Human vaccination against Q fever; first advisory report

Q fever is a zoonotic disease (i.e. a disease that can be transmitted from animals to humans) caused by the Coxiella burnetii bacterium (C. burnetii).
For humans infected by C. burnetii, more than 60 percent of the cases are asymptomatic. A distinction is made, in the case of those that do fall ill, between acute Q fever, most commonly manifested as flu-like symptoms, sometimes accompanied by pneumonia and hepatitis, and the far less common chronic Q fever, which predominantly manifests itself as endocarditis (inflammation of the tissue lining the inner layer of the heart chambers and the heart valves). Generally speaking, acute Q fever is a self-limiting disease, but research shows that forty percent of patients still experience health problems and/or impairments a year after first contracting the disease. Chronic Q fever occurs more frequently in individuals with underlying conditions, such as (hidden) heart valve defects.
Q fever cannot be diagnosed on purely clinical grounds. Diagnostic tests are used to confirm suspected cases. It is far from easy to interpret the results of such tests, or to do so on objective grounds. It is also hard to distinguish between acute and chronic Q fever on the basis of these tests.

Committee

• Prof. E.J. Ruitenberg, Emeritus professor of immunology, University of Utrecht; Professor of international health, VU, Amsterdam, chair
• Prof. J.G. Aarnoudse, Professor of obstetrics en gynaecology, University Medical Center Groningen
• M. Augustijn, Ministry of Agriculture, Nature and Food Quality, The Hague, observer
• Prof. C. Boog, Professor of infectious diseases & immunology, University of Utrecht, Nederlands Vaccin Instituut, Bilthoven
• Prof. W.J.H.M. van den Bosch, Professor of healthcare innovation, University Medical Center St. Radboud, Nijmegen
• Prof. A. Brand, Professor of transfusion medicine, Leiden University Medical Centrum
• Prof. E. Hak, Professor of clinical pharmacoepidemiology, University Medical Center Groningen
• Prof. J.A.P. Heesterbeek, Professor of theoretical epidemiology, University of Utrecht
• W. van der Hoek, Physician-epidemiologist, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven
• Dr H. Houweling, Physician-epidemiologist, Health Council of the Netherlands, The Hague, adviser
• M.M. Kraaij-Dirkzwager, Ministry of Health, Welfare and Sport, The Hague, observer
• Prof. J.W.M. van der Meer, Professor of internal medicine, University Medical Center St. Radboud, Nijmegen
• Dr J.H. Ovelgönne, Medicines Evaluation Board, The Hague, adviser
• Dr P. Schneeberger, Medical microbiologist, Jeroen Bosch hospital, Den Bosch
• Prof. H.A. Verbrugh, Professor of medical microbiology, Erasmus MC, Rotterdam
• Dr M.F. Verweij, Ethicist, Ethics Institute, University Utrecht
• Prof. H.L. Zaaijer, Clinical microbiologist, Academic Medical Center, Sanquin Blood Supply Foundation, Amsterdam, adviser
• F.G. van Zijderveld, Bacteriology, Central Veterinary Institute, Wageningen
• Dr K. Groeneveld, Medical immunologist, Health Council of the Netherlands, The Hague, scientific secretary
• Dr R. van Houdt, Molecular epidemiologist, Health Council of the Netherlands, The Hague, scientific secretary