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This article is part of the supplement: International Conference on Prevention & Infection Control (ICPIC 2011)

Open Access Poster presentation

Q-fever and delivery: a risky business?

M Nabuurs-Franssen1*, J Munster2, C Delsing3, J Tilburg1, L Groen4, C Klaassen1, A Leenders4, S Wennekes1 and A Voss1

  • * Corresponding author: M Nabuurs-Franssen

Author Affiliations

1 Canisius Wilhelmina hospital, Nijmegen, Netherlands

2 University Medical Center Groningen, Groningen, Netherlands

3 Radboud University Nijmegen Medical Center, Nijmegen, Netherlands

4 Jeroen bosch hospital, Den Bosch, Netherlands

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BMC Proceedings 2011, 5(Suppl 6):P289  doi:10.1186/1753-6561-5-S6-P289

The electronic version of this article is the complete one and can be found online at: http://www.biomedcentral.com/1753-6561/5/S6/P289


Published:29 June 2011

© 2011 Nabuurs-Franssen et al; licensee BioMed Central Ltd.

This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Introduction / objectives

Since 2007, the Netherlands is facing a large ongoing Q-fever outbreak with > 4000 cases of acute Q-fever reported. Q-fever is a zoonotic disease with (almost) only animal-to-human transmission. Pregnant women with Q-fever develop placentitis with highly infectious birth-products which may result in human-to-human transmission during delivery. In the absence of guidelines, a Q-fever protocol was developed and prospectively evaluated.

Methods

All pregnant women with Q-fever were included. All were treated with antibiotics. During delivery strict isolation measures were taken. After delivery the room was cleaned, ventilated and strict isolation ended. A combination of contact- and droplet-isolation during personal hygiene of the mother was continued as lochia may still be infectious.

Results

In total 11 women were identified. All gave birth to healthy babies. Q-fever PCR on birth-products and umbilical blood were negative except for one case who received inadequate antimicrobial treatment. All babies had maternal antibodies which disappeared over time. Breast milk was found PCR negative; therefore breastfeeding was allowed. No human-to-human transmission (no clinical cases of Q-fever) occurred during these deliveries.

Conclusion

While the combination of antibiotic treatment and strict isolation measures during delivery was effective in preventing human-to-human transmission in our cohort, the psychological burden of the measures for the patients and their family was extremely high. Effective antibiotic treatment seems to eliminate the bacterial load of human birth products, but isolation measures should be continued until our findings are confirmed in a higher number of cases.

Disclosure of interest

None declared.