• A case-control study into risk factors for acute hepatitis E in the Netherlands, 2015-2017.

      Tulen, Anna Dolores; Vennema, Harry; van Pelt, Wilfrid; Franz, Eelco; Hofhuis, Agnetha (2019-02-08)
      A case-control study was performed (2015-2017) to identify risk factors for acute hepatitis E in the Netherlands. A questionnaire on potential sources of hepatitis E virus (HEV) exposure, health and socio-demographics was completed by 376 patients with acute hepatitis E, and 1534 controls matched for age, gender and region of residence. Traditional Dutch dry raw sausages of pork muscle meat, called "cervelaat", "snijworst", and "boerenmetworst" were reported by 72% of the patients, and 46% of controls (aOR 3.0; 95%CI 2.2-4.1), with a population attributable fraction (PAF) of 48%. Direct contact with pigs and working with a septic tank were strong risk factors (aOR 3.1; 95%CI 1.3-7.3 and aOR 6.9; 95%CI 1.2-40.8, respectively), with a low PAF (2% and 1%, respectively). Host risk factors were pre-existing liver disease (aOR 3.8; 95%CI 2.0-7.1), diabetes (aOR 2.1; 95%CI 1.4-3.2), immunosuppressive medication (aOR 2.5; 95%CI 1.5-4.1), and gastric acid inhibitors (aOR 2.3; 95%CI 1.7-3.1). Dry raw pork sausages were the major source of HEV infection among our study population. The prevalence and cause of HEV contamination in these pork muscle meat products require further investigation. Infrequently reported, yet strong risk factors were contact with pigs, or a septic tank.
    • Coxiella burnetii (Q fever) prevalence in associated populations of humans and small ruminants in The Gambia.

      Bok, Jeroen; Hogerwerf, Lenny; Germeraad, Eveline A; Roest, Hendrik I J; Faye-Joof, Tisbeh; Jeng, Momodou; Nwakanma, Davis; Secka, Arss; Stegeman, Arjan; Goossens, Bart; et al. (2017)
      To simultaneously estimate the prevalence of antibodies against Coxiella burnetii (Q fever) among adults and small ruminants, and C. burnetii shedding prevalence among small ruminants in households in the Kiang West district of The Gambia, and to assess associated risk factors.
    • Temporal and spatial analysis of psittacosis in association with poultry farming in the Netherlands, 2000-2015.

      Hogerwerf, Lenny; Holstege, Manon M C; Benincà, Elisa; Dijkstra, Frederika; van der Hoek, Wim (2017-07-26)
      Human psittacosis is a highly under diagnosed zoonotic disease, commonly linked to psittacine birds. Psittacosis in birds, also known as avian chlamydiosis, is endemic in poultry, but the risk for people living close to poultry farms is unknown. Therefore, our study aimed to explore the temporal and spatial patterns of human psittacosis infections and identify possible associations with poultry farming in the Netherlands.