Increase in Q fever cases

What is the issue?

Q fever is a disease caused by infection with Coxiella burnetii bacteria. It is mainly spread to humans from cattle, sheep and goats, but can also spread from other domestic and wild animals such as kangaroos, camels, rodents, cats, dogs, birds and wallabies. The bacteria can stay in the environment for long periods of time and survive disinfection and harsh conditions. This means dust, hay and other small particles may also carry the bacteria.

Cases of Q fever in Victoria are increasing. There were 77 cases of Q fever notified in 2024, a significant increase compared to the previous five years. There have been five outbreaks of Q fever notified in Victoria in 2024 (all reported between August and December).

Who is at risk?

People who work with animals, animal products and animal waste in high-risk occupational groups are at increased risk. These include people in the following occupations:

abattoir and meat workers (such as workers involved in slaughtering, skinning, meat processing, rendering; by-products workers; meat inspectors and packers; administration staff; and maintenance workers)

• agriculture, livestock and dairy farm workers
• stockyard/feedlot workers and transporters of animals, animal products and animal waste
• shearers, wool classers/sorters, pelt and hide processors
• knackery and tannery workers
• pet food manufacturing workers
• veterinarians, veterinary nurses/students/researchers, and others who work with veterinary specimens
• agriculture college staff and students (working with high-risk animals)
• animal shooters/hunters
• laboratory personnel who work with materials containing viable C. burnetii (e.g. birth products of infected animals/humans, tissue culture)
• wildlife/zoo workers and animal trainers (working with high-risk animals)
• other people exposed to high-risk animals and/or products derived from these animals (including contractors or maintenance workers)

There are other groups who may be at increased risk of Q fever. This can include:

• family members of workers in high-risk occupations listed above (from exposure to contaminated clothes, boots or equipment)
• visitors to at-risk environments (e.g. farms, abattoirs, animal saleyards, agricultural shows).
• people living on or in close proximity to a high-risk industry and people living downwind or near livestock transport routes.

Symptoms and transmission

Symptoms

Many people with Q fever have no symptoms or a mild illness. Some people may have a severe flu-like illness. Symptoms can include fever, sweats or chills, headaches, muscle/joint pain, fatigue, cough and weight loss. Patients may also develop hepatitis (inflammation of the liver) or pneumonia (infection of the lungs).

The incubation period is typically 14 to 21 days but can range from 4 days to 6 weeks.

While most people with Q fever make a full recovery, occasionally it can cause long-term complications such as heart disease, bone and joint infections and vascular infections. These complications are more common for pregnant women and people with weakened immune systems or previous heart problems.

Approximately 10 to 15 per cent of people with severe infections develop chronic fatigue, also known as Q fever fatigue syndrome, which can last for many years.

Transmission

Q fever is most commonly transmitted to humans through inhalation of dust or aerosols contaminated with bacteria from birth fluids, faeces, urine, or blood of infected animals in circumstances such as:

• animal birthing
• animal slaughter, skinning and meat processing
• herding
• shearing and wool processing
• work with animal manure
• transport of infected animals
• mowing in or through areas where there are livestock or wild animals
• veterinary procedures

Contaminated dust or aerosols may potentially travel considerable distances from the source to cause exposure.

Recommendations

At-risk groups

People working in high-risk occupational groups are strongly recommended to be vaccinated against Q fever which provides a high level of protection.

However, people who have previously had Q fever or have already received the Q fever vaccine should not be vaccinated due to the risk of adverse reactions (severe local reactions). It is necessary to be screened for previous exposure prior to vaccination. Contact your Local Public Health Unit for a list of Q fever vaccine providers in your area and discuss further with a doctor.

Individuals, companies and employers can take steps to reduce the risk of exposure to Q fever through workplace design and safe work practices. If there are difficulties in obtaining the vaccine, or people are unable to be vaccinated, actions that can be taken to reduce exposure include, but are not limited to:

• Washing hands and arms thoroughly in soapy water after any contact with animals.
• Wearing a properly fitted P2 mask (available from pharmacies and hardware stores) and gloves in handling and disposing of animal products, waste, placentas and aborted foetuses.
• Keeping personal protective equipment (PPE) and contaminated clothing at the workplace and appropriately bagging and washing them on site where possible, to reduce the risk of infection to households from taking them home.
• Appropriately managing and disposing of animal products and animal waste to prevent spread of C. burnetii bacteria.
• Minimising dust and aerosols in slaughter and animal housing areas.
• Ensuring that if symptoms develop, individuals and staff know to seek early medical attention and let their doctor know about the exposure risk.

Employers of at-risk industries

• Identify co-exposed individuals (e.g. those at the same workplace) and advise them of early signs and symptoms of Q fever to aid early diagnosis and treatment.
• Ensure workplace design and safe work practices are adhered to (by employees and all visitors and contractors to the premises)

If employees are unable to be vaccinated, ensure a properly fitted P2 mask and other appropriate PPE is used or they are restricted to lower-risk areas (i.e. away from areas where they may be exposed such as kill floors, offal rooms and rendering areas or where they will not be handling animals, noting there may be no lower-risk areas at some worksites).

See WorkSafe’s Q fever Guidance Note for further information for employers about preventing transmission of Q fever in the workplace.

Health professionals

Clinicians should be aware of the increase in cases and test individuals with compatible illness and potential exposure.

• Offering early antibiotic treatment can reduce the risk of chronic Q fever.
• Q fever infection is a ‘routine’ notifiable condition and must be notified by medical practitioners and pathology services in writing within 5 days of diagnosis.
• A Q fever vaccination is available for those working in high-risk industries. Specialist training is recommended prior to undertaking screening and administering the vaccine.