Land-Applied Goat Manure as a Source of Human QFever in the Netherlands, 2006–2010

C.M.L. Hermans, L.J.J. Jeurissen, V. Hackert, C. Hoebe

Research output: Contribution to journalArticleAcademicpeer-review

19 Citations (Scopus)


Studies have shown a link between Q-fever positive farms (QFPFs) and community cases of human Q-fever. Our study is the first to investigate the potential role of contaminated land-applied manure in human Q-fever, based on a large set of nationwide notification and farm management data. Time between manure application and disease onset in geographically linked notified human cases coincided with the incubation period of Q-fever. Proximity of contaminated land parcels predicted human cases better than proximity of QFPFs (80% vs. 58%, 0–5 km in 2009). Incidence around QFPFs and contaminated land parcels decreased with distance, but not around non-contaminated land parcels. Incidence was higher around contaminated land parcels than non-contaminated land parcels (RR = [10],95%CI = [7], [1]–[14,2]). Our findings deliver evidence that, apart from QFPFs, land-applied contaminated manure may be another source of human Q-fever.
Original languageEnglish
Article numbere96607
Number of pages9
JournalPLoS ONE
Issue number5
Publication statusPublished - 2014


  • coxiella-burnetii
  • infection
  • epidemic
  • outbreak

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