Abstract
We describe the investigation of an outbreak of Q fever in the town of Cheltenham, England. The outbreak was detected in June 2007, and prospective and retrospective case finding identified 30 confirmed or probable human cases. The investigation identified windborne spread of Coxiella burnetii from nearby sheep farms as the most likely source of infection. A telephone survey was conducted to identify risk practices at local farms. Subsequently the atmospheric dispersion model NAME was used to identify whether air from the identified farms with high risk practices had been carried into Cheltenham town centre during the risk period. Three high risk farms were identified and the modelling showed that air from all of these farms was carried over Cheltenham in the estimated risk period. The investigation resulted in an information campaign to farmers and production of improved advice for livestock farmers on reducing the risks of transmitting Q fever to humans.
Highlights
Q fever is caused by the bacterium Coxiella burnetii, which has major zoonotic potential and is found worldwide in many different animal species, including wildlife [1]
All General Practitioners (GPs) in the Cheltenham area were informed of the outbreak and encouraged to consider the diagnosis of Q fever in patients with relevant symptoms
Fifteen had been identified through retrospective case finding among people hospitalised with pneumonia
Summary
Q fever is caused by the bacterium Coxiella burnetii, which has major zoonotic potential and is found worldwide in many different animal species, including wildlife [1]. It is not a notifiable disease in animals or humans in the United Kingdom (UK). Infection in animals is mainly subclinical and inapparent, it can occasionally cause abortion. Specific laboratory examinations for C. burnetii are not undertaken routinely in animals in the UK, and the infection is only likely to be detected as part of in-depth investigations into major abortion outbreaks in domesticated ruminant species. The bacterium persists in the environment in a resistant spore-like form which may become airborne and transported long distances by the wind [4,5,6,7]
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