Q FEVER IN THE NETHERLANDS IS LESS REPORTED IN CHILDREN
Mr. Edwin Slok
Netherlands 
7 slide(s) – English – 2011-06-07
Title: Q-FEVER IN THE NETHERLANDS IS LESS REPORTED IN CHILDREN
Author(s) E.N.E. Slok(1), E. de Vries(2), A. Rietveld(3), F. Dijkstra(1), JE van S1teenbergen(1,4)
Institute(s):
1. Preparedness and response unit, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
2. Department of Paediatrics, Jeroen Bosch Hospital, ‘s Hertogenbosch, the Netherlands;
3. Public Health Services (GGD) Hart voor Brabant, ‘s Hertogenbosch, the Netherlands;
4. Centre for Infectious Diseases, Leiden University Medical Centre, Leiden, The Netherlands
Text Background/aims:
The Q fever outbreak in the Netherlands of 2007-2009 is the largest one ever reported: 3522 notifications. Coxiella bumetii, that causes this zoonotic disease, is mainly transmitted to human through aerosols. Living near contaminated farms, especially in the lambing period, is the main risk factor. In theory, the exposure risk is equal for all those living in the same area, both adults
and children.
Methods:
We inventoried the number of cases amongst children (0-l9yr) during that period, calculated the reported incidence and compared this with adults We reviewed the literature to inventory case reports among children.
Results:
123 children (3,6% of total notifications) were reported. The incidence in children was 0,31 per 10.000 compared to 2,65 in adults, Main reported symptoms were fever of unknown origin and gastro-intestinal symptoms. Besides 14 pneumonias, no other serious complications were reported. We found 20 national and/or regional scientific studies reporting seroprevalences between 0-70%. In 19 artides 52 cases with a serious outcome were described. 4 children died of
complications. In chronic 0 fever cardiac infections were predominant,
Conclusion:
With only 3,6% of notifications from 23,11% of the exposed population we conclude that infections in children are less symptomatic but also frequently overlooked, Children get infections that can present themselves with self-limiting flu-like symptoms but also as rare conditions like encephalitis, osteomyelitis, hepatitis or endocarditis. Therefore paediatricians should be aware a
Coxiella infections in these or unexplained cases. The Dutch Society of Paediatrics (www.nvk.nl, has drafted a guideline “Advices on q fever”).
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