What pathogens cause pneumonia in patients? 

When a person has pneumonia, it is usually treated immediately by their general practitioner (GP). Often, no diagnostic tests are done to identify which pathogen caused the pneumonia. For the purposes of this sub-study, a group of several hundred participants will be selected from patients who consult their GP for pneumonia and who live in the vicinity of a goat farm. We will investigate which pathogen caused pneumonia in each of these patients. The pathogens that may have caused the illness will be mapped.

Researchers will not only be looking at new patients, but also at people who have had pneumonia in the past. This will be done by investigating data from several hospitals on pathogens that caused pneumonia. Data on people living in relative proximity to a goat farm will then be compared to data on people who live further away.

Which pathogens occur in local residents who do not have pneumonia? 

In order to gain a better understanding of why pneumonia occurs more often in proximity to goat farms, we will not only be studying pneumonia patients. In addition, we will be taking health measurements among local residents who do not have pneumonia. This allows us to look at differences in pathogens between people who have pneumonia and people who do not. In addition, we will be able to see whether certain pathogens are associated with residential proximity to goat farms. 

Which pathogens are goat farmers exposed to?

If pneumonia in local residents living near goat farms is caused by one or more pathogens originating from goats, then goat farmers and their employees should be the most likely people to come into contact with it. This does not necessarily mean that pneumonia would also be more prevalent among goat farmers. People can come into contact with pathogens without becoming ill. We will therefore be taking samples from goat farmers and their employees to identify which pathogens they are exposed to. 

When we know which pathogens occur among goat farmers and their employees, that data can be compared with findings from the other studies among patients and local residents. 

Do certain pathogens occur more frequently on or around different types of goat farms?

We want to map out which pathogens are present on goat farms and whether there are differences between types of goat farms and different locations (housing for adult goats, of lambs, manure storage) on goat farms. To that end, RIVM, Wageningen Research and Nivel will be conducting research at some 15 goat farms to determine which pathogens are present.

• Researchers will identify which pathogens are present on goat farms that could be related to the cases of pneumonia among local residents. Animals will be tested, and feed, water, manure, dust and air samples will also be examined.
• The various working methods used on goat farms will be documented, focusing among others on how a farm deals with manure removal and storage, straw dividing, rearing lambs etc. The researchers will combine this with results of pathogen analyses in the various sources and in indoor air within households. This will make it possible to see whether the occurrence of possible relevant pathogens is related to certain farm characteristics and/or operational measures.

What potential airborne pathogens from goat farms are local residents exposed to?

We will take air samples in residential areas. These will be used to investigate whether pathogens that can be found in goat farms and can cause pneumonia can also be detected in the residential areas.