Human psittacosis: a review with emphasis on surveillance in Belgium.

Chlamydia psittaci causes psittacosis in humans, mainly in persons in contact with birds in either the setting of occupational or companion bird exposure. Infection is associated with a range of clinical manifestations from asymptomatic infection to severe atypical pneumonia and systemic disease. This paper reviews new knowledge on psittacosis, its legal and regulatory aspects and presents epidemiological data on psittacosis in Belgium. In Belgium, the number of reported positive laboratory results increased slowly since 2010, and in 2017, the number almost doubled compared to the two previous years. The number of psittacosis cases in Belgium, as in other countries, is probably highly underestimated, because of underdiagnoses and underreporting. Over the 3-year period, the mandatory notification system registered 24% only of all reported positive laboratory result. Therefore, increased awareness among general and occupational physicians, clinicians and the public is needed. Policies aimed at reducing psittacosis disease burden are justified, nevertheless national health authorities should provide more legal and financial support to implement more adequate C. psittaci diagnostic tools.