Q fever. The present situation in Germany and the Netherlands.

Q fever is a zoonotic infection caused by the obligate intracellular bacterium Coxiella burnetii. The infection occurs in cattle herds, sheep and goat flocks in nearly all parts of Germany. Moreover, wildlife populations can form a reservoir for C. burnetii. From 2000 to 2009, Q fever infections were notified for 1,333 animal holdings in Germany. For the year 2009, the Robert Koch-Institut received notifications on 191 confirmed human cases of Q fever In the course of an ongoing Q fever epidemic in the Netherlands which started in 2007, a total of 2,357 human cases was reported for 2009. Six persons who died in 2009 as a result of Q fever infections, were known to suffer from other health problems which were able to facilitate a severe course of the disease. A large proportion of the human cases occurred in the south of the Netherlands in the province of North Brabant. It is believed that the outbreak has been primarily caused by infected animals in dairy goat farms. As part of control measures which started in 2009, mandatory vaccination of sheep and goats against Q fever was planned. However, due to shortage of vaccine, not all animals could he immunised. In December 2009, the killing of all male and pregnant female animals in flocks with proven Q fever-infections was decreed (appr. 64,000 animals). Surviving female animals from the affected farms are banned from breeding for the rest of their lives. A full ban was imposed on the transportation of dairy goats and dairy sheep except for fattening and slaughter.