ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Roest HJ, van Gelderen B, Dinkla A, Frangoulidis D, van Zijderveld F, Rebel J, van Keulen L, 2012. Q Fever in pregnant goats: pathogenesis and excretion of Coxiella burnetii. PLoS ONE 7: e48949.
-
2.
Scott GH, Williams JC, 1990. Susceptibility of Coxiella burnetii to chemical disinfectants. Ann N Y Acad Sci 590: 291–296.
-
3.
Hawker JI, Ayres JG, Blair I, Evans MR, Smith DL, Smith EG, Burge PS, Carpenter MJ, Caul EO, Coupland B, Desselberger U, Farrell ID, Saunders PJ, Wood MJ, 1998. A large outbreak of Q fever in the West Midlands: windborne spread into a metropolitan area? Commun Dis Public Health 1: 180–187.
-
4.
Tissot-Dupont H, Torres S, Nezri M, Raoult D, 1999. Hyperendemic focus of Q fever related to sheep and wind. Am J Epidemiol 150: 67–74.
-
5.
Rotz LD, Khan AS, Lillibridge SR, Ostroff SM, Hughes JM, 2002. Public health assessment of potential biological terrorism agents. Emerg Infect Dis 8: 225–230.
-
6.
Noah DL, Noah DL, Crowder HR, 2002. Biological terrorism against animals and humans: a brief review and primer for action. J Am Vet Med Assoc 221: 40–43.
-
7.
Madariaga MG, Rezai K, Trenholme GM, Weinstein RA, 2003. Q fever: a biological weapon in your backyard. Lancet Infect Dis 3: 709–721.
-
8.
Tissot-Dupont H, Amadei MA, Nezri M, Raoult D, 2004. Wind in November, Q fever in December. Emerg Infect Dis 10: 1264–1269.
-
9.
Oyston PC, Davies C, 2011. Q fever: the neglected biothreat agent. J Med Microbiol 60: 9–21.
-
10.
Anonymous, 1977. Q fever transmitted by blood transfusion—United States. Can Dis Wkly Rep 3: 210.
-
11.
Kruszewska D, Lembowicz K, Tylewska-Wierzbanowska S, 1996. Possible sexual transmission of Q fever among humans. Clin Infect Dis 22: 1087–1088.
-
12.
Milazzo A, Hall R, Storm PA, Harris RJ, Winslow W, Marmion BP, 2001. Sexually transmitted Q fever. Clin Infect Dis 33: 399–402.
-
13.
Signs KA, Stobierski MG, Gandhi TN, 2012. Q Fever cluster among raw milk drinkers in Michigan, 2011. Clin Infect Dis 55: 1387–1389.
-
14.
Janbon F, Raoult D, Reynes J, Bertrand A, 1989. Concomitant human infection due to Rickettsia conorii and Coxiella burnetii. J Infect Dis 160: 354–355.
-
15.
Robbins FC, Gauld RL, Warner FB, 1946. Q fever in the Mediterranean area; report of its occurrence in allied troops; epidemiology. Am J Hyg 44: 23–50.
-
16.
Spicknall CG, Huebner RJ, Finger JA, Blocker WP, 1947. Report on an outbreak of Q fever at the National Institute of Health; clinical features. Ann Intern Med 27: 28–40.
-
17.
Topping NH, Shepard CC, Irons JV, 1947. Q fever in the United States; epidemiologic studies of an outbreak among stock handlers and slaughterhouse workers. J Am Med Assoc 133: 813–815.
-
18.
Shepard CC, 1947. An outbreak of Q fever in a Chicago packing house. Am J Hyg 46: 185–192.
-
19.
Centers for Disease Control, 1986. Q fever among slaughterhouse workers—California. MMWR Morb Mortal Wkly Rep 35: 223–226.
-
20.
Graham CJ, Yamauchi T, Rountree P, 1989. Q fever in animal laboratory workers: an outbreak and its investigation. Am J Infect Control 17: 345–348.
-
21.
Faix DJ, Harrison DJ, Riddle MS, Vaughn AF, Yingst SL, Earhart K, Thibault G, 2008. Outbreak of Q fever among US military in western Iraq, June–July 2005. Clin Infect Dis 46: e65–e68.
