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The Netherlands is again facing a sharp increase in Q fever notifications, after the unprecedented outbreaks of 2007 and 2008. The most affected province of Noord Brabant has a high density of large dairy goat farms, and farms with abortion waves have been incriminated. Mandatory vaccination of small ruminants has started and should have an effect in 2010. A large multidisciplinary research portfolio is expected to generate better knowledge about transmission and additional control measures.

Sustained intensive transmission of Q fever in the south of the Netherlands, 2009