Netherlands - Q fever outbreak - 20+ deaths

[Gert van der Hoek]

Re: Netherlands: Q fever outbreaks

9 March 2009

Overijssel is a province bordering Germany.


Q fever in goats in Overijssel

At a goat farm in Overijssel Q-fever is confirmed . The animals are quarantined to avoid contamination of other animals and people.

The Health Service will not say which farm it is and how many goats are fallen ill. LTO Nederland (Famer Union, ed) says this is the first time in Overijssel is that so many goats have Q-fever.

The disease is caused by a bacterium. Goats have a miscarriage. People can
get flu symptoms, pneumonia or heart problems.

In 2007 and 2008 over 300 people in Southern Holland were hospitalized with Q fever.

http://www.nos.nl/nos/artikelen/2009/03/art000001C9A0C639419788.html

[Gert van der Hoek]

Re: Netherlands: Q fever outbreaks

First Q-fever in Overijssel

(Novum) - On a farm in the vicinity of Deventer is the first time in Overijssel an animal infected with Q fever. This was reported by a spokesman for LTO Nederland Monday.

The disease, which can be transmitted to humans, has not affected people, says a spokesman for the GG & GD. (Health Service,ed) According to the spokeswoman it often happens that an animal gets infected without an outbreak without people being infected.

The goat with the Q-fever was found on Tuesday . A contra-expertise must now show whether the animal is really sick. When the result of the test is will be ready the spokesman did not say. The animal is not quarantined. Goats and sheep can miscarry because of the bacterial disease.

Minister of LNV Gerda Verburg (CDA) previously announced March 2 by a hygiene protocol for all professional milking goats and milking holdings. They should be better hygiene in storage, transport and spreading of manure in the aflammerperiode . Holders are also required to record all cases of Q fever to report to the Food and Consumer Product Authority. Vaccination for Q fever in contrast to some regions in Southern Holland is not mandatory in Overijssel.

Last year, about six hundred people in North Brabant were infected by Q-fever. When people suffer from this infectious disease they have flu-like symptoms. The disease can not be transmitted person to person.

http://www.trouw.nl/nieuws/nederland/article2050141.ece/Eerste_geval_Q-koorts_in_Overijssel.html

[Gert van der Hoek]

Re: Netherlands: Q fever outbreaks

google translated

March 29, 2009

Q fever case in South Limburg

(Reuters) - In South-Limburg is a company affected by Q-fever. Initially there was only one
suspicion, but now is clear that the infection is. This confirms a
spokesman for the Food and Consumer Product Safety Authority (VWA) Sunday.

Limburg where exactly this company is established is unknown. It is a farm with
totaling thousand sheep and goats. The owner of the plant must ninety days no manure
spreading and in that period no visitors, says the spokesman.

The risk of more contamination of the VWA large. "Especially with this dry weather spreads the fever
easily, "says the spokesman." This promise for the forthcoming summer. "

It is the second company in the Netherlands this year, Q fever has been established. Previously, a
company in the near Deventer affected. Q fever is caused by the bacterium Coxiella
burnetii and causes abortion in sheep and goats. Also, the animals out death.
People can also become infected and influenza-like symptoms get.

Last year, in North Brabant and Gelderland more than a thousand people sick by Q-fever.

[Gert van der Hoek]

Re: Netherlands: Q fever outbreaks

Update on the current situation in this presentation (may 6 2009)

http://ec.europa.eu/food/committees/regulatory/scfcah/animal_health/presentations/q_fever0506052009.pdf

[Gert van der Hoek]

Re: Netherlands: Q fever outbreaks

More Q fever in 2009


The last two weeks are over 260 new patients with Q fever were reported. More than half
of the reports of the Municipal Health Service Hart voor Brabant.

In total, in 2009 and now 1133 patients reported.

Throughout 2008 there were approximately 1000.

The percentage of hospital admissions is higher this year than last year: 25.6% in 2009 versus 20.9% in 2008.

http://www.rivm.nl/cib/actueel/nieuws/20090610_Meer_Q-koorts_dan_in_2008.jsp

[Gert van der Hoek]

Re: Netherlands - Q fever outbreaks - 4 deaths

google translated

1 patient died in 2008, 3 died this year, 2009; all are reported to have "underlying diseases".

