1737Managing a Cluster Outbreak of Psittacosis

Background. Psittacosis is category B bioterrorism disease. Here we present a cluster outbreak in Belgium and the steps taken by the authorities to prevent further spread. Methods. In July 2013 a husband a wife, both 54 years old, presented at our department with a history of fever and dry cough since five days. Laboratory test showed strongly elevated inflammation parameters. Chest X-ray confirmed a diagnosis of pneumonia in both patients. The patients were specifically asked if they had had contact with birds. It appeared that they had bought a lovebird (agapornis roseicollis) 11 days earlier in the Netherlands. The bird became ill the day of the purchase, with a flulike syndrome and died a few days later. In addition, the couple’s daughter who accompanied them at the bird trader, reported similar symptoms, but was at the time on holiday in Brazil. Pharyngeal swabs from the couple were taken and sent to the Belgian reference laboratory for psittacosis in Ghent. The couple was treated with a 14 day course of doxycyclin and the daughter started with quinolone-therapy. They all had an uneventful recovery. Since Chlamydia psittaci is a notifiable disease in Belgium and the local health care authorities (WIV) were informed. They contacted their Dutch counterparts (nVWA). The pet-shop was visited and a sales ban was issued. Seven samples of bird manure were taken and analysed by PCR for presence of Chlamydia psittaci. Results. Cultures from the pharyngeal swabs of the patients on BGM cells became positive and additional genotype-specific real-time PCR indicated a genotype A. Four of the seven manure samples tested positive with PCR-analysis. Genotyping also showed genotype A. The health authority issued the treatment of all approximately 60 birds in the pet shop with a 6 week course of doxycyclin. Manure cultures after treatment remained negative. No more cases of psittacosis were reported that could be linked to the pet shop. Conclusion. Asking for bird contact is essential for identification of psittacosis in patients with pneumonia. Furthermore, rapidly informing health authorities is warranted so that appropriate action can be taken to prevent further spread Disclosures. All authors: No reported disclosures.