- This outbreak and the epidemiology of it will need careful
investigation. IS it naturally - occurring or is something else going on...?
This suspiciously comses right on the heels of the FMD outbreak.
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- Patty
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- BBC News
- 9-21-7
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- An outbreak of a rare illness called Q fever, which is
caught from infected livestock, is being investigated in the Cheltenham
area of Gloucestershire. A total of 28 cases have been identified among
local people, most requiring hospital treatment. Victims can suffer severe
pnuemonia while others show no ill effects. Some people recover without
treatment. The infection is often caught by close contact with farm animals
but it can be also be blown through the air. A team led by the Health Protection
Agency is looking at how residents may have caught the infection. Epidemiologist
Dr Deirdre Lewis said: "Q fever is generally a mild infection but
we know that it can cause complications, so we've been keen to look into
this as thoroughly as we can. We've not had any reported cases of Q fever
in Gloucestershire residents since 2002, so seeing 28, mostly from the
Cheltenham area, is unusual." The evidence so far points to the period
of risk being more than 3 months ago. Most of the patients, who are aged
between 40 and 70, are said to be recovering well after falling ill earlier
in the summer. Q, standing for Query, fever, was so called originally because
for many years its cause was unknown. It tends to be more common around
the lambing season, although it can occur at any time of year. "I
appreciate that news of this outbreak will surprise some local people,"
said Dr Lewis. "They can be reassured that we're working hard to investigate
it." An outbreak of Q fever in Solihull in 1989 led to 147 human cases.
Researchers have suggested that it was caused by a combination of outdoor
lambing and calving and particular weather conditions leading to the infective
organism being blown several miles to populated areas.
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- http://news.bbc.co.uk/1/hi/england/gloucestershire/7004615.stm
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- ProMed Mail -
- ProMED-mail previously posted regarding the early part
of this outbreak [Q fever - UK (England): alert, RFI 20070723.2367].
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- _Coxiella burnetii_, the causative agent, was discovered
in 1937. This organism is an agent that can be resistant to heat and desiccation,
and is highly infectious by the aerosol route. A single inhaled organism
may produce clinical illness. Indeed, in [non-human] primates, the dose
to kill 50 per cent of the primates was found to be 1.7 organisms (1).
Cattle, sheep, and goats are the primary reservoirs of _C. burnetii_. Infection
has been noted in a wide variety of other animals, including other species
of livestock and in domesticated pets. _C. burnetii_ does not usually cause
clinical disease in these animals, although abortion in goats and sheep
has been linked to _C. burnetii_ infection. Organisms are excreted in milk,
urine, and feces of infected animals. Most importantly, during birthing
the organisms are shed in high numbers within the amniotic fluids and the
placenta. Contact with contaminated wool is known to be a mode of transmission
(2). The organisms can be resistant to heat, drying, and many common disinfectants.
These features enable the bacteria to survive for long periods in the environment.
This very stable form of _C. burnetii_ is associated with compact small
cell variants of the organism that are produced during standard replication
along with the less resistant large cell form, metabolically dormant, and
spore-like (3). Infection of humans usually occurs by inhalation of these
organisms from air that contains airborne barnyard dust contaminated by
dried placental material, birth fluids, and excreta of infected herd animals.
Humans are often very susceptible to the disease, and very few organisms
may be required to cause infection. Ingestion of contaminated milk, followed
by regurgitation and inspiration of the contaminated food, is a less common
mode of transmission. Other modes of transmission to humans, including
tick bites and human-to-human transmission, are rare. 1. Lille RD, Perrin
TL, Armstrong C. An institutional outbreak of pneumonitis. III. Histopathology
in man and rhesus monkeys in the pneumonitis due to the virus of "Q
fever." Pub Hlth Rep 1941; 56: 1419-25. 2. Maurin M, Raoult D. Q fever.
Clin Microbiol Rev 1999; 12: 518-53. 3. Norlander L. Q fever epidemiology
and pathogenesis. Microbes Infect 2000; 2: 417-24. Cheltenham is in the
west of England, in Gloucestershire, and can be found on a map at <http://en.wikipedia.org/wiki/Cheltenham.
More information is needed to assess how these individuals acquired this
airborne infection, which can spread over at least 1/2 mile. - Mod.LL]
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- Patricia A. Doyle DVM, PhD
- Bus Admin, Tropical Agricultural Economics
- Univ of West Indies
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- Please visit my "Emerging Diseases" message
board at:
- http://www.emergingdisease.org/phpbb/index.php
- Also my new website: http://drpdoyle.tripod.com/
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- Zhan le Devlesa tai sastimasa
- Go with God and in Good Health
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