Until now this year we have 1,400 + cases . About 1 out of 4 is hospitalized this year.

Last year a 1,000 cases were reported, 1 out of 5 went to a hospital last year.

Four Q-fever patients deceased

Bilthoven - The past two years, there are four people deceased in the Netherlands after the Q-fever had accrued. Reported that the National Institute for Health and Environment (RIVM) Thursday. It is not certain that the fever was the main cause of death.

The first Q-fever patient as possible to the disease completely, it was reported in June 2008. It was unclear whether the man from South Limburg to his infection died, or that he died of old age, said the health authorities at the time.

Thursday claimed a microbiologist from the Jeroen Bosch Hospital in Den Bosch, Peter Weaver, it was confirmed that the disease in its region for two deaths took. Shortly after, the RIVM the number of possible deaths of the Q-fever in four.

Weaver believes that on the basis of foreign literature is to say that even more people by Q-fever are deceased. The study indicates that 1 to 2 percent of people diagnosed with Q fever in the hospital brings it collapses. Situations abroad can certainly be difficult but with the outbreak of Q fever in the Netherlands, says the RIVM.

About the exact number of death cases by only Q fever believes RIVM no sensible word to say. There,''in the hospital more than we look. Q fever is a horrible problem. The situation for us would really change if they were previously healthy people. In that case, I rather like conscience''said infectieziektebestrijding coordinator Jim van Steenbergen Thursday.

1429 patients

Until a few years ago, Q fever as an occupational disease which occasionally came to farmers and their staff. In 2007 became the first of many more infected people than normal (168). Since then, the disease suddenly spread to the Netherlands, first in Brabant, now in Limburg, Gelderland and Utrecht. This year so far in 1429 patients with Q fever were reported. Last year there were 998. A quarter of people in the hospital.

The disease is caused by a bacterium (Coxiella burnetii). The Q is probably the word "query" that question means. The agent of the disease was long unknown. Q fever in the Netherlands mainly spread by goats but also sheep. Especially livestock farmers, veterinarians and slaughterhouse personnel at risk.

But because the bacteria through the air is circulated, may in fact everyone in the vicinity of infected animals reach the bacterium. Pregnant women and people with low resistance (eg other diseases) are extra sensitive. Mothers are, for example, a small increased risk of premature birth or miscarriage.

In Australia, people are vaccinated against the disease. In the Netherlands do not. Experts say there are many drawbacks. Since April, goats have been vaccinated. The effect is noticeable next year, experts expect.

http://www.parool.nl/parool/nl/265/GEZONDHEID/article/detail/250266/2009/06/25/Vier-Q-koortspatienten-overleden.dhtml

[tropical]

Re: Netherlands - Q fever outbreaks - 4 deaths

After many years of spreadings and reporting, tollerating such an illness to be entrenched in an European country as Netherland, and at the same time having enaugh scientific options to crunch it, is ...

Saying it is not possible to achieve a goal, would mean retreating to health civilization levels and control practices of the XIX century.

[Gert van der Hoek]

Re: Netherlands - Q fever outbreaks - 4 deaths

Mmm, `tolerating` this illness ?

In previous years there were not many cases, they were very mild, probably underreported.

In 2007 20 cases were reported, it exploded last year and still is growing this year.

Last year Health Service was caught by surprise. The bacteria here in Holland doesn't behave like in other countries. Research is going on.
There even was a meeting with experts from all over the world, who concluded: we can't do very much at the moment. Yes, doing more research.

Health people hope the vaccination of the goats and sheep will help in the long term. However the bacteria seems to survive in the environment for a long time. The disease continues to spread this year.

Vaccination of people doesn't seem to be an option at the moment, people who were ill and did not know it, could have a very serious allergic reaction.

Mother Nature is full of surprises, pleasant ones and unpleasant ones. You just can't always force her to do what you want her to do .

Like with bird flu and novel H1N1 there seems to be a link between Q-fever and highly intensive animalfarming. Goats this time.

