Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Infectious Diseases
Published in: BMC Infectious Diseases 1/2018

Open Access 01-12-2018 | Research article

Airborne geographical dispersal of Q fever from livestock holdings to human communities: a systematic review and critical appraisal of evidence

Authors: Nicholas J. Clark, Ricardo J. Soares Magalhães

Published in: BMC Infectious Diseases | Issue 1/2018

Login to get access

Abstract

Background

Q fever is a zoonotic disease caused by Coxiella burnetii. This bacterium survives harsh conditions and attaches to dust, suggesting environmental dispersal is a risk factor for outbreaks. Spatial epidemiology studies collating evidence on Q fever geographical contamination gradients are needed, as human cases without occupational exposure are increasing worldwide.

Methods

We used a systematic literature search to assess the role of distance from ruminant holdings as a risk factor for human Q fever outbreaks. We also collated evidence for other putative drivers of C. burnetii geographical dispersal.

Results

In all documented outbreaks, infective sheep or goats, not cattle, was the likely source. Evidence suggests a prominent role of airborne dispersal; Coxiella burnetii travels up to 18 km on gale force winds. In rural areas, highest infection risk occurs within 5 km of sources. Urban outbreaks generally occur over smaller distances, though evidence on attack rate gradients is limited. Wind speed / direction, spreading of animal products, and stocking density may all contribute to C. burnetii environmental gradients.

