Volume 26, Number 2—February 2020
Cost-effectiveness of Screening Program for Chronic Q Fever, the Netherlands
|Area of residence|
|High incidence||>50 acute QF notifications/100,000 inhabitants and >2 acute QF notifications OR presence of a farm with QF abortion waves† within a 5-km range during the epidemic period.|
|Middle incidence||10–49 acute QF notifications/100,000 inhabitants and >2 acute QF notifications OR presence of a farm that tested positive in the mandatory bulk tank milk monitoring initiated during the QF epidemic.|
||<10 acute QF notifications/100,000 inhabitants OR <2 notifications during the epidemic period.
|Preexisting risk factor|
|Diagnosed cardiovascular risk factor||Heart valve disorder (all types of defects), heart valve prosthesis, aortic aneurysm, prosthesis/stent, history of endocarditis and congenital heart anomalies.|
|Immunocompromised patients||HIV infection, asplenia, spleen disorder, malignancy or bone marrow transplantation, and patients using immunosuppressant drugs. As proxy for patients using immunosuppressant drugs, prevalence data were used of rheumatoid arthritis patients and patients with inflammatory bowel disease, assuming these patients frequently use immunosuppressant medication.|
|Unknown, >60 y||Age >60 y AND no or undiagnosed cardiovascular risk factor, e.g., heart valve disorder, aortic aneurysm.|
|Unknown 18–59 y||Age 18–59 y AND no or undiagnosed cardiovascular risk factor, e.g., heart valve disorder, aortic aneurysm.|
*The epidemic period was 2007–2010. QF, Q fever.
†Abortion of >5% of pregnant goats in a farm over a 4-week period.