Date: Wed 19 Sep 2012
From: Marcella Mori <Marcella.Mori@coda-cerva.be> [edited]

On Mon 20 Aug 2012, the Veterinary and Agrochemical Research Centre in Brussels (CODA-CERVA) was contacted by the official Health Inspectorate (Control of infectious diseases) of the Walloon region to investigate an outbreak of leptospirosis in boys attending a scout camp. The camp was located on the banks of the Semois River, in the province of Luxembourg. 10 out of 25 boys participating developed clinical symptoms. The diagnosis of leptospirosis was confirmed by the microscopic agglutination test (MAT) in the 3 boys that were hospitalized.

Contamination from an infected wildlife reservoir was immediately suspected because boy-scouts deemed to have played with a rat, most probably a muskrat considering the dimensions (information is scarce due to the discomfort of the patients). On site investigations were conducted by CODA-CERVA in association with the environmental unit of the Walloon region to collect water samples and muskrats. Animals were captured from 2 nests in the vicinity of the scout camp.

Pathogenic _Leptospira_ spp. was found in the liver and kidney of these animals and antibodies against _Leptospira_ were demonstrated by MAT in the body fluids. Water samples were negative, which could be explained by the absence of stagnant water. The definitive link between the human infections and the infected animals requires further investigations.

Leptospirosis is a pandemic zoonosis and may affect various species, including domestic animals and humans. The natural hosts are wild animals particularly rats where the pathogenicity is not manifested but whose role is expressed as carriers. Those animals are important determinants for leptospirosis and their control can positively impact the wellness at veterinary and public health levels.

In Belgium, leptospirosis is present in domestic animals (particularly dogs and horses) but it is infrequent in humans. The human cases are the result of direct contact with animal reservoirs or contaminated water sources in Belgium or result from recreational activities in (sub)tropical regions.

Combination of both climate change and increased uncontrolled water sports is certainly playing a role in driving favorable conditions for leptospirosis spreading worldwide. Under beneficial weather conditions the rodent population is growing fast. These premises suggest rodent surveillance programs to complement the control of leptospirosis, particularly in regions with opportunities for water sports and recreation.
-------------------------------
Dr Marcella Mori
Dr David Fretin
Belgian Reference Laboratory for Leptospirosis in animals
CODA-CERVA, Brussels

Dr Sylvia Depoorter
Pediatrics Department in AZ-Sint Jan, Brugge

Dr Marjan Van Esbroeck
Belgian Reference Laboratory for Leptospirosis in humans
Institute of Tropical Medicine, Antwerp

Dr Carole Schirvel
Directeur Generale de la Sante,
Direction Surveillance et Protection de la Sante
Federation Wallonie-Bruxelles
Belgium
================
[ProMED very much appreciates this outbreak report direct from the Belgium authorities. It serves as a warning to people who operate campsites that may be contaminated with bat guano in any country. - ProMed Mod.JW]

[Leptospirosis is a zoonotic spirochetal infection that is distributed throughout the world in warm climates and is transmitted to humans by direct contact of abraded skin or mucous membranes with the urine of infected animals or by contact with wet soil, vegetation, or water that has been contaminated with infected animal urine. These animals are mostly asymptomatic, but chronically infected with one of the several hundred serovars of pathogenic _Leptospira_. Different leptospiral serovars are prevalent in particular geographical regions. In carrier animals with chronic renal infections, leptospiruria persists for long periods or for life. _Leptospira_ bacteria shed in urine may survive in water or moist soil for weeks to months. Many species of wild and domestic animals (including dogs, cattle, swine, and especially rodents) are susceptible to chronic urinary infection with pathogenic leptospira. Outbreaks of leptospirosis frequently follow heavy rainfall, flooding with fresh water, and increasing rodent numbers.

Leptospirosis is an occupational hazard for people who work outdoors or with animals -- for example, farmers, sewer workers, veterinarians, dairy farmers, rice and sugarcane field workers, and military personnel. It is a recreational hazard for those who participate in outdoor water sports such as swimming, rowing, or whitewater rafting in contaminated lakes and rivers.

Because of the relatively nonspecific nature of the clinical presentation of leptospirosis, its diagnosis cannot be made confidently without laboratory confirmation. The United States Centers for Disease Control and Prevention can provide _Leptospira_ Dip-S-Tick (DST) IgM dot-ELISA test kits (PanBio Integrated Diagnostics) to local laboratories for serological testing of suspected leptospirosis cases in support of the response to a disaster. The DST is suitable for in-the-field testing of suspected patients. Confirmatory testing uses the microscopic agglutination test (MAT).

The muskrat, the apparent wildlife reservoir for this leptospirosis outbreak in Belgian boy scouts, is a medium-sized semiaquatic rodent (<http://en.wikipedia.org/wiki/Muskrat>).

Belgium is a federal state with 3 regions: the Brussels-Capital Region, the Dutch-speaking region of Flanders in the north, and the landlocked French-speaking region of Wallonia in the south (for a map showing these 3 regions of Belgium, see <http://ssy.org.uk/wp-content/uploads/2010/04/belgium.gif>.) Wallonia consists of the provinces of Walloon Brabant, Hainaut, Liege, Luxembourg, and Namur (<http://www.yurtdisiegitimim.net/sites/default/files/belgium_regions_map.jpg>). The source of the Semois River, where this leptospirosis outbreak occurred, is in the province of Luxembourg, close to the border with the Grand Duchy of Luxembourg; it flows westerly to France and joins the Meuse River (<http://en.wikipedia.org/wiki/Semois>). For a map of Semois River see <http://en.wikipedia.org/wiki/File:KaartSemois.jpg>.