-
22.
Raoult D, Tissot-Dupont H, Foucault C, Gouvernet J, Fournier PE, Bernit E, Stein A, Nesri M, Harle JR, Weiller PJ, 2000. Q fever 1985–1998. Clinical and epidemiologic features of 1,383 infections. Medicine (Baltimore) 79: 109–123.
-
23.
McQuiston JH, Childs JE, 2002. Q fever in humans and animals in the United States. Vector Borne Zoonotic Dis 2: 179–191.
-
24.
Marmion BP, 1962. Subacute rickettsial endocarditis: an unusual complication of Q fever. J Hyg Epidemiol Microbiol Immunol 6: 79–84.
-
25.
Turck WP, Howitt G, Turnberg LA, Fox H, Longson M, Matthews MB, Das Gupta R, 1976. Chronic Q fever. Q J Med 45: 193–217.
-
26.
Fergusson RJ, Shaw TR, Kitchin AH, Matthews MB, Inglis JM, Peutherer JF, 1985. Subclinical chronic Q fever. Q J Med 57: 669–676.
-
27.
Raoult D, Marrie T, 1995. Q fever. Clin Infect Dis 20: 489–495.
-
28.
Anderson A, Bijlmer H, Fournier PE, Graves S, Hartzell J, Kersh GJ, Limonard G, Marrie TJ, Massung RF, McQuiston JH, Nicholson WL, Paddock CD, Sexton DJ, 2013. Diagnosis and management of Q fever–United States, 2013: recommendations from CDC and the Q Fever Working Group. MMWR Recomm Rep 62: 1–30.
-
29.
Council of State and Territorial Epidemiologists, 1999. Placing Q Fever (Coxiella burnetii) Under National Surveillance in the United States Under the National Public Health Surveillance System (NPHSS). Position Statement.
-
30.
Council of State and Territorial Epidemiologists, 2007. Revision of the Surveillance Case Definition for Q Fever. Position Statement.
-
31.
McQuiston JH, Holman RC, McCall CL, Childs JE, Swerdlow DL, Thompson HA, 2006. National surveillance and the epidemiology of human Q fever in the United States, 1978–2004. Am J Trop Hyg 75: 36–40.
-
32.
United States Census Bureau, 2011. Intercensal estimates of the resident population by single year of age and sex for states and the United States: April 1, 2000 to July 1, 2010.
-
33.
United States Census Bureau, 2013. Annual state resident population estimates for 6 race groups by age, sex, and Hispanic origin: April 1, 2010 to July 1, 2012.
-
34.
SAS Institute, 2012. SAS System for Windows [computer program]. Version 9.3. Cary, NC: SAS Institute.
-
35.
Bureau of Labor Statistics, United States Department of Labor, 2013. 2010 Standard Occupational Classification Definitions.
-
36.
Bureau of Labor Statistics, United States Department of Labor, 2010. Occupational Employment Statistics.
-
37.
United States Department of Agriculture, 2010. Cattle. Washington, DC: National Agricultural Statistics Service, Agricultural Statistics Board, United States Department of Agriculture.
-
38.
United States Department of Agriculture, 2011. Sheep and Goats. Washington, DC: National Agricultural Statistics Service, Agriculture Statistics Board, United States Department of Agriculture.
-
39.
United States Department of Agriculture, 1997. Beef 1997. Part I: Reference of 1997 Beef Cow-Calf Management Practices. USDA, ed. Fort Collins, CO: Veterinary Services' Centers for Epidemiology and Animal Health, Animal and Plant Inspection Service, United States Department of Agriculture, 49–52.
-
40.
Dargatz DA, Dewell GA, Mortimer RG, 2004. Calving and calving management of beef cows and heifers on cow-calf operations in the United States. Theriogenology 61: 997–1007.
-
41.
United States Department of Agriculture, 2010. Goat 2009. Part I: Reference of Goat Management Practices in the United States. USDA, ed. Fort Collins, CO: Veterinary Services' Centers for Epidemiology and Animal Health, Animal and Plant Inspection Service, United States Department of Agriculture, 63–64.
-
42.
