title: Q fever outbreak in Cheltenham, United Kingdom, in 2007 and the use of dispersion modelling to investigate the possibility of airborne spread.
abstract: We describe the investigation of an outbreak of Q fever in the town of Cheltenham, England. The outbreak was detected in June 2007, and prospective and retrospective case finding identified 30 confirmed or probable human cases. The investigation identified windborne spread of Coxiella burnetii from nearby sheep farms as the most likely source of infection. A telephone survey was conducted to identify risk practices at local farms. Subsequently the atmospheric dispersion model NAME was used to identify whether air from the identified farms with high risk practices had been carried into Cheltenham town centre during the risk period. Three high risk farms were identified and the modelling showed that air from all of these farms was carried over Cheltenham in the estimated risk period. The investigation resulted in an information campaign to farmers and production of improved advice for livestock farmers on reducing the risks of transmitting Q fever to humans.
authors.affiliation: Health Protection Agency South West, Stonehouse, United Kingdom.
authors.forename: A
authors.initials: A
authors.lastname: Wallensten
authors.forename: P
authors.initials: P
authors.lastname: Moore
authors.forename: H
authors.initials: H
authors.lastname: Webster
authors.forename: C
authors.initials: C
authors.lastname: Johnson
authors.forename: G
authors.initials: G
authors.lastname: van der Burgt
authors.forename: G
authors.initials: G
authors.lastname: Pritchard
authors.forename: J
authors.initials: J
authors.lastname: Ellis-Iversen
authors.forename: I
authors.initials: I
authors.lastname: Oliver
mesh_terms: D000391:Air Microbiology; D000392:Air Movements; D004196:Disease Outbreaks / Q000517:prevention & control / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D011159:Population Surveillance / Q000379:methods*; D016016:Proportional Hazards Models; D011778:Q Fever / Q000453:epidemiology* / Q000382:microbiology* / Q000517:prevention & control; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology