title: Visits on 'lamb-viewing days' at a sheep farm open to the public was a risk factor for Q fever in 2009.
abstract: Between February and May 2009, 347 laboratory-confirmed cases of acute Q fever were reported in a southern municipal health service region in The Netherlands. Commercial dairy-goat farms were implicated and control measures were initially targeted there. A preliminary investigation also implicated a non-dairy sheep farm, open to the public on 'lamb-viewing days'. This study tested the association between visiting the non-dairy sheep farm and developing Q fever in residents of the region between February and May 2009. A case-control study of 146 cases and 431 address-matched controls was conducted. Multivariable logistic regression analysis confirmed the association between visiting to the sheep farm and Q fever disease (matched odds ratio 43, 95% confidence interval 9-200). Other risk factors were being a smoker, having a past medical history and being aged >40 years. Vaccination of sheep and goats on farms open to the public should help to reduce the number of future human cases.
authors.affiliation: Centre for Infectious Disease Control, National Institute for Public Health and the Environment, RIVM, Bilthoven, The Netherlands. jane.whelan@rivm.nl
authors.forename: J
authors.initials: J
authors.lastname: Whelan
authors.forename: B
authors.initials: B
authors.lastname: Schimmer
authors.forename: A
authors.initials: A
authors.lastname: de Bruin
authors.forename: M Robert-du Ry
authors.initials: MR
authors.lastname: van Beest Holle
authors.forename: W
authors.initials: W
authors.lastname: van der Hoek
authors.forename: R
authors.initials: R
authors.lastname: ter Schegget
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000829:Animals, Domestic; D016022:Case-Control Studies; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011778:Q Fever / Q000453:epidemiology*; D018570:Risk Assessment; D012756:Sheep; D055815:Young Adult; D015047:Zoonoses / Q000453:epidemiology*