United States Department of Agriculture, 2012. Sheep 2011. Part I: Reference of Sheep Management Practices in the United States, 2011. USDA, ed. Fort Collins, CO: Veterinary Services' Centers for Epidemiology and Animal Health, Animal and Plant Inspection Service, United States Department of Agriculture, 87–90.
-
43.
Dijkstra F, van der Hoek W, Wijers N, Schimmer B, Rietveld A, Wijkmans CJ, Vellema P, Schneeberger PM, 2012. The 2007–2010 Q fever epidemic in The Netherlands: characteristics of notified acute Q fever patients and the association with dairy goat farming. FEMS Immunol Med Microbiol 64: 3–12.
-
44.
Office of the Deputy Under Secretary of Defense (Military Community and Family Policy) under contract with ICF International, Demographics, 2010. Profile of the Military Community.
-
45.
Tissot Dupont H, Raoult D, Brouqui P, Janbon F, Peyramond D, Weiller PJ, Chicheportiche C, Nezri M, Poirier R, 1992. Epidemiologic features and clinical presentation of acute Q fever in hospitalized patients: 323 French cases. Am J Med 93: 427–434.
-
46.
Angelakis E, Million M, D'Amato F, Rouli L, Richet H, Stein A, Rolain JM, Raoult D, 2013. Q fever and pregnancy: disease, prevention, and strain specificity. Eur J Clin Microbiol Infect Dis 32: 361–368.
-
47.
Centers for Disease Control and Prevention, 2006–2007. Foodborne Active Surveillance Network (FoodNet) Population Survey Atlas of Exposures. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention.
-
48.
Clark WH, Lennette EH, Romer MS, 1951. Q fever in California. XI. An epidemiologic summary of 350 cases occurring in northern California during 1948–1949. Am J Hyg 54: 319–330.
-
49.
Fishbein DB, Raoult D, 1992. A cluster of Coxiella burnetii infections associated with exposure to vaccinated goats and their unpasteurized dairy products. Am J Trop Med Hyg 47: 35–40.
-
50.
Kim SG, Kim EH, Lafferty CJ, Dubovi E, 2005. Coxiella burnetii in bulk tank milk samples, United States. Emerg Infect Dis 11: 619–621.
-
51.
Loftis AD, Priestley RA, Massung RF, 2010. Detection of Coxiella burnetii in commercially available raw milk from the United States. Foodborne Pathog Dis 7: 1453–1456.
-
52.
Eldin C, Angelakis E, Renvoise A, Raoult D, 2013. Coxiella burnetii DNA, but not viable bacteria, in dairy products in France. Am J Trop Med Hyg 88: 765–769.
-
53.
Anderson AD, Kruszon-Moran D, Loftis AD, McQuillan G, Nicholson WL, Priestley RA, Candee AJ, Patterson NE, Massung RF, 2009. Seroprevalence of Q fever in the United States, 2003–2004. Am J Trop Med Hyg 81: 691–694.
-
54.
Dahlgren FS, Haberling DL, McQuiston JH, 2015. Q fever is underestimated in the United States: a comparison of fatal Q fever cases from two national reporting systems. Am J Trop Med Hyg 92: 244–246.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1909 | 1715 | 34 |
| Full Text Views | 453 | 17 | 1 |
| PDF Downloads | 177 | 15 | 0 |
Q Fever in the United States: Summary of Case Reports from Two National Surveillance Systems, 2000–2012
F. Scott Dahlgren
F. Scott Dahlgren
Rickettsial Zoonoses Branch, Division of Vector-borne Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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Jennifer H. McQuiston
Jennifer H. McQuiston
Rickettsial Zoonoses Branch, Division of Vector-borne Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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Robert F. Massung
Robert F. Massung
Rickettsial Zoonoses Branch, Division of Vector-borne Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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Alicia D. Anderson
Alicia D. Anderson
Rickettsial Zoonoses Branch, Division of Vector-borne Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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Q fever is a worldwide zoonosis historically associated with exposure to infected livestock. This study summarizes cases of Q fever, a notifiable disease in the United States, reported to the Centers for Disease Control and Prevention through two national surveillance systems with onset during 2000–2012. The overall incidence rate during this time was 0.38 cases per million persons per year. The reported case fatality rate was 2.0%, and the reported hospitalization rate was 62%. Most cases (61%) did not report exposure to cattle, goats, or sheep, suggesting that clinicians should consider Q fever even in the absence of livestock exposure. The prevalence of drinking raw milk among reported cases of Q fever (8.4%) was more than twice the national prevalence for the practice. Passive surveillance systems for Q fever are likely impacted by underreporting and underdiagnosis because of the nonspecific presentation of Q fever.
