Changing epidemiology of Q fever in Germany, 1947-1999.
The epidemiology of Q fever in Germany was examined by reviewing relevant studies since 1947 and by analyzing available surveillance data since 1962. The average annual Q fever incidence nationwide from 1979 to 1989 was 0.8 per million and from 1990 to 1999, 1.4 per million. The mean annual incidence from 1979 to 1999 ranged from a minimum of 0.1 per million in several northern states to 3.1 per million in Baden-Württemberg, in the South. We identified 40 documented outbreaks since 1947; in 24 of these sheep were implicated as the source of transmission. The seasonality of community outbreaks has shifted from predominantly winter- spring to spring-summer, possibly because of changes in sheep husbandry. The location of recent outbreaks suggests that urbanization of rural areas may be contributing to the increase in Q fever. Prevention efforts should focus on reducing sheep-related exposures, particularly near urban areas.
Hellenbrand
W
W
Robert-Koch-Institut, Berlin, Germany. HellenbrandW@rki.de
Breuer
T
T
Petersen
L
L
D000818:Animals; D000907:Antibodies, Bacterial / Q000097:blood; D002417:Cattle; D002418:Cattle Diseases / Q000453:epidemiology / Q000382:microbiology; D016997:Coxiella burnetii / Q000276:immunology; D004196:Disease Outbreaks; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D011159:Population Surveillance / Q000379:methods; D011778:Q Fever / Q000453:epidemiology* / Q000662:veterinary; D016036:Seroepidemiologic Studies; D012756:Sheep; D012757:Sheep Diseases / Q000453:epidemiology / Q000382:microbiology
D000907:Antibodies, Bacterial