Q fever in the Netherlands: public perceptions and behavioral responses in three different epidemiological regions: a follow-up study

Abstract

BackgroundOver the past years, Q fever has become a major public health problem in the Netherlands, with a peak of 2,357 human cases in 2009. In the first instance, Q fever was mainly a local problem of one province with a high density of large dairy goat farms, but in 2009 an alarming increase of Q fever cases was observed in adjacent provinces. The aim of this study was to identify trends over time and regional differences in public perceptions and behaviors, as well as predictors of preventive behavior regarding Q fever.MethodsOne cross-sectional survey (2009) and two follow-up surveys (2010, 2012) were performed. Adults, aged ≥18 years, that participated in a representative internet panel were invited (survey 1, n = 1347; survey 2, n = 1249; survey 3, n = 1030).ResultsOverall, public perceptions and behaviors regarding Q fever were consistent with the trends over time in the numbers of new human Q fever cases in different epidemiological regions and the amount of media attention focused on Q fever in the Netherlands. However, there were remarkably low levels of perceived vulnerability and perceived anxiety, particularly in the region of highest incidence, where three-quarters of the total cases occurred in 2009. Predictors of preventive behavior were being female, older aged, having Q fever themselves or someone in their household, more knowledge, and higher levels of perceived severity, anxiety and (self-) efficacy.ConclusionsDuring future outbreaks of (zoonotic) infectious diseases, it will be important to instil a realistic sense of vulnerability by providing the public with accurate information on the risk of becoming infected. This should be given in addition to information about the severity of the disease, the efficacy of measures, and instructions for minimising infection risk with appropriate, feasible preventative measures. Furthermore, public information should be adapted to regional circumstances.

Epidemiological characteristics of the most common zoonoses in the central Banat district of Vojvodina from 2002 to 2016

“…In accordance with this, we believe that the aforementioned modes of transmission were presented in the majority of patients in our study. Findings of other authors across European countries also confirmed these observations [45].…”

Risk perception regarding the COVID-19 outbreak among the general population: a comparative Middle East survey

“…The second section was the “Standard questionnaire on risk perception of an infectious disease outbreak,” which was designed by the Municipal Public Health Service Rotterdam-Rijnmond, together with the National Institute for Public Health and the Environment in the Netherlands [ 32 ]. This tool was designed to study risk perceptions associated with the outbreak of infectious disease and has been used in many previous studies [ 33 , 34 ]. The generic questionnaire was tailored to address COVID-19 and was then translated into Arabic, which is the predominant language of the study sample in the chosen countries.…”

A Q fever cluster among workers at an abattoir in south-western Sydney, Australia, 2015

“…An outbreak in the Netherlands in 2007–2010 was thought to be associated with intensive dairy goat farming that reported an increased number of abortions in the years before the first human cases. ( 17 , 18 ) Cases were found to be residing within close proximity to the farms (5 km radius) that were thought to be the primary source of infection precipitated by the dry weather aerosolizing C. burnetti . ( 17 , 19 , 20 ) This demonstrates the necessity for surveillance and active case finding in the area surrounding an abattoir.…”

“…( 17 , 18 ) Cases were found to be residing within close proximity to the farms (5 km radius) that were thought to be the primary source of infection precipitated by the dry weather aerosolizing C. burnetti . ( 17 , 19 , 20 ) This demonstrates the necessity for surveillance and active case finding in the area surrounding an abattoir. It is important to note that only looking for symptomatic cases may grossly underestimate the number of exposures associated with an outbreak as was demonstrated by the Dutch experience.…”