{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T05:00:48Z","timestamp":1761541248840},"reference-count":26,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2015,7,27]],"date-time":"2015-07-27T00:00:00Z","timestamp":1437955200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Zoonoses and Public Health"],"published-print":{"date-parts":[[2016,3]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Intensive animal farming could potentially lead to outbreaks of infectious diseases. Clinicians are at the forefront of detecting unusual diseases, but the lack of specificity of zoonotic disease symptoms makes this a challenging task. We evaluated patients with community\u2010acquired pneumonia (<jats:styled-content style=\"fixed-case\">CAP<\/jats:styled-content>) with known and unknown aetiology in an area with a high livestock density and a potential association with animal farms in the proximity. Between 2008 and 2009, a period coinciding with a large Q fever outbreak in the Netherlands, patients with <jats:styled-content style=\"fixed-case\">CAP<\/jats:styled-content> were tested for the presence of possible respiratory pathogens. The presence and number of farm animals within 1\u00a0km of the patients' home address were assessed using geographic information system (<jats:styled-content style=\"fixed-case\">GIS<\/jats:styled-content>) and were compared between cases and age\u2010matched control subjects. Of 408 patients with <jats:styled-content style=\"fixed-case\">CAP<\/jats:styled-content>, pathogens were detected in 275 (67.4%) patients. The presence of sheep and the number of goats were associated with <jats:styled-content style=\"fixed-case\">CAP<\/jats:styled-content> caused by <jats:italic>Coxiella burnetii<\/jats:italic> in a multiple logistic regression model (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05). <jats:styled-content style=\"fixed-case\">CAP<\/jats:styled-content> with unknown aetiology was not associated with the presence of animal farms (<jats:italic>P<\/jats:italic>\u00a0&gt;\u00a00.10). The use of <jats:styled-content style=\"fixed-case\">GIS<\/jats:styled-content> in combination with aetiology of <jats:styled-content style=\"fixed-case\">CAP<\/jats:styled-content> could be potentially used to target diagnostics and to identify outbreaks of rare zoonotic disease.<\/jats:p>","DOI":"10.1111\/zph.12218","type":"journal-article","created":{"date-parts":[[2015,7,27]],"date-time":"2015-07-27T12:23:51Z","timestamp":1437999831000},"page":"160-166","source":"Crossref","is-referenced-by-count":26,"title":["Evaluation of Patients with Community\u2010Acquired Pneumonia Caused by Zoonotic Pathogens in an Area with a High Density of Animal Farms"],"prefix":"10.1111","volume":"63","author":[{"given":"E. G. W.","family":"Huijskens","sequence":"first","affiliation":[{"name":"Department of Medical Microbiology Albert Schweitzer Hospital Dordrecht The Netherlands"},{"name":"Laboratory of Medical Microbiology and Immunology St. Elisabeth Hospital Tilburg The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L. A. M.","family":"Smit","sequence":"additional","affiliation":[{"name":"Division Environmental Epidemiology Institute for Risk Assessment Sciences Utrecht University Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. W. A.","family":"Rossen","sequence":"additional","affiliation":[{"name":"Laboratory of Medical Microbiology and Immunology St. Elisabeth Hospital Tilburg The Netherlands"},{"name":"Department of Medical Microbiology University Medical Center Groningen University of Groningen Groningen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Heederik","sequence":"additional","affiliation":[{"name":"Division Environmental Epidemiology Institute for Risk Assessment Sciences Utrecht University Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Koopmans","sequence":"additional","affiliation":[{"name":"Department of Virology Erasmus Medical Centre Rotterdam The Netherlands"},{"name":"National Institute of Public Health and the Environment Centre for Infectious Disease Control Bilthoven The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,7,27]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268811000409"},{"key":"e_1_2_7_3_1","first-page":"382","article-title":"Q fever in the Netherlands from 2007 to 2010","volume":"68","author":"Delsing C. 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