Author Notes
Authors' addresses: F. Scott Dahlgren, Jennifer H. McQuiston, Robert F. Massung, and Alicia D. Anderson, Centers for Disease Control and Prevention, Rickettsial Zoonoses Branch, Atlanta, GA, E-mails: iot0@cdc.gov, fzh7@cdc.gov, rmassung@cdc.gov, and aha5@cdc.gov.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Roest HJ, van Gelderen B, Dinkla A, Frangoulidis D, van Zijderveld F, Rebel J, van Keulen L, 2012. Q Fever in pregnant goats: pathogenesis and excretion of Coxiella burnetii. PLoS ONE 7: e48949.
-
2.
Scott GH, Williams JC, 1990. Susceptibility of Coxiella burnetii to chemical disinfectants. Ann N Y Acad Sci 590: 291–296.
-
3.
Hawker JI, Ayres JG, Blair I, Evans MR, Smith DL, Smith EG, Burge PS, Carpenter MJ, Caul EO, Coupland B, Desselberger U, Farrell ID, Saunders PJ, Wood MJ, 1998. A large outbreak of Q fever in the West Midlands: windborne spread into a metropolitan area? Commun Dis Public Health 1: 180–187.
-
4.
Tissot-Dupont H, Torres S, Nezri M, Raoult D, 1999. Hyperendemic focus of Q fever related to sheep and wind. Am J Epidemiol 150: 67–74.
-
5.
Rotz LD, Khan AS, Lillibridge SR, Ostroff SM, Hughes JM, 2002. Public health assessment of potential biological terrorism agents. Emerg Infect Dis 8: 225–230.
-
6.
Noah DL, Noah DL, Crowder HR, 2002. Biological terrorism against animals and humans: a brief review and primer for action. J Am Vet Med Assoc 221: 40–43.
-
7.
Madariaga MG, Rezai K, Trenholme GM, Weinstein RA, 2003. Q fever: a biological weapon in your backyard. Lancet Infect Dis 3: 709–721.
-
8.
Tissot-Dupont H, Amadei MA, Nezri M, Raoult D, 2004. Wind in November, Q fever in December. Emerg Infect Dis 10: 1264–1269.
-
9.
Oyston PC, Davies C, 2011. Q fever: the neglected biothreat agent. J Med Microbiol 60: 9–21.
-
10.
Anonymous, 1977. Q fever transmitted by blood transfusion—United States. Can Dis Wkly Rep 3: 210.
-
11.
Kruszewska D, Lembowicz K, Tylewska-Wierzbanowska S, 1996. Possible sexual transmission of Q fever among humans. Clin Infect Dis 22: 1087–1088.
-
12.
Milazzo A, Hall R, Storm PA, Harris RJ, Winslow W, Marmion BP, 2001. Sexually transmitted Q fever. Clin Infect Dis 33: 399–402.
-
13.
Signs KA, Stobierski MG, Gandhi TN, 2012. Q Fever cluster among raw milk drinkers in Michigan, 2011. Clin Infect Dis 55: 1387–1389.
-
14.
Janbon F, Raoult D, Reynes J, Bertrand A, 1989. Concomitant human infection due to Rickettsia conorii and Coxiella burnetii. J Infect Dis 160: 354–355.
-
15.
Robbins FC, Gauld RL, Warner FB, 1946. Q fever in the Mediterranean area; report of its occurrence in allied troops; epidemiology. Am J Hyg 44: 23–50.
-
16.
Spicknall CG, Huebner RJ, Finger JA, Blocker WP, 1947. Report on an outbreak of Q fever at the National Institute of Health; clinical features. Ann Intern Med 27: 28–40.
-
17.
