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Risk Factors for Q Fever in the Netherlands
By Mr. Thijs Veenstra , Dr. Bianca E Snijders , Ms. Barbara Schimmer , Mrs. Ariene Rietveld , Ms. Sandra Van Dam , Dr. Peter M Schneeberger , Ms. Frederika Dijkstra , Dr. Marianne A Van Der Sande , Mr. Wim Van Der Hoek
Submited on: 01 Jul 2011 12:22:20 PM GMT
Published on: 02 Jul 2011 01:55:49 PM GMT
 
Risk factors for Q fever in the Netherlands
Posted by Dr. Anja Brandsen-Schreijer on 05 Dec 2011 12:22:35 PM GMT

1 Is the subject of the article within the scope of the subject category? Yes
2 Are the interpretations / conclusions sound and justified by the data? Partly
3 Is this a new and original contribution? Yes
4 Does this paper exemplify an awareness of other research on the topic? Yes
5 Are structure and length satisfactory? Yes
6 Can you suggest brief additions or amendments or an introductory statement that will increase the value of this paper for an international audience? No
7 Can you suggest any reductions in the paper, or deletions of parts? No
8 Is the quality of the diction satisfactory? Yes
9 Are the illustrations and tables necessary and acceptable? Yes
10 Are the references adequate and are they all necessary? Yes
11 Are the keywords and abstract or summary informative? Yes
  • Other Comments:

    This is a well written article on the largest Q fever outbreak ever described. It is one of first studies into Q fever outbreak in the Netherlands that included a control group. However, I have some concerns about the methods that were uses for the selection of the controls (some of them are accounted for in the discussion by the authors):

    -          Cases were included from May 1st till June 30th whereas controls were included around the 30th May (in 4 weeks). Possibly, differences in the weather could have influenced outdoor activities and therefore partly explain differences in outdoor activities between cases and controls.

    -          Controls who regularly undertake outdoor activities could also have been more at risk for Q fever before the study period and could have experienced Q fever (asymptomatically) and be immune. 

    -          Controls were not serologically tested and could be falsely assigned to the control group.

    -          Controls were invited to participate by advertisement in the news paper. Possibly the subscribers of this newspaper do not reflect the source population.

    -          Also, people who are more concerned with health, such as health care workers, are more likely to participate and respond to a call in a news paper.

    Furthermore, the response rate among cases was 18%. This could have affected the results in several ways.

    Overall the study gives an important contribution to identification of risk factors for Q fever.

  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    MD, PhD in the field of Public Health, Communicable Disease Control

  • How to cite:  Brandsen-Schreijer A .Risk factors for Q fever in the Netherlands[Review of the article 'Risk Factors for Q Fever in the Netherlands ' by Van Der Hoek W].WebmedCentral 2011;2(12):WMCRW001204
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Risk Factors for Q Fever in the Netherlands
Posted by Dr. Thomas Herchline on 11 Oct 2011 12:34:27 AM GMT

1 Is the subject of the article within the scope of the subject category? Yes
2 Are the interpretations / conclusions sound and justified by the data? Partly
3 Is this a new and original contribution? Yes
4 Does this paper exemplify an awareness of other research on the topic? Yes
5 Are structure and length satisfactory? Yes
6 Can you suggest brief additions or amendments or an introductory statement that will increase the value of this paper for an international audience? No
7 Can you suggest any reductions in the paper, or deletions of parts? No
8 Is the quality of the diction satisfactory? Yes
9 Are the illustrations and tables necessary and acceptable? Yes
10 Are the references adequate and are they all necessary? Yes
11 Are the keywords and abstract or summary informative? Yes
  • Other Comments:

    There is evidence that the control group was not well-matched for the cases; there was a much higher percentage of females and healthcare workers in the control group than the general population. In addition, there was no testing of the control group to exclude recent (or remote) Q fever. The finding that contact with animal or farm waste products or having visited nature areas seemed to have a protective effect implies that individuals in the control group may have had remote and/or asymptomatic infection.

     

    The study confirms an increased risk for smokers and those leaving nearest an affected goat farm; both have been identified as risk factors in other studies. The possible protective effect of contact with animal or farm waste products or having visited nature areas needs to be confirmed in other studies.

     

  • Competing interests:
    None
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    Infectious Diseases Physician

  • How to cite:  Herchline T .Risk Factors for Q Fever in the Netherlands[Review of the article 'Risk Factors for Q Fever in the Netherlands ' by Van Der Hoek W].WebmedCentral 2011;2(10):WMCRW001002
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