The HealthMap/ProMED-mail interactive map of Belgium is available at
<http://healthmap.org/r/3wCR>. - ProMed Mod.ML]

[Muskrat photo at:
<http://upload.wikimedia.org/wikipedia/commons/0/00/Muskrat_swimming_Ottawa.jpg>. - ProMed Mod.JW]
Date: Wed 17 Aug 2011
Source: Wort.lu/Luxembourg [edited]
<http://www.wort.lu/wort/web/en/luxembourg/articles/2011/08/158878/index.php>
----------------------------------
A [bacterium] which could prove fatal to certain livestock has been found in 2 goat farms in Luxembourg.

Luxembourg's veterinary services has conducted regular tests in goat farms in the Grand Duchy since the last outbreak of Q fever in Holland in 2009.

Today (Wed 17 Aug 2011) it announced that it had found 2 separate outbreaks in smallholdings in the country.

Since the discovery, emergency procedures have been carried out to prevent any further spread, by limiting access to the farms in question, and disposing correctly of animal by-products and dead livestock.

The animals have also been vaccinated and their milk pasteurised before being sold on the market.

Q fever is a disease caused by infection with the _Coxiella burnetii_ bacterium, which can affect humans and other animals. Infection occurs through inhaling the spores and from contact with milk, urine, or feces of infected animals.

It can cause miscarriages in livestock and, if transferred to humans, it causes flu-like symptoms. Contamination is not possible by eating infected animals alone. The incubation period of the bacterium is 9 to 40 days.
--------------------------------
Communicated by:
Sabine Zentis
Castleview Pedigree English Longhorns
Gut Laach
52385 Nideggen
Germany
<http://www.cvlonghorns.de>
cvlonghorns@aol.com
=================
[It may be assumed that the identification of Q fever in Luxembourg's goats does not mean a 1st introduction but reflects intensified surveillance. Has this been a clinical disease (abortions/milk contamination) or rather an odd positive serological finding?

The following information on the Q fever situation in Luxembourg is available in OIE's WAHID interface:
2007: never reported (0000), not notifiable
2008: never reported (0000), not notifiable
2009: confirmed infection (no clinical disease), not notifiable
2010: confirmed infection (no clinical disease), not notifiable.

It will be interesting to note if Q fever vaccination has been applied also in other (adjacent?) goat or sheep farms in Luxembourg. In case officially confirmed, a notification to the OIE may be expected. - ProMed Mod.AS]

[A HealthMap/ProMED-mail interactive map of Luxembourg can be seen at
<http://healthmap.org/r/19eN>. - ProMed Sr.Tech.Ed.MJ]
Date: Tue, 2 Jun 2009 12:14:45 +0200 (METDST)

LUXEMBOURG, June 2, 2009 (AFP) - Luxembourg has its first confirmed case of swine flu, the national health ministry announced on Tuesday.   "It concerns someone from the north of the country who had recently visited the United States of America (New York) and presented himself to his doctor on Monday afternoon with flu symptoms," the ministry said in a statement.   Analysis at the national health laboratory confirmed that he was suffering from Luxembourg's first case of the A(H1N1) virus which has claimed 115 deaths, mainly in Mexico.   The patient was said to be in good condition but remained isolated at home, the health services said.   The small land-locked Duchy thus joins its neighbours Belgium, France and Germany as countries which have identified swine flu victims.

Eurosurveillance, Volume 14, Issue 7, 19 February 2009
Full article and author information available at http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19121

In the last quarter of 2008, an outbreak of mumps occurred in Luxembourg affecting initially 10 young adults at a military centre. Following a mass vaccination campaign, no further clinical cases were observed. 90% of 136 vaccine recipients were IgG positive one month after vaccination compared to 54% before vaccination. Until 31 December 2008, 19 mumps cases were also reported from the community. The outbreak strain belonged to genogroup G.

Date: Sat, 15 Jul 2006 12:20:59 +0200 (METDST) LUXEMBOURG, July 15, 2006 (AFP) - A total of 36 people were injured, half of them seriously, when a fire was deliberately lit on a passenger train in Luxembourg, the government said Saturday, updating the injury toll. Eighteen people, one of them a child, were still in intensive care Saturday, the tiny Duchy's state ministry said in a statement. Most of the those hurt were suffering from burns and breathing difficulties. The fire broke out at around 5:20 pm (1520 GMT) on Friday in one of five wagons on a train carrying some 400 people just as it left Luxembourg's central station for nearby Esch-sur-Alzette. Witnesses said that a "disturbed" passenger had poured petrol on a newspaper and set it alight in the carriage, which was holding around 100 people. "The investigation has progressed well and allowed us to confirm the theory that the fire was deliberately set," the statement said. The man, who was believed to be aged in his early to mid-forties but was not identified, was remanded in custody after appearing in court early Saturday. The fire gutted the second-class carriage's seats and windows were smashed as people tried to escape the blaze. Luxembourg's last major train accident happened on December 1, 1997. Around 20 people were injured.
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