Topping NH, Shepard CC, Irons JV, 1947. Q fever in the United States; epidemiologic studies of an outbreak among stock handlers and slaughterhouse workers. J Am Med Assoc 133: 813–815.
-
18.
Shepard CC, 1947. An outbreak of Q fever in a Chicago packing house. Am J Hyg 46: 185–192.
-
19.
Centers for Disease Control, 1986. Q fever among slaughterhouse workers—California. MMWR Morb Mortal Wkly Rep 35: 223–226.
-
20.
Graham CJ, Yamauchi T, Rountree P, 1989. Q fever in animal laboratory workers: an outbreak and its investigation. Am J Infect Control 17: 345–348.
-
21.
Faix DJ, Harrison DJ, Riddle MS, Vaughn AF, Yingst SL, Earhart K, Thibault G, 2008. Outbreak of Q fever among US military in western Iraq, June–July 2005. Clin Infect Dis 46: e65–e68.
-
22.
Raoult D, Tissot-Dupont H, Foucault C, Gouvernet J, Fournier PE, Bernit E, Stein A, Nesri M, Harle JR, Weiller PJ, 2000. Q fever 1985–1998. Clinical and epidemiologic features of 1,383 infections. Medicine (Baltimore) 79: 109–123.
-
23.
McQuiston JH, Childs JE, 2002. Q fever in humans and animals in the United States. Vector Borne Zoonotic Dis 2: 179–191.
-
24.
Marmion BP, 1962. Subacute rickettsial endocarditis: an unusual complication of Q fever. J Hyg Epidemiol Microbiol Immunol 6: 79–84.
-
25.
Turck WP, Howitt G, Turnberg LA, Fox H, Longson M, Matthews MB, Das Gupta R, 1976. Chronic Q fever. Q J Med 45: 193–217.
-
26.
Fergusson RJ, Shaw TR, Kitchin AH, Matthews MB, Inglis JM, Peutherer JF, 1985. Subclinical chronic Q fever. Q J Med 57: 669–676.
-
27.
Raoult D, Marrie T, 1995. Q fever. Clin Infect Dis 20: 489–495.
-
28.
Anderson A, Bijlmer H, Fournier PE, Graves S, Hartzell J, Kersh GJ, Limonard G, Marrie TJ, Massung RF, McQuiston JH, Nicholson WL, Paddock CD, Sexton DJ, 2013. Diagnosis and management of Q fever–United States, 2013: recommendations from CDC and the Q Fever Working Group. MMWR Recomm Rep 62: 1–30.
-
29.
Council of State and Territorial Epidemiologists, 1999. Placing Q Fever (Coxiella burnetii) Under National Surveillance in the United States Under the National Public Health Surveillance System (NPHSS). Position Statement.
-
30.
Council of State and Territorial Epidemiologists, 2007. Revision of the Surveillance Case Definition for Q Fever. Position Statement.
-
31.
McQuiston JH, Holman RC, McCall CL, Childs JE, Swerdlow DL, Thompson HA, 2006. National surveillance and the epidemiology of human Q fever in the United States, 1978–2004. Am J Trop Hyg 75: 36–40.
-
32.
United States Census Bureau, 2011. Intercensal estimates of the resident population by single year of age and sex for states and the United States: April 1, 2000 to July 1, 2010.
-
33.
United States Census Bureau, 2013. Annual state resident population estimates for 6 race groups by age, sex, and Hispanic origin: April 1, 2010 to July 1, 2012.
-
34.
SAS Institute, 2012. SAS System for Windows [computer program]. Version 9.3. Cary, NC: SAS Institute.
-
35.
Bureau of Labor Statistics, United States Department of Labor, 2013. 2010 Standard Occupational Classification Definitions.
-
36.
Bureau of Labor Statistics, United States Department of Labor, 2010. Occupational Employment Statistics.
-
37.
United States Department of Agriculture, 2010. Cattle. Washington, DC: National Agricultural Statistics Service, Agricultural Statistics Board, United States Department of Agriculture.
-
38.
United States Department of Agriculture, 2011. Sheep and Goats. Washington, DC: National Agricultural Statistics Service, Agriculture Statistics Board, United States Department of Agriculture.
