Spatial transmission risk during the 2007-2010 Q fever epidemic in The Netherlands: Analysis of the farm-to-farm and farm-to-resident transmission.

Aline A De Koeijer,Arno N Swart,Thomas J Hagenaars,Gert Jan Boender,Jeroen P G Van Leuken,Luisa Gregori

doi:10.1371/journal.pone.0227491

Aline A De Koeijer, Arno N Swart + Show 4 more

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https://doi.org/10.1371/journal.pone.0227491

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Abstract

Between 2007 and 2010 a Q fever epidemic in Dutch dairy goat farms caused a large Q fever outbreak in human residents in the southern part of the Netherlands. Here we characterize the transmission of Coxiella burnetii, the aetiological agent of Q fever, between infected and susceptible dairy goat farms by estimating a spatial transmission kernel. In addition, we characterize the zoonotic transmission of C. burnetii by estimating the spatial kernel for transmission from infected farms to neighbouring residents. Whereas the range of between-farm transmission is comparable to the scale of the Netherlands, likely due to long-range between-farm contacts such as animal transport, the transmission risk from farms to humans is more localized, although still extending to 10 km and beyond. Within a range of about 10 km, the transmission risk from an infected goat farm to a single resident is of the same order of magnitude as the farm-to-farm transmission risk per animal in a receiving farm. We illustrate how, based on the estimated kernels, spatial patterns of transmission risks between farms and from farms to residents can be calculated and visualized by means of risk maps, offering further insight relevant to policy making in a one-health context.

Highlights

From 2007 until 2010 the Netherlands experienced a human Q fever outbreak [1]
Q fever is a zoonosis caused by the intracellular Gram-negative bacterium Coxiella burnetii, and is prevalent throughout the world [3, 4]
Farms with less than 50 goats were not taken into account in a bulk tank milk monitoring (BTM) program for Q fever

Summary

Introduction

From 2007 until 2010 the Netherlands experienced a human Q fever outbreak [1]. This was referred to as the largest outbreak of Q fever ever reported in the literature [2]. Domestic ruminants are considered to be the main reservoir causing Q fever in humans [3]. There is still an incomplete understanding of the maintenance of C. burnetii within the animal reservoir and its transmission pathways to humans [5]. Transmission to humans is thought to be mainly accomplished through inhalation of airborne dust particles originating from an environment contaminated with C. burnetii [4, 6,7,8].

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