Q-fever is killing more people than Mexican flu

Some experts say Q-fever, which has already killed five people in the Netherlands, is not getting enough attention compared to the Mexican flu.

The Mexican flu has so far killed two people in the Netherlands. Q-fever has killed five, but it is getting nothing near the media attention that the Mexican flu has attracted.

Some experts think the silence about Q-fever, which can cause permanent heart problems, is misguided. "It is almost as if it is being hushed up to protect the agricultural and tourism industries," said retired professor of medicine Ton Maassen. "There should be transparent communication about this, especially for people who have a low resistance because they are hiv-positive or have recently undergone chemotherapy."

No more cycling

Maassen himself has given up on bicycle trips in the countryside of North Brabant, a province in the south of the Netherlands. North Brabant has a high concentration of sheep and goat farms, which the authorities say are the source of Q-fever. The disease first surfaced in 2007, but the agriculture ministry said it won't know exactly which farms are infected before the end of this year.

There are no plans to exterminate entire farms as was done for diseases like classic swine fever or foot and mouth disease. Neither will the ministry name the infected farms, said Peter de Leeuw, the chief veterinary officer at the ministry. Instead the farmers themselves will be asked to present a plan for making their farms disease-free.

Why is the approach to Q-fever so much more cautious than in the case of other animal diseases? One reason is that not a whole lot is known about the disease.

"It has still not been established beyond doubt what causes it," said Peter Schneeberger, a microbiologist at the Jeroen Bosch hospital in Den Bosch, which recently opened a special polyclinic for Q-fever. Schneeberger: "It's not even 100 percent certain that it comes from goats. The only thing we know for sure is that is caused by a bacteria, Coxiella burnetii, and that it is airborn."

Spores of the bacteria can survive for a long time and can be carried by the wind. Because of its persistency, the US Center for Disease Control and Prevention has called it a possible means of biological warfare or terror.

Millions of farm animals

Schneeberger feels the official approach is slow and underestimates the public health implications of Q-fever because animal diseases resort under the agriculture ministry. "Their main concern is to protect the agricultural industry."

The 'industry' means the millions of pigs, chickens, cows and goats that are kept in the Netherlands. Schneeberger said the fact that the Netherlands has seen an outbreak of Q-fever is directly related to the size of the lifestock industry.

Until now the only indication of the presence of Q-fever at a farm has been an unusually high number of spontaneous miscarriages among goat or sheep. This would prompt an inspection of the farm in question. "But we know there must be many infected farms out there that we don't know about," said Van Steenbergen.

It is hoped that a new test, in which the milk coming from farms is tested for traces of the bacteria, will lead to the discovery of as many as a hundred more farms. The ministry hopes to counter the disease through compulsory vaccination, the controlled processing of manure and checks on animal transports.