-
39.
United States Department of Agriculture, 1997. Beef 1997. Part I: Reference of 1997 Beef Cow-Calf Management Practices. USDA, ed. Fort Collins, CO: Veterinary Services' Centers for Epidemiology and Animal Health, Animal and Plant Inspection Service, United States Department of Agriculture, 49–52.
-
40.
Dargatz DA, Dewell GA, Mortimer RG, 2004. Calving and calving management of beef cows and heifers on cow-calf operations in the United States. Theriogenology 61: 997–1007.
-
41.
United States Department of Agriculture, 2010. Goat 2009. Part I: Reference of Goat Management Practices in the United States. USDA, ed. Fort Collins, CO: Veterinary Services' Centers for Epidemiology and Animal Health, Animal and Plant Inspection Service, United States Department of Agriculture, 63–64.
-
42.
United States Department of Agriculture, 2012. Sheep 2011. Part I: Reference of Sheep Management Practices in the United States, 2011. USDA, ed. Fort Collins, CO: Veterinary Services' Centers for Epidemiology and Animal Health, Animal and Plant Inspection Service, United States Department of Agriculture, 87–90.
-
43.
Dijkstra F, van der Hoek W, Wijers N, Schimmer B, Rietveld A, Wijkmans CJ, Vellema P, Schneeberger PM, 2012. The 2007–2010 Q fever epidemic in The Netherlands: characteristics of notified acute Q fever patients and the association with dairy goat farming. FEMS Immunol Med Microbiol 64: 3–12.
-
44.
Office of the Deputy Under Secretary of Defense (Military Community and Family Policy) under contract with ICF International, Demographics, 2010. Profile of the Military Community.
-
45.
Tissot Dupont H, Raoult D, Brouqui P, Janbon F, Peyramond D, Weiller PJ, Chicheportiche C, Nezri M, Poirier R, 1992. Epidemiologic features and clinical presentation of acute Q fever in hospitalized patients: 323 French cases. Am J Med 93: 427–434.
-
46.
Angelakis E, Million M, D'Amato F, Rouli L, Richet H, Stein A, Rolain JM, Raoult D, 2013. Q fever and pregnancy: disease, prevention, and strain specificity. Eur J Clin Microbiol Infect Dis 32: 361–368.
-
47.
Centers for Disease Control and Prevention, 2006–2007. Foodborne Active Surveillance Network (FoodNet) Population Survey Atlas of Exposures. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention.
-
48.
Clark WH, Lennette EH, Romer MS, 1951. Q fever in California. XI. An epidemiologic summary of 350 cases occurring in northern California during 1948–1949. Am J Hyg 54: 319–330.
-
49.
Fishbein DB, Raoult D, 1992. A cluster of Coxiella burnetii infections associated with exposure to vaccinated goats and their unpasteurized dairy products. Am J Trop Med Hyg 47: 35–40.
-
50.
Kim SG, Kim EH, Lafferty CJ, Dubovi E, 2005. Coxiella burnetii in bulk tank milk samples, United States. Emerg Infect Dis 11: 619–621.
-
51.
Loftis AD, Priestley RA, Massung RF, 2010. Detection of Coxiella burnetii in commercially available raw milk from the United States. Foodborne Pathog Dis 7: 1453–1456.
-
52.
Eldin C, Angelakis E, Renvoise A, Raoult D, 2013. Coxiella burnetii DNA, but not viable bacteria, in dairy products in France. Am J Trop Med Hyg 88: 765–769.
-
53.
Anderson AD, Kruszon-Moran D, Loftis AD, McQuillan G, Nicholson WL, Priestley RA, Candee AJ, Patterson NE, Massung RF, 2009. Seroprevalence of Q fever in the United States, 2003–2004. Am J Trop Med Hyg 81: 691–694.
-
54.
Dahlgren FS, Haberling DL, McQuiston JH, 2015. Q fever is underestimated in the United States: a comparison of fatal Q fever cases from two national reporting systems. Am J Trop Med Hyg 92: 244–246.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1909 | 1715 | 34 |
| Full Text Views | 453 | 17 | 1 |
| PDF Downloads | 177 | 15 | 0 |