Municipal Health Service Region Nijmegen, The Netherlands.
Epidemiol Infect. 2011 Jan;139(1):13-8. doi: 10.1017/S095026881000021X. Epub 2010 Feb 9.
In May 2008 the Nijmegen Municipal Health Service (MHS) was informed about an outbreak of atypical pneumonia in three in-patients of a long-term psychiatric institution. The patients had been hospitalized and had laboratory confirmation of acute Q fever infection. The MHS started active case finding among in-patients, employees of and visitors to the institution. In a small meadow on the institution premises a flock of sheep was present. One of the lambs in the flock had been abandoned by its mother and cuddled by the in-patients. Samples were taken of the flock. Forty-five clinical cases were identified in employees, in-patients and visitors; 28 were laboratory confirmed as Q fever. Laboratory screening of pregnant women and persons with valvular heart disease resulted in one confirmed Q fever case in a pregnant woman. Of 27 samples from animals, seven were positive and 15 suspect for Coxiella burnetii infection. This outbreak of Q fever in a unique psychiatric setting pointed to a small flock of sheep with newborn lambs as the most likely source of exposure. Care institutions that have vulnerable residents and keep flocks of sheep should be careful to take adequate hygienic measures during delivery of lambs and handling of birth products.
2008 年 5 月，奈梅亨市卫生局（MHS）获悉，一家长期精神病院的三名住院患者爆发了非典型性肺炎。这些患者已住院，并经实验室确认急性 Q 热感染。MHS 开始在该机构的住院患者、员工和访客中主动寻找病例。在该机构的一个小草地上，有一群绵羊。羊群中有一只羔羊被母亲遗弃，被住院患者拥抱。采集了羊群的样本。在员工、住院患者和访客中发现了 45 例临床病例；28 例实验室确诊为 Q 热。对孕妇和有心脏瓣膜病的人的实验室筛查在一名孕妇中发现了一例确诊的 Q 热病例。从 27 个动物样本中，有 7 个呈阳性，15 个疑似感染柯克斯体。在这种独特的精神科环境中爆发的 Q 热表明，一群新生羔羊的小羊群很可能是暴露的来源。有弱势居民和养羊的护理机构应注意在分娩和处理分娩产品时采取适当的卫生措施。
