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 = ,95%CI = , –[14,2]). Our findings deliver evidence that, apart from QFPFs, land-applied contaminated manure may be another source of human Q-fever.
Hermans, C. M. L., Jeurissen, L. J. J., Hackert, V., & Hoebe, C. (2014). Land-Applied Goat Manure as a Source of Human QFever in the Netherlands, 2006–2010. PLoS ONE, 9(5), [e96607]. https://doi.org/10.1371/journal.pone.0096607