Farmers started to milk more goats in large farms after having problems with EU regulations regarding freezing the production of milk from cows.

[tropical]

Re: Netherlands - Q fever outbreaks - 4 deaths

Mmm, `tolerating` this illness ?
...
Like with bird flu and novel H1N1 there seems to be a link between Q-fever and highly intensive animalfarming. Goats this time.

Farmers started to milk more goats in large farms after having problems with EU regulations regarding freezing the production of milk from cows.

"Tolerating" is intended to be a surprise that in a high developed country could remains sustained for years an illness which is mostly entrenched in rural developing countries.

The illness surviving long in the environment indeed.
More decontaminations of the fields by adding an covering substrate, at the same time by herd vaccinations?
Deminishing the production and giving compensations?

[Gert van der Hoek]

Re: Netherlands - Q fever outbreaks - 4 deaths

Before 2007 aprox. 15 cases a year

In 2007 aprox. 190 cases

In 2008 aprox 1,000 cases


Update august 12, 2009


Cumulative number of confirmed infections in 2009 : 2,026

Probable cases : 99

Deaths : 4

http://www.rivm.nl/cib/themas/Q-koorts/

Link to graph: http://www.rivm.nl/cib/binaries/epic...m92-59728.pdf# class=

Link to map: http://www.rivm.nl/cib/binaries/Qkoo....pdf#%20class=

[Treyfish]

Re: Netherlands - Q fever outbreaks - 4 deaths

Number of Dutch Q fever cases soars
Published on12 August 2009 - 6:25pm
Filed under:
There has been a dramatic increase in the number of cases of Q fever in the Netherlands since 2007. The National Institute for Public Health and the Environment (RIVM) reports that there have been 2,026 recorded cases this year. This is twice as many as the number reported in all of 2008.

Although at first the disease was concentrated in the province of North Brabant, it has now spread to other provinces.

Q fever is caused by a bacteria carried by goats, sheep and cattle. The disease, which is spread by contact with livestock, produces flu-like symptoms such as fever, headaches and vomiting. However, it can also cause life-threatening pneumonia, and in its chronic form an inflammation of the lining of the heart.

• 

http://www.rnw.nl/english/article/nu...er-cases-soars

[Gert van der Hoek]

Re: Netherlands - Q fever outbreaks - 6 deaths

October 7, 2009

A 6th patient died of Q-fever. It is a 57-year-old man with an
underlying vascular disease, who developed chronic Q-fever.


Total number of confirmed Q-fever cases : 2 098

Probable cases : 106

http://www.rivm.nl/cib/themas/Q-koorts/#index_3

Graph

http://www.rivm.nl/cib/binaries/epicurve%20Q-koorts_tcm92-59728.pdf

[Gert van der Hoek]

Re: Netherlands - Q fever outbreaks - 6 deaths

Q FEVER - NETHERLANDS (12): UPDATE
***********************************

Date: Mon 7 Dec 2009
Source: Agrarisch Dagblad [in Dutch, trans. Mod.AS, edited]

http://www.agd.nl/1090668/Nieuws/Varkenshouderij/Advies-drachtige-geiten-op-besmette-bedrijven-ruimen.htm

The RIVM [Dutch National Institute for Public Health and the
Environment] expert consultation on Q-fever advises the Ministry of
Agriculture to remove [in fact, kill] all pregnant goats from farms
infected with Q fever.

This advice is included in the opinion paper, submitted by RIVM to
the Ministry. The measure is meant to be applied on holdings where
bulk milk tests have repeatedly been found positive for Q fever.

The expert consultation related to this as a one-off measure to
prevent infection spread during the due kidding season, when
apparently normal or aborted offspring may spread the pathogen. "It
is possible that uninfected pregnant goats will be removed as well,"
writes the RIVM. The organization indicates that there may be a
distinction made between vaccinated and unvaccinated holdings. "In
unvaccinated holdings, this strategy is the only way to eliminate or
substantially reduce the secretion of the pathogen in 2010," said the
RIVM. "On vaccinated holdings, this strategy can be used as an
additional reducing measure, because these holdings have already
reduced the secretion by the vaccination."

