In search of hidden Q-fever outbreaks: Linking syndromic hospital clusters to infected goat farms

C. C. Van Den Wijngaard, F. Dijkstra, W. Van Pelt, L. Van Asten, M. Kretzschmar, B. Schimmer, N. J.D. Nagelkerke, P. Vellema, G. A. Donker, M. P.G. Koopmans

Research output: Contribution to journalArticlepeer-review

27 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)19-26
Number of pages8
JournalEpidemiology and Infection
Issue number1
Publication statusPublished - Jan 2011
Externally publishedYes


  • Outbreaks
  • Q fever
  • respiratory infections
  • surveillance
  • zoonoses

ASJC Scopus subject areas

  • Epidemiology
  • Infectious Diseases


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