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. 2010 Mar 16:10:69.
doi: 10.1186/1471-2334-10-69.

The use of a geographic information system to identify a dairy goat farm as the most likely source of an urban Q-fever outbreak

Barbara Schimmer  1 , Ronald Ter Schegget, Marjolijn Wegdam, Lothar Züchner, Arnout de Bruin, Peter M Schneeberger, Thijs Veenstra, Piet Vellema, Wim van der Hoek
Affiliations

The use of a geographic information system to identify a dairy goat farm as the most likely source of an urban Q-fever outbreak

Barbara Schimmer et al. BMC Infect Dis. .

Abstract

Background: A Q-fever outbreak occurred in an urban area in the south of the Netherlands in May 2008. The distribution and timing of cases suggested a common source. We studied the spatial relationship between the residence locations of human cases and nearby small ruminant farms, of which one dairy goat farm had experienced abortions due to Q-fever since mid April 2008. A generic geographic information system (GIS) was used to develop a method for source detection in the still evolving major epidemic of Q-fever in the Netherlands.

Methods: All notified Q-fever cases in the area were interviewed. Postal codes of cases and of small ruminant farms (size >40 animals) located within 5 kilometres of the cluster area were geo-referenced as point locations in a GIS-model. For each farm, attack rates and relative risks were calculated for 5 concentric zones adding 1 kilometre at a time, using the 5-10 kilometres zone as reference. These data were linked to the results of veterinary investigations.

Results: Persons living within 2 kilometres of an affected dairy goat farm (>400 animals) had a much higher risk for Q-fever than those living more than 5 kilometres away (Relative risk 31.1 [95% CI 16.4-59.1]).

Conclusions: The study supported the hypothesis that a single dairy goat farm was the source of the human outbreak. GIS-based attack rate analysis is a promising tool for source detection in outbreaks of human Q-fever.

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Figures

Figure 1
Figure 1
Epidemic curve of Q-fever and wind direction. Number of Q-fever cases in the Municipal Health Service region Brabant Southeast by week of illness onset (n = 95, black bars); and number of days in the week with prevailing eastern or north-eastern wind (white bars). Information on date of illness onset is missing for one case.
Figure 2
Figure 2
Map of the study area. Locations of goat and sheep farms with >40 animals (farm A-G) and residential addresses of Q-fever cases in urban and rural areas, 14 April to 10 August 2008.
See this image and copyright information in PMC

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