title: Detection of Coxiella burnetii in Ambient Air after a Large Q Fever Outbreak.
abstract: One of the largest Q fever outbreaks ever occurred in the Netherlands from 2007-2010, with 25 fatalities among 4,026 notified cases. Airborne dispersion of Coxiella burnetii was suspected but not studied extensively at the time. We investigated temporal and spatial variation of Coxiella burnetii in ambient air at residential locations in the most affected area in the Netherlands (the South-East), in the year immediately following the outbreak. One-week average ambient particulate matter < 10 μm samples were collected at eight locations from March till September 2011. Presence of Coxiella burnetii DNA was determined by quantitative polymerase chain reaction. Associations with various spatial and temporal characteristics were analyzed by mixed logistic regression. Coxiella burnetii DNA was detected in 56 out of 202 samples (28%). Airborne Coxiella burnetii presence showed a clear seasonal pattern coinciding with goat kidding. The spatial variation was significantly associated with number of goats on the nearest goat farm weighted by the distance to the farm (OR per IQR: 1.89, CI: 1.31-2.76). We conclude that in the year after a large Q fever outbreak, temporal variation of airborne Coxiella burnetii is suggestive to be associated with goat kidding, and spatial variation with distance to and size of goat farms. Aerosol measurements show to have potential for source identification and attribution of an airborne pathogen, which may also be applicable in early stages of an outbreak.
authors.affiliation: Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands.
authors.forename: Myrna M T
authors.initials: MM
authors.lastname: de Rooij
authors.affiliation: Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands.
authors.forename: Floor
authors.initials: F
authors.lastname: Borlée
authors.affiliation: Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands.
authors.forename: Lidwien A M
authors.initials: LA
authors.lastname: Smit
authors.affiliation: Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
authors.forename: Arnout
authors.initials: A
authors.lastname: de Bruin
authors.affiliation: Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
authors.forename: Ingmar
authors.initials: I
authors.lastname: Janse
authors.affiliation: Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands.
authors.forename: Dick J J
authors.initials: DJ
authors.lastname: Heederik
authors.affiliation: Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands.
authors.forename: Inge M
authors.initials: IM
authors.lastname: Wouters
mesh_terms: D000818:Animals; D016997:Coxiella burnetii / Q000235:genetics / Q000302:isolation & purification; D004269:DNA, Bacterial / Q000235:genetics*; D004196:Disease Outbreaks; D005260:Female; D006041:Goats; D006801:Humans; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D052638:Particulate Matter; D011778:Q Fever / Q000453:epidemiology* / Q000235:genetics
chemical_list: D004269:DNA, Bacterial; D052638:Particulate Matter