Centre for Infectious Disease Control, National Institute for Public Health and The Environment, Bilthoven, The Netherlands.
PLoS One. 2012;7(7):e42364. doi: 10.1371/journal.pone.0042364. Epub 2012 Jul 27.
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.
2007-2009 年，荷兰发生了社区 Q 热疫情，奶牛场和奶绵羊场是受影响的来源。本研究旨在确定在奶牛场农民及其在这些农场居住或工作的家庭成员中的血清流行率和血清阳性的危险因素。使用免疫荧光分析检测居住或工作在 111 个奶牛场的 268 人血清中的柯克斯体 IgG 和 IgM 抗体。农民、配偶和 12-17 岁儿童的血清阳性率分别为 73.5%、66.7%和 57.1%。血清阳性的危险因素为：每天进行 3 次或 3 次以上的与山羊相关的任务、农场位于该国的两个南部省份、靠近大容量牛奶阳性农场、最近的牛棚距离住所 10 米或更近、牛棚中存在猫和多种山羊品种、覆盖牛棚空气空间和工作人员不穿农场靴子。山羊农民感染这种职业感染的风险很高。临床医生应考虑在出现与该人群相符的症状时，对 Q 热进行诊断和治疗，以避免严重的后遗症。根据确定的危险因素，建议加强一般生物安全措施，例如农场工作人员始终穿着靴子和防护服，以避免间接传播，并避免伴侣动物进入山羊棚。此外，这为继续实施小反刍动物的当前疫苗接种政策提供了证据，防止从污染农场传播到附近的其他农场。最后，可以考虑对血清阴性的农民和家庭成员进行疫苗接种。
