A systematic knowledge synthesis on the spatial dimensions of Q fever epidemics.
Myrna M T De RooijJeroen P G Van LeukenArno SwartMirjam E E KretzschmarMirjam NielenAline A De KoeijerIngmar JanseInge M WoutersDick J J HeederikPublished in: Zoonoses and public health (2018)
From 2007 through 2010, the Netherlands experienced the largest Q fever epidemic ever reported. This study integrates the outcomes of a multidisciplinary research programme on spatial airborne transmission of Coxiella burnetii and reflects these outcomes in relation to other scientific Q fever studies worldwide. We have identified lessons learned and remaining knowledge gaps. This synthesis was structured according to the four steps of quantitative microbial risk assessment (QMRA): (a) Rapid source identification was improved by newly developed techniques using mathematical disease modelling; (b) source characterization efforts improved knowledge but did not provide accurate C. burnetii emission patterns; (c) ambient air sampling, dispersion and spatial modelling promoted exposure assessment; and (d) risk characterization was enabled by applying refined dose-response analyses. The results may support proper and timely risk assessment and risk management during future outbreaks, provided that accurate and structured data are available and exchanged readily between responsible actors.
Keyphrases
- risk assessment
- healthcare
- particulate matter
- high resolution
- human health
- air pollution
- heavy metals
- quality improvement
- microbial community
- randomized controlled trial
- machine learning
- current status
- electronic health record
- skeletal muscle
- infectious diseases
- glycemic control
- deep learning
- quantum dots
- weight loss
- breast cancer risk