National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
Epidemiol Infect. 2011 Jan;139(1):19-26. doi: 10.1017/S0950268810001032. Epub 2010 May 18.
Large Q-fever outbreaks were reported in The Netherlands from May 2007 to 2009, with dairy-goat farms as the putative source. Since Q-fever outbreaks at such farms were first reported in 2005, we explored whether there was evidence of human outbreaks before May 2007. Space-time scan statistics were used to look for clusters of lower-respiratory infections (LRIs), hepatitis, and/or endocarditis in hospitalizations, 2005-2007. We assessed whether these were plausibly caused by Q fever, using patients' age, discharge diagnoses, indications for other causes, and overlap with reported Q fever in goats/humans. For seven detected LRI clusters and one hepatitis cluster, we considered Q fever a plausible cause. One of these clusters reflected the recognized May 2007 outbreak. Real-time syndromic surveillance would have detected four of the other clusters in 2007, one in 2006 and two in 2005, which might have resulted in detection of Q-fever outbreaks up to 2 years earlier.
自 2005 年首次报告山羊养殖场发生 Q 热疫情以来，荷兰于 2007 年至 2009 年期间报告了多起大型 Q 热疫情，这些疫情被认为源自奶山羊养殖场。由于首次报告山羊养殖场发生 Q 热疫情是在 2005 年，我们探讨了 2007 年 5 月之前是否有人类爆发疫情的证据。我们使用时空扫描统计方法来查找 2005-2007 年住院患者的下呼吸道感染（LRIs）、肝炎和/或心内膜炎的聚集病例。我们根据患者的年龄、出院诊断、其他病因的指征以及与山羊/人类报告的 Q 热的重叠情况，评估这些病例是否可能由 Q 热引起。对于七个已检测到的 LRI 聚集病例和一个肝炎聚集病例，我们认为 Q 热是一个合理的病因。其中一个聚集病例反映了 2007 年 5 月公认的疫情。实时综合征监测本可以在 2007 年检测到其中四个聚集病例，2006 年一个，2005 年两个，这可能导致更早发现 Q 热疫情，最多可提前 2 年。