Conclusions

Q fever environmental gradients depend on urbanization level, ruminant species, stocking density and wind speed. While more research is needed, evidence suggests that residential exclusion zones around holdings may be inadequate to contain this zoonotic disease, and should be species-specific.
Appendix
Available only for authorised users
Literature
1.
Orr H, Christensen H, Smyth B, Dance D, Carrington D, Paul I, Stuart J. Case-control study for risk factors for Q fever in Southwest England and Northern Ireland. Eur Surveill. 2006;11(10):260–2.CrossRef
2.
Roest H-J, van Gelderen B, Dinkla A, Frangoulidis D, van Zijderveld F, Rebel J, van Keulen L. Q fever in pregnant goats: pathogenesis and excretion of Coxiella burnetii. PLoS One. 2012;7(11):e48949.CrossRefPubMedPubMedCentral
3.
Raoult D, Marrie T, Mege J. Natural history and pathophysiology of Q fever. The Lancet Infect Dis. 2005;5(4):219–26.CrossRefPubMed
4.
Vaglia A, Di Fabrizio N, Dal Pra P. Q fever: clinical epidemiological remarks on our case report. Giornale di Malattie Infettive e Parassitarie. 1984;36(12):1343–5.
5.
Caron F, Meurice JC, Ingrand P, Bourgoin A, Masson P, Roblot P, Patte F. Acute Q fever pneumonia: a review of 80 hospitalized patients. Chest. 1998;114(3):808–13.CrossRefPubMed
6.
7.
Brouqui P, Dupont HT, Drancourt M, Berland Y, Etienne J, Leport C, Goldstein F, Massip P, Micoud M, Bertrand A. Chronic Q fever: ninety-two cases from France, including 27 cases without endocarditis. Arch Intern Med. 1993;153(5):642–8.CrossRefPubMed
8.
Lai CH, Chang LL, Lin JN, Chen WF, Wei YF, Chiu CT, Wu JT, Hsu CK, Chen JY, Lee HS, et al. Clinical characteristics of Q fever and etiology of community-acquired pneumonia in a tropical region of southern Taiwan: a prospective observational study. PLoS One. 2014;9(7):e102808.CrossRefPubMedPubMedCentral
9.
Fenollar F, Fournier P-E, Carrieri MP, Habib G, Messana T, Raoult D. Risks factors and prevention of Q fever endocarditis. Clin Infect Dis. 2001;33(3):312–6.CrossRefPubMed
10.
Roest H, Tilburg J, Van der Hoek W, Vellema P, Van Zijderveld F, Klaassen C, Raoult D. The Q fever epidemic in the Netherlands: history, onset, response and reflection. Epidemiol Infect. 2011;139(1):1–12.CrossRefPubMed
11.
Arricau-Bouvery N, Rodolakis A. Is Q fever an emerging or re-emerging zoonosis? Vet Res. 2005;36(3):327–49.CrossRefPubMed
12.
Arricau-Bouvery N, Souriau A, Lechopier P, Rodolakis A. Experimental Coxiella burnetii infection in pregnant goats: excretion routes. Vet Res. 2003;34(4):423–33.CrossRefPubMed
13.
Guatteo R, Beaudeau F, Berri M, Rodolakis A, Joly A, Seegers H. Shedding routes of Coxiella burnetii in dairy cows: implications for detection and control. Vet Res. 2006;37(6):827–33.CrossRefPubMed
14.
Massey PD, Durrheim DN, Way A. Q-fever vaccination—unfinished business in Australia. Vaccine. 2009;27(29):3801.CrossRefPubMed
15.
Patel M, Sheridan J, Bell M. Q fever vaccination in Queensland abattoirs. Commun Dis Intel. 1997;21(3):29.
16.
Gidding HF, Wallace C, Lawrence GL, McIntyre PB. Australia’s national Q fever vaccination program. Vaccine. 2009;27(14):2037–41.CrossRefPubMed
17.
Reedijk M, van Leuken JP, van der Hoek W. Particulate matter strongly associated with human Q fever in the Netherlands: an ecological study. Epidemiol Infect. 2013;141(12):2623–33.CrossRefPubMed
18.
Cooper A, Goullet M, Mitchell J, Ketheesan N, Govan B. Serological evidence of Coxiella burnetii exposure in native marsupials and introduced animals in Queensland, Australia. Epidemiol Infect. 2012;140(7):1304–8.CrossRefPubMed
19.
Cooper A, Hedlefs R, Ketheesan N, Govan B. Serological evidence of Coxiella burnetii infection in dogs in a regional centre. Aus Vet J. 2011;89(10):385–7.CrossRef
20.
Sloan-Gardner T, Massey P, Hutchinson P, Knope K, Fearnley E. Trends and risk factors for human Q fever in Australia, 1991–2014. Epidemiol Infect. 2017;145(4):787–95.CrossRefPubMed
21.
Gürtler L, Bauerfeind U, Blümel J, Burger R, Drosten C, Gröner A, Heiden M, Hildebrandt M, Jansen B, Offergeld R, et al. Coxiella burnetii – pathogenic agent of Q (query) fever. Transfus Med Hemother. 2014;41(1):60–72.PubMed
22.
Tissot-Dupont H, Torres S, Nezri M, Raoult D. Hyperendemic focus of Q fever related to sheep and wind. Am J Epidemiol. 1999;150(1):67–74.CrossRefPubMed
23.
Heymann DL. In: Heymann DL, editor. Control of communicable diseases manual. 18th ed. Washington DC: American Public Health Association; 2004.
24.
Commandeur M, Jeurissen L, van der Hoek W, Roest HJ, Hermans T. Spatial relationships in the Q fever outbreaks 2007-2010 in the Netherlands. Int J Environ Health Res. 2014;24(2):137–57.CrossRefPubMed
