The Dutch Q fever situation - Lessons learned?

About 60 to 75% of the emerging infectious diseases are zoonotic. A special group of zoonotic diseases are these that are endemic but in a dormant state. A good example of such a disease is Q fever in the Netherlands. Before 2005, Q fever was known to be present in the human and animal populations but did not cause significant disease. This changed in 2005, when the first abortions in dairy goats were registered and in 2007 when the first human Q fever outbreak in the Netherlands was recorded. Between 2005 and 2009 abortions on 28 dairy goat farms and 2 dairy sheep farms were detected and between 2007 and 2010 about 4000 human cases were notified. This is recognised as the largest laboratory confirmed Q fever outbreak ever reported. To identify the cause of the human disease, genotyping of the causative Q fever agent Coxiella burnetii confirmed the epidemiological link between humans and dairy goats and sheep. Furthermore, an intergraded human-veterinary approach was needed to combat the outbreak. The need for such a One Health approach was also the conclusion of the official evaluation of the Q fever outbreak in the Netherlands. This resulted in a currently implemented national zoonosis structure with a signalling forum that meets monthly. This structure has already been helpful in assessing the human risk of the Schmallenberg virus outbreak