less than 8 km (5 miles) south of the Dutch border] have
announced measures to prevent Q fever. Plants applying direct milk
marketing are obliged to introduce bulk tank milk Q sampling for Q fever
testing. The direct marketing will be resumed once it is demonstrated that
the plant is not infected.
Though there is, so far, no evidence of Q fever in Cleves, the German
authorities are worried about the risk that the bacterium will cross the
border from the nneighboring Dutch teritory, where the disease is raging.
--
c
******
[3]
Date: Sat 27 Feb 2010 [accessed]
Source: Letter to the Editor, Vaccine 2009; 27: 3801 [edited]
Q fever vaccination ? unfinished business in Australia
------------------------------------------------------
We celebrate with Gidding et al [1] the achievements of the short-lived
national Q fever vaccination program in Australia. The data presented
suggest a significant impact on Q fever in certain at-risk populations at
the time of the program, particularly abattoir workers. Similar benefits
may accrue in other countries with a Q fever burden, if a national program
was conducted.
However, Australia's Q fever immunisation challenge is not yet completed.
More than 400 cases of Q fever were reported in Australia for 2006 and in
New South Wales, Australia's most populous state, during 2007 the crude
rate of notification was 3.15 per 100 000 population (n=215). These cases
occurred despite an effective vaccine being available. The national Q fever
vaccination program in Australia was a short-term intervention and public
health history clearly demonstrates that intensive time-limited
interventions that are not accompanied by system change are unlikely to be
sustainable.
There has been a shift in the epidemiology of Q fever notifications in NSW.
Recent data suggest that the ongoing burden is being borne by rural people
who live and work in close contact with farm animals. Human infection
commonly occurs through inhaling contaminated aerosols or dust, such as
when people work and live around livestock.
It is clear that while advocating international application of Q fever
vaccination in at-risk populations, there is a need for a sustainable
systematic program in Australia that ensures that non-abattoir workers who
remain at risk from this serious disease can access the protection offered
by the available vaccine.
Reference
---------
1. Gidding HF, Wallace C, Lawrence G, McIntyre PB. (). Australia's national
Q fever vaccination program. Vaccine 2009; 27: 2037*41.
[byline: Peter D Massey, David N Durrheim, Andrew Way. Hunter New England
Health, Population Health]
-
[The 76th infected goat farm was declared as "Q fever infected" on 26 Feb
2010 in Zegveld, Utrecht province. The farm, with 1251 dairy goats, has
been added to the Dutch Q fever distribution map, available at
<http://www.vwa.nl/portal/page?_pageid=119,1639827&_dad=portal&_schema=PORTAL&p_file_id=46922>.
During 25-26 Feb 2010, an international conference, entitled "One Health in
relation to Q fever, in humans and animals", was held in Breda, south
Netherlands. The following presentations were scheduled:
- Christianne Bruschke *- actual veterinary situation and developments in
the Netherlands
- Yvonne van Duynhoven -- actual situation from the human side in the
Netherlands
- Francisco Reviriego Gordejo (DG SANCO) -- the EU public and animal health
legislative context
- Pia Makela (EFSA) *- current Q-fever monitoring practices in the EU
- Denis Coulombier (ECDC) -- implications for public health in the EU
- Mark Paauw -- the meaning and consequences of Q-fever for farmers in
general and especially the situation of the goat farming
- Annie Rodolakis (France) *- history and developments in France, effects
of vaccination, diagnostics, virulency, cooperation between human and
veterinary medicine, notification, intervention methods
- Stephen Graves (Australia) -- history and developments in Australia,
effects of vaccination diagnostics (humane), role of non-ruminants,
cooperation between human and veterinary medicine, notification,
intervention methods
- Martin Ganter (Germany) -- history and developments in Germany, effects
of vaccination, cooperation between human and veterinary medicine, notification
- Paula Menzies (Canada) -- history and developments in Canada, role of
non-ruminants, cooperation between human and veterinary medicine,
notification, intervention methods
- Piet Vellema (Netherlands) *- research in the relation to the approach of
Q fever
- Hendrik Jan Roest (Netherlands) -- diagnosis, genotype differences,
virulence, culture of _C. burnetii_
- Richard Thiery (EFSA) -- results of EFSA's grant on improving harmonised
Q fever monitoring in the EU
- Dimitrios Frangoulidis (Germany) -- pasteurization, genotype differences,
virulence, culture of _C. burnetii_
- Benaouda Kadra ( CEVA) -- Q fever: vaccine production and control.
Abstracts of the papers and results of the groups' discussions will be
posted when available. - Mod.AS]
http://www.promedmail.org/pls/otn/f..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,81550