It has also been recommended to continue the vaccination strategy as
well as to temporarily ban increase in the size of goat holdings or
adding new ones.

The expert consultation involved both veterinary as well as public
health experts. The ministries of agriculture and health are expected
to decide during this week about the approach towards Q fever
control. The experts' advice addresses 8 possible strategies.

[Byline: Mariska Vermaas]
--
Communicated by:
Sabine Zentis
Castleview Pedigree English Longhorns
Gut Laach 52385 Nideggen, Germany
<cvlonghorns@aol.com>

[According to data from RIVM, as of 25 Nov 2009, 2293 clinical cases
of Q fever and 6 fatalities have been recorded during 2009 (as of 25
Nov 2009). The numbers for previous years were: 2007 -- 168, 2008 --
1000. A histogram presenting weekly figures for the period 1 Jan 2007
- 25 Nov 2009, and a map showing the affected regions, are available
at http://www.rivm.nl/cib/themas/Q-koorts/index.jsp.

This Q fever outbreak, soon to enter its 4th year, has become the
world's largest on record. Satisfactory explanation for the highly
unusual event, characterized by mass infections in humans in spite of
the rather low-keyed clinical disease in animals, and the underlined
role of goats, is still anticipated. The destruction of pregnant
animals as a preventive measure to protect humans is unusual as well.
Debates in the Dutch Parliament, reportedly scheduled for next week,
reflect the growing concern on this issue.

An updated epigram and a map of the affected areas is available at
http://www.rivm.nl/cib/themas/Q-koorts/index.jsp. - Mod.AS]

http://www.promedmail.org/pls/otn/f?p=2400:1001:2142311840498928::NO::F2400_P1001_BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,80390

Comment: currently concerns regarding Q-fever are growing nationwide.

- Q-fever cases exploded this year

- reports circulate reporting another 5 Q-fever deaths, however no yet on the website of RIVM

- it seems clear the handling of the outbreak is hampered because of a struggle between Ministry of Health and Ministry of Agriculture. The latter has won until now, "we need more data etc" , nothing much happened, except vaccinating of goats and sheep.


The Q-fever outbreak seems to be related to a combination of:

----strong growth of the number of huge goatfarms in the Netherlands

----Holland is a small country, so you always have people living near the goatfarms

----Dry summer: the bacteria seems to spread via manure, which is spread on the land and later partly turns into dust, carrying the bacteria. Could be miles away.

----Underestimation and burocratic struggle of authorities, a strong agricultural lobby.


Culling goats and sheep with the Coxiella burnetii bacteria, causing the Q-fever is unprecedented indeed, however the current outbreak with 11 deaths is unprecedented too.

-


Recent news reports in Dutch here: http://www.flutrackers.com/forum/sho...d.php?t=132531


.

[Gert van der Hoek]

Re: Netherlands - Q fever outbreaks - 6 deaths

Presentation on Q-fever, from Ministry of Agriculture , dated october 2009.

http://ec.europa.eu/food/committees/regulatory/scfcah/animal_health/presentations/0304112009_q_fever_nl.pdf

[Gert van der Hoek]

Re: Netherlands - Q fever outbreaks - 6 deaths

Interesting comment on cats and dogs

Q FEVER - NETHERLANDS (13): CONTROL MEASURES
***********************************************

[1]
Date: Wed 9 Dec 2009
Source: RNW - Radio Netherlands Worldwide [edited]

http://www.rnw.nl/english/article/ministers-call-q-fever-animal-slaughter

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 [2009] 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.

--
Communicated by:
ProMED-mail promed@promedmail.org

******
[2]
Date: Wed 9 Dec 2009
Source: NRC-Handelsblad, Daily, Netherlands [edited]
<http://www.nrc.nl/international/article2433914.ece/Tougher_approach_on_Q-fever_in_the_Netherlands?service=Print>


To stop the spread of Q-fever, which has killed 6 people so far, the
Dutch authorities are ordering all pregnant goats on contaminated
farms slaughtered.

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.

--
Communicated by:
ProMED-mail promed@promedmail.org

[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/View...?ArticleId=138. - Mod.AS]

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