Abstract
Community Q fever epidemics occurred in the Netherlands in 2007–2009, with dairy goat and dairy sheep farms as the implicated source. The aim of the study was to determine the seroprevalence and risk factors for seropositivity in dairy goat farmers and their household members living or working on these farms. Sera of 268 people living or working on 111 dairy goat farms were tested for Coxiella burnetii IgG and IgM antibodies using immunofluorescence assay. Seroprevalences in farmers, spouses and children (12–17 years) were 73.5%, 66.7%, and 57.1%, respectively. Risk factors for seropositivity were: performing three or more daily goat-related tasks, farm location in the two southern provinces of the country, proximity to bulk milk-positive farms, distance from the nearest stable to residence of 10 meters or less, presence of cats and multiple goat breeds in the stable, covering stable air spaces and staff not wearing farm boots. Goat farmers have a high risk to acquire this occupational infection. Clinicians should consider Q fever in this population presenting with compatible symptoms to allow timely diagnosis and treatment to prevent severe sequelae. Based on the risk factors identified, strengthening general biosecurity measures is recommended such as consistently wearing boots and protective clothing by farm staff to avoid indirect transmission and avoiding access of companion animals in the goat stable. Furthermore, it provides an evidence base for continuation of the current vaccination policy for small ruminants, preventing spread from contaminated farms to other farms in the vicinity. Finally, vaccination of seronegative farmers and household members could be considered.
Highlights
Q fever is a ubiquitous zoonosis caused by the bacterium Coxiella burnetii (C. burnetii)
Descriptive characteristics Of all 334 invited eligible dairy goat farms, 111 (33.2%) farms participated in this study
IgG phase II end titres were known for the 75 participants with a past infection with IgG phase I,1:32: 1:32 (n = 20), 1:64 (n = 14), 1:128 (n = 16), 1:256 (n = 12), 1:512 (n = 9) and $1:1024 (n = 4)
Summary
Q fever is a ubiquitous zoonosis caused by the bacterium Coxiella burnetii (C. burnetii). Human Q fever may range from subclinical infection to endocarditis and ruptured aneurysms, and long-term sequelae such as chronic fatigue syndrome (1–4). In 2009– 2010, our integrated human-animal-environmental Q-VIVE study among Dutch dairy goat farms showed a farm prevalence of 43.1% and a goat seroprevalence of 21.4% [6]. The aim of the present study was to determine within the same farm study population, the seroprevalence in farmers and household members living and/or working on dairy goat farms and to assess the farmrelated and individual risk factors for seropositivity in order to update control measures and to provide targeted advice for this occupational group and the Dutch dairy goat industry
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