25.
Schimmer B, Ter Schegget R, Wegdam M, Zuchner L, de Bruin A, Schneeberger PM, Veenstra T, Vellema P, van der Hoek W. The use of a geographic information system to identify a dairy goat farm as the most likely source of an urban Q-fever outbreak. BMC Infect Dis. 2010;10.
26.
Ladbury GA, Van Leuken JP, Swart A, Vellema P, Schimmer B, Ter Schegget R, Van der Hoek W. Integrating interdisciplinary methodologies for one health: goat farm re-implicated as the probable source of an urban Q fever outbreak, the Netherlands, 2009. BMC Infect Dis. 2015;15(1):372.CrossRefPubMedPubMedCentral
27.
Brooke RJ, Kretzschmar ME, Hackert V, Hoebe CJ, Teunis PF, Waller LA. Spatial prediction of Coxiella burnetii outbreak exposure via notified case counts in a dose–response model. Epidemiology. 2017;28(1):127–35.CrossRefPubMed
28.
de Rooij MM, Borlée F, Smit LA, de Bruin A, Janse I, Heederik DJ, Wouters IM. Detection of Coxiella burnetii in ambient air after a large Q fever outbreak. PLoS One. 2016;11(3):e0151281.CrossRefPubMedPubMedCentral
29.
Hermans T, Jeurissen L, Hackert V, Hoebe C. Land-applied goat manure as a source of human Q-fever in the Netherlands, 2006-2010. PLoS One. 2014;9(5):e96607.
30.
van den Berg EJ, Wielders CC, Schneeberger PM, Wegdam-Blans MC, Van Der Hoek W. Spatial analysis of positive and negative Q fever laboratory results for identifying high-and low-risk areas of infection in the Netherlands. Infect Ecol Epidemiol. 2013;3(1):20432.CrossRef
31.
Gilsdorf A, Kroh C, Grimm S, Jensen E, Wagner-Wiening C, Alpers K. Large Q fever outbreak due to sheep farming near residential areas, Germany, 2005. Epidemiol Infect. 2008;136(8):1084–7.CrossRefPubMed
32.
Boden K, Brasche S, Straube E, Bischof W. Specific risk factors for contracting Q fever: lessons from the outbreak Jena. Int J Hyg Environ Health. 2014;217(1):110–5.CrossRefPubMed
33.
Carrieri MP, Tissot-Dupont H, Rey D, Brousse P, Renard H, Obadia Y, Raoult D. Investigation of a slaughterhouse-related outbreak of Q fever in the French alps. Eur J Clin Microbiol Infect Dis. 2002;21(1):17–21.CrossRefPubMed
34.
van Leuken JP, van de Kassteele J, Sauter FJ, van der Hoek W, Heederik D, Havelaar AH, Swart AN. Improved correlation of human Q fever incidence to modelled C. burnetii concentrations by means of an atmospheric dispersion model. Int J Health Geogr. 2015;14(1):14.CrossRefPubMedPubMedCentral
35.
36.
Armengaud A, Kessalis N, Desenclos J, Maillot E, Brousse P, Brouqui P, Tixier-Dupont H, Raoult D, Provensal P, Obadia Y. Urban outbreak of Q fever, Briancon, France, march to June 1996. Eur Surveill. 1997;2(2):12–3.CrossRef
37.
Porten K, Rissland J, Tigges A, Broll S, Hopp W, Lunemann M, Van Treeck U, Kimmig P, Brockmann SO, Wagner-Wiening C. A super-spreading ewe infects hundreds with Q fever at a farmers' market in Germany. BMC Infect Dis. 2006;6(1):147.CrossRefPubMedPubMedCentral
38.
Panaiotov S, Ciccozzi M, Brankova N, Levterova V, Mitova-Tiholova M, Amicosante M, Rezza G, Kantardjiev T. An outbreak of Q fever in Bulgaria. Annali dell'Istituto superiore di sanita. 2009;45(1):83–6.PubMed
39.
40.
Dupuis G, Petit J, Peter O, Vouilloz M. An important outbreak of human Q fever in a Swiss alpine valley. Int J Epidemiol. 1987;16(2):282–7.CrossRefPubMed
41.
42.
Gyuranecz M, Sulyok K, Balla E, Mag T, Balazs A, Simor Z, Denes B, Hornok S, Bajnoczi P, Hornstra H, et al. Q fever epidemic in Hungary, April to July 2013. Euro Surveill. 2014;19(30).
43.
Hackert VH, van der Hoek W, Dukers-Muijrers N, de Bruin A, Al Dahouk S, Neubauer H, Bruggeman CA, Hoebe C. Q fever: single-point source outbreak with high attack rates and massive numbers of undetected infections across an entire region. Clin Infect Dis. 2012;55(12):1591–9.CrossRefPubMed
44.
King LA, Goirand L, Tissot-Dupont H, Giunta B, Giraud C, Colardelle C, Duquesne V, Rousset E, Aubert M, Thiery R, et al. Outbreak of Q fever, Florac, southern France, spring 2007. Vector Borne Zoonotic Dis. 2011;11(4):341–7.CrossRefPubMed
45.
46.
47.
van der Hoek W, Dijkstra F, Schimmer B, Schneeberger PM, Vellema P, Wijkmans C, ter Schegget R, Hackert V, van Duynhoven Y. Q fever in the Netherlands: an update on the epidemiology and control measures. Euro Surveill. 2010;15(12).
48.
Georgiev M, Afonso A, Neubauer H, Needham H, Thiery R, Rodolakis A, Roest HJ, Stark KD, Stegeman JA, Vellema P, et al. Q fever in humans and farm animals in four European countries, 1982 to 2010. Eur Surveill. 2013;18(8):13–25.
49.
