title: Risk factors of Coxiella burnetii (Q fever) seropositivity in veterinary medicine students.
abstract: BACKGROUND
  Q fever is an occupational risk for veterinarians, however little is known about the risk for veterinary medicine students. This study aimed to assess the seroprevalence of Coxiella burnetii among veterinary medicine students and to identify associated risk factors.
  
  
  METHODS
  A cross-sectional study with questionnaire and blood sample collection was performed among all veterinary medicine students studying in The Netherlands in 2006. Serum samples (n = 674), representative of all study years and study directions, were analyzed for C. burnetii IgG and IgM phase I and II antibodies with an immunofluorescence assay (IFA). Seropositivity was defined as IgG phase I and/or II titer of 1:32 and above.
  
  
  RESULTS
  Of the veterinary medicine students 126 (18.7%) had IgG antibodies against C. burnetii. Seropositivity associated risk factors identified were the study direction 'farm animals' (Odds Ratio (OR) 3.27 [95% CI 2.14-5.02]), advanced year of study (OR year 6: 2.31 [1.22-4.39] OR year 3-5 1.83 [1.07-3.10]) having had a zoonosis during the study (OR 1.74 [1.07-2.82]) and ever lived on a ruminant farm (OR 2.73 [1.59-4.67]). Stratified analysis revealed study direction 'farm animals' to be a study-related risk factor apart from ever living on a farm. In addition we identified a clear dose-response relation for the number of years lived on a farm with C. burnetii seropositivity.
  
  
  CONCLUSIONS
  C. burnetii seroprevalence is considerable among veterinary medicine students and study related risk factors were identified. This indicates Q fever as an occupational risk for veterinary medicine students.
authors.affiliation: Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht, The Netherlands.
authors.forename: Myrna M T
authors.initials: MM
authors.lastname: de Rooij
authors.forename: Barbara
authors.initials: B
authors.lastname: Schimmer
authors.forename: Bart
authors.initials: B
authors.lastname: Versteeg
authors.forename: Peter
authors.initials: P
authors.lastname: Schneeberger
authors.forename: Boyd R
authors.initials: BR
authors.lastname: Berends
authors.forename: Dick
authors.initials: D
authors.lastname: Heederik
authors.forename: Wim
authors.initials: W
authors.lastname: van der Hoek
authors.forename: Inge M
authors.initials: IM
authors.lastname: Wouters
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D000829:Animals, Domestic / Q000382:microbiology; D016997:Coxiella burnetii / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009426:Netherlands / Q000453:epidemiology; D011778:Q Fever / Q000097:blood* / Q000453:epidemiology* / Q000382:microbiology; D012307:Risk Factors; D057566:Self Report; D013337:Students, Medical / Q000706:statistics & numerical data*; D014730:Veterinary Medicine / Q000706:statistics & numerical data*; D015047:Zoonoses / Q000453:epidemiology / Q000382:microbiology