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September 2008
Vol. 18, No. 9
Global ID
Q Fever in Holland

Dutch health authorities have reported 660 cases of Q fever this year, according to the U.S. Centers for Disease Control and Prevention (CDC). The outbreak is centered in the southern part of the country. A sharp increase in cases occurred in May. Last year also saw an outbreak of Q fever in Holland, with most cases occurring between May and July.

Q fever is caused by Coxiella burnetii, most often carried by goats, sheep, or cattle. Patients contract Q fever by inhaling contaminated dust or soil, or by consuming unpasteurized dairy products. Patients generally become ill two to five weeks after exposure. About half of those infected develop symptoms, including fever, chills, sweats, severe headache, muscle aches, abdominal pain, chest pain, sore throat, non-productive cough, vomiting, diarrhea, and malaise. One-third to one-half of patients will develop pneumonia. Liver function may be affected and hepatitis may develop. The disease is fatal in 1 to 2 percent of cases.

The more serious, chronic form of the disease is uncommon but may lead to endocarditis. Chronic Q fever is fatal in 65 percent of cases. Most of those who develop chronic Q fever have pre-existing valvular heart disease or have received a vascular graft.

Serologic testing or DNA detection are recommended for diagnosing Q fever. Doxycycline is the drug of choice to treat it. More information on the outbreak is available on CDC’s Travelers’ Health website.
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