Berri M, Rousset E, Champion J, Russo P, Rodolakis A. Goats may experience reproductive failures and shed Coxiella burnetii at two successive parturitions after a Q fever infection. Res Vet Sci. 2007;83(1):47–52.CrossRefPubMed
50.
Porter SR, Czaplicki G, Mainil J, Guattéo R, Saegerman C. Q fever: current state of knowledge and perspectives of research of a neglected zoonosis. Int J Microbiol. 2011;2011:248418.
51.
Harris P, Eales K, Squires R, Govan B, Norton R. Acute Q fever in northern Queensland: variation in incidence related to rainfall and geographical location. Epidemiol Infect. 2013;141(5):1034–8.CrossRefPubMed
52.
Cooper A, Stephens J, Ketheesan N, Govan B. Detection of Coxiella burnetii DNA in wildlife and ticks in northern Queensland, Australia. Vector Borne Zoonotic Dis. 2013;13(1):12–6.CrossRefPubMed
53.
Cooper A, Hedlefs R, McGowan M, Ketheesan N, Govan B. Serological evidence of Coxiella burnetii infection in beef cattle in Queensland. Aus Vet J. 2011;89(7):260–4.CrossRef
54.
Marrie T, Williams J, Schlech W, Yates L. Q fever pneumonia associated with exposure to wild rabbits. Lancet. 1986;327(8478):427–9.CrossRef
55.
Psaroulaki A, Chochlakis D, Angelakis E, Ioannou I, Tselentis Y. Coxiella burnetii in wildlife and ticks in an endemic area. Trans R Soc Trop Med Hyg. 2014;108(10):625–31.CrossRefPubMed
56.
Psaroulaki A, Hadjichristodoulou C, Loukaides F, Soteriades E, Konstantinidis A, Papastergiou P, Ioannidou MC, Tselentis Y. Epidemiological study of Q fever in humans, ruminant animals, and ticks in Cyprus using a geographical information system. Eur J Clin Microbiol Infect Dis. 2006;25(9):576–86.CrossRefPubMed
57.
Clark NJ, Seddon JM, Šlapeta J, Wells K. Parasite spread at the domestic animal - wildlife interface: anthropogenic habitat use, phylogeny and body mass drive risk of cat and dog flea (Ctenocephalides spp.) infestation in wild mammals. Paras Vec. 2018;11(1):8.CrossRef
58.
59.
Sellens E, Norris JM, Dhand NK, Heller J, Hayes L, Gidding HF, Willaby H, Wood N, Bosward KL. Q fever knowledge, attitudes and vaccination status of Australia’s veterinary workforce in 2014. PLoS One. 2016;11(1):e0146819.CrossRefPubMedPubMedCentral
60.
Bontje D, Backer J, Hogerwerf L, Roest H, van Roermund H. Analysis of Q fever in Dutch dairy goat herds and assessment of control measures by means of a transmission model. Prev Vet Med. 2016;123:71–89.CrossRefPubMed
61.
van der Hoek W, van de Kassteele J, Bom B, de Bruin A, Dijkstra F, Schimmer B, Vellema P, ter Schegget R, Schneeberger PM. Smooth incidence maps give valuable insight into Q fever outbreaks in the Netherlands. Geospat Health. 2012;7(1):127–34.CrossRefPubMed
62.
63.
van der Hoek W, Meekelenkamp JC, Dijkstra F, Notermans DW, Bom B, Vellema P, Rietveld A, van Duynhoven YT, Leenders AC. Proximity to goat farms and Coxiella burnetii seroprevalence among pregnant women. Emerg Infect Dis. 2011;17(12):2360–3.CrossRefPubMedPubMedCentral
64.
Karagiannis I, Schimmer B, Van Lier A, Timen A, Schneeberger P, Van Rotterdam B, De Bruin A, Wijkmans C, Rietveld A, Van Duynhoven Y. Investigation of a Q fever outbreak in a rural area of the Netherlands. Epidemiol Infect. 2009;137(9):1283–94.CrossRefPubMed
Metadata
Title
Airborne geographical dispersal of Q fever from livestock holdings to human communities: a systematic review and critical appraisal of evidence
Authors
Nicholas J. Clark
Ricardo J. Soares Magalhães
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2018
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-018-3135-4

Other articles of this Issue 1/2018

BMC Infectious Diseases 1/2018 Go to the issue

Study protocol

SESOTHO trial (“Switch Either near Suppression Or THOusand”) – switch to second-line versus WHO-guided standard of care for unsuppressed patients on first-line ART with viremia below 1000 copies/mL: protocol of a multicenter, parallel-group, open-label, randomized clinical trial in Lesotho, Southern Africa

Research article

Immunogenicity and safety of a tetanus-diphtheria vaccine and a 13-valent pneumococcal conjugate vaccine after concomitant vaccination in ≥ 50-year-old adults

Case report

Series of 10 dengue fever cases with unusual presentations and complications in Sri Lanka: a single centre experience in 2016

Research article

Bacterial risk factors for treatment failure and relapse among patients with isoniazid resistant tuberculosis

Research article

Identification of genetic variants associated with dengue or West Nile virus disease: a systematic review and meta-analysis

Research article

Prediction of mortality in severe dengue cases
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits