Q Fever Netherlands…Catagory B bioterrorism agent.

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    Though this is not in the US, the potential of spread or weaponization is high.

    Date: Fri 15 Jan 2010
    Source: Science Magazine [abridged, edited]
    (abstract; the full article requires a subscription)

    [Ref: Enserink M: Questions abound in Q-fever explosion in the
    Netherlands. Science 2010 Jan; 327(5963): 266-7]

    In the United States, Q fever is classified as a “Category B”
    bioterrorism agent because it would be relatively easy to use and
    because, although not as deadly as anthrax or plague, attacks could
    still create widespread disease and panic. The US Army exposed human
    volunteers to it as part of its biowarfare program in the 1950s; the
    Soviet Union experimented with it as well, as did the Japanese cult
    Aum Shinrikyo, known for its 1995 sarin attack. Bioterror worries
    brought more attention to it in the 1990s and prompted the United
    States to make it reportable in 1999. This increased awareness —
    along with better diagnostic tests — may explain the rising number of
    reported outbreaks of Q fever over the past 10 years worldwide, says
    epidemiologist Didier Raoult of the Universite de la Mediterranee in
    Marseille, France, the foremost expert in human Q fever. “Once you
    start looking for Q fever, you’ll find more and more of it,” he says.

    But what is going on in the Netherlands now is not just better
    detection but something new and different, says epidemiologist Roel
    Coutinho, head of the Centre for Infectious Disease Control in
    Bilthoven. When 182 human cases were detected in and around a town
    called Herpen in the summer of 2007, it seemed like a one-off
    outbreak. But in 2008, a new wave erupted, quickly filling up
    intensive-care units in the province of Noord-Brabant. A thousand
    cases were reported that year. In 2009, the number of new cases jumped
    to almost 2200, and the disease was found across the country. It is
    still unclear what is behind the massive spread. Part of the reason
    has to be the recent expansion of high-intensity goat farming in the
    densely populated country, says Coutinho. The number of goats has
    quadrupled in Holland to more then 350 000 since 1995, and the number
    of them per farm has tripled; the country is now home to some of the
    biggest goat farms in the world. (In a sad twist of fate, some farmers
    switched to goats after a devastating swine flu outbreak ruined the
    Dutch pig industry in the 1990s.) Farms are often close together, and
    animals are frequently transported between them, presumably
    facilitating spread, says Coutinho. Bacteria released during abortions
    end up in manure, which is often spread onto farm fields; the wind may
    have carried them to the many surrounding towns and cities.

    But Hendrik-Jan Roest, a scientist at the Central Veterinary Institute
    of Wageningen UR in Lelystad, says the sudden increase could be linked
    to a more virulent subtype of the microbe that started spreading in
    about 2005. Genetic typing by Corne Klaassen at Canisius Wilhelmina
    Hospital in Nijmegen has shown that all Dutch farms and patients are
    infected by a single subtype of _C. burnetii_. That suggests that the
    strain is somehow better at propagating itself than others, Roest
    says. He plans to compare strains in a collaborative study with Annie
    Rodolakis of the French National Institute for Agricultural Research
    in Tours, who has developed a mouse model of Q fever.

    A more urgent question is how to bring the outbreak under control. In
    2008, veterinary and public health authorities hoped that hygienic
    measures, such as a ban on distributing manure on farm fields, would
    help reduce human exposure. Now, the hope is that an animal vaccine
    produced by CEVA, a French company, can help bring the microbe under
    control. In short supply in 2008 and 2009, the vaccine will be
    plentiful this year [2010], says Christianne Bruschke, chief
    veterinary officer at the agriculture ministry. The vaccine does not
    prevent all infections, but it does prevent most abortions, which
    should help curtail the spread of the disease. The vaccine does not
    work in infected animals, however, which is why an expert panel
    recommended in early December [2009] the emergency slaughter of all
    pregnant goats at affected farms. (There is no reliable way to quickly
    distinguish infected goats from healthy goats.) Bruschke says the cull
    is a one-time measure to prevent another massive release of microbes
    in the spring of 2010, when the goats would normally give birth. Then
    from 2011 on, the effects of the vaccine should start kicking in.

    The impact on some farmers could be devastating, says Van Lokven. The
    Dutch government reimburses farmers for the current value of the goats
    but doesn’t do so for the loss of income while they rebuild their
    flocks. How well the measure will work is unclear as well. The huge
    numbers of _C. burnetii_ already in the environment may persist for
    months or years; there is no good way to measure their numbers or to
    assess the threat they pose, says Roest. And there are many other
    questions. Although there is little doubt that goat farms are key
    amplifiers in the current outbreak, the role of cattle farms is unclear.

    For now, most experts say another surge of human cases this spring
    [2010] is inevitable — they just hope it will be smaller than that of

    http://www.sciencemag.org/cgi/content/summary/sci;327/5963/266-b&#8221; onclick=”window.open(this.href);return false

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