Q fever

Q fever is a bacterial infection that can cause a severe flu-like illness. The bacteria are spread from animals, mainly cattle, sheep and goats.

A safe and effective vaccine is available to protect people who are at risk.

What is Q fever?

Q fever is an illness caused by the bacterium Coxiella burnetii.

It is spread to humans from cattle, sheep and goats and a range of other domestic and wild animals. Even people who do not have contact with animals may be infected.

Symptoms

Many people with Q fever have no symptoms or only a mild illness.

People who do become sick often have a severe flu-like illness.

Symptoms usually begin 2-3 weeks after coming into contact with the bacteria and typically include:

• high fevers and chills
• severe ‘drenching’ sweats
• severe headaches, often behind the eyes
• muscle and joint pains
• extreme fatigue (tiredness).

Patients may also develop hepatitis (inflammation of the liver) or pneumonia (infection of the lungs). Without treatment, symptoms can last from 2-6 weeks. Illness often results in time off work, lasting from a few days to several weeks.

Most people make a full recovery and become immune to repeat infections. Some people develop chronic fatigue-like illness (post Q fever fatigue syndrome) which can be present for years.

Occasionally, persistent, localised infections, such as Q fever endocarditis, can develop.
This is more common in people who have a weakened immune system, are pregnant, and/or have existing problems with their heart valves.

How Q fever is spread

Animals shed the bacteria into the environment through their body fluids, including their:

• birthing materials
• milk
• faeces
• urine.

People can become infected:

• by breathing in contaminated dust or aerosols
• through contact with an infected animal or its body fluids
• through contact with items or materials that have been contaminated with fluids from an infected animal.

Infected animals often have no symptoms. The bacterium can survive for a long time in the environment. It can also spread over long distances, so people can be infected even when they haven’t been around animals.

Who is at risk of infection

Workers in some occupations are at higher risk of Q fever, including:

• abattoir and meat workers
• livestock and dairy farmers
• farm workers
• shearers, wool classers/sorters, pelt and hide processors
• stockyard/feedlot workers and transporters of animals, animal products and waste
• veterinarians, veterinary nurses, assistants, students and others working with veterinary specimens
• wildlife and zoo workers working with high-risk animals (including Australian native wildlife)
• agriculture college staff and students (working with high-risk animals)
• dog/cat breeders, and anyone regularly exposed to animals who are due to give birth
• laboratory workers (working with the bacteria or with high-risk veterinary specimens)
• animal shooters and hunters
• people whose work involves regular mowing in areas frequented by livestock or wild animals, for example, golf course workers or staff of mowing businesses in regional and rural areas.

All workers who enter workplaces in which Q fever may be present are also at risk of infection, such as, tradespeople, contractors, labour hire workers, sales representatives and buyers.

Other people at increased risk of Q fever include:

• people who have contact with high-risk animals outside of work
• family members of those in high-risk occupations (from contaminated clothes, boots or equipment)
• people living near a high-risk industry (e.g. neighbouring livestock farms, stockyards housing cattle/sheep/goats, meatworks, land being fertilised with untreated animal manure)
• visitors to at-risk environments (e.g. farms, abattoirs, animal saleyards and agricultural shows)
• people in regional and rural areas who are more likely to breathe contaminated dust and particles in the environment
• horticulturists or gardeners in environments where dust, potentially contaminated by animal urine, faeces or birth products, is aerosolised (e.g. lawn mowing).

Prevention

A safe and effective vaccine is the best way to prevent Q fever infection. Vaccination is highly recommended for people who work or intend to work in high-risk occupations.

Vaccination is also recommended for everyone aged 15 years and over who have the potential to be exposed to the bacteria during activities outside of work, or in the environments in which they live or visit.

To reduce your risk of infection:

• wash hands and arms thoroughly in soapy water after any contact with animals
• wear a properly fitted P2 mask (available from pharmacies and hardware stores) and gloves, and cover wounds with waterproof dressings when handling or disposing of animal products, waste, placentas, and aborted foetuses
• wear a properly fitted P2 mask when mowing or gardening in areas where there are livestock or native animals
• remove and wash dirty clothing, coveralls and boots worn during high-risk activities in outdoor wash areas. Avoid taking these items home to reduce the risk of infection to your household. If you do take them home, bag and wash them separately (should only be handled by those immune to Q fever)
• do not drink unpasteurised milk.

Diagnosis and treatment

For more information about Q fever, contact your doctor.

If your healthcare professional suspects you have Q fever, they will refer you for blood tests to confirm the diagnosis. Make sure you tell them if you have been around animals or in an area where animals might have been.

Q fever is treated with antibiotics. Early treatment is important to reduce the risk of complications.

Health professionals’ responsibilities

Q fever is a notifiable condition in the ACT.

Read about reporting notifiable diseases in the ACT.

Public health teams investigate each case to determine the likely source of infection, identify other people at risk of infection, ensure control measures are in place and provide information to cases.