Q Fever Dr Keat Teo (mbbs, Bmedsc, cs) Moora Health Centre Dalwallinu Medical Centre

No conflict of interest

History Mid 1930s, first recognised in Queensland. Named ‘Query Fever’ initially due to unknown cause, becomes Q fever now Caused by Coxiella Burnetti

About Febrile illness. Very similar to Influenza (Flu) Zoonotic disease (ie. Spread from animals to humans)

Potential reservoirs Feral mammals in Australian bush Camels Horses Cats Dogs Foxes Rabbits kangaroos

Transmission to human beings Direct or indirect contact with infected animals, or products from these animals. C. Burnetti is shed in Urine Milk Faeces Birth Products (in particularly high numbers)

At risk population Livestock rearing Meat processing Shearing Abattoir Farm workers Q fever is by no means restricted to those working directly with cattle, sheep and goats !

An effective vaccine against Q fever has been available since 1989 ( Q-VAX )

Why vaccinate? Most cases, acute illness lasts 1-6 weeks striking loss of weight (6-12kg) Q fever fatigue syndrome – 20%. Can lasts for 5-10 years Hepatitis Pneumonitis endocarditis

Why vaccinate? Q fever notification has reduced substancially since vaccination programs! First introduced in abattoirs in 1991-1994, and later more widely in rural community in 2001 – 2006 Reported cases from 800 in 2002 to 300 in 2008

Who should NOT receive Q fever Vaccine History of Q fever Previous vaccination Pregnant Known hypersensitivity to Egg proteins or other components of the vaccine Severe Local Abscess

Pre- Vaccination Screening Skin prick test Blood test Vaccine can be given if both negative

Vaccination process (1 week, 2 visits) Consent Pre-vaccination screening Screening result vaccination Day 1 Day 7

The screening results and vaccination status will be updated to the Australian Q fever register www.qfever.org

Common adverse reactions Frequency Local tenderness 48% Local erythema 33% Local oedema 0.6% Fever ( defines as >38 C) 0.2% Headache 9% Other (aching joints; swollen glands; flu-like symptoms; feeling faint; itching and induration at injection site ) 15% Later reactions ( e.g. coincidental viral respiratory tract infections ) 1.3%

Rare adverse reactions Frequency Dizziness Very rare (< 1/10,000) Nausea, vomiting, diarrhoea Uncommon ( <1/100 , >=1/1000) Muscle aches Uncommon Joint aches Very rare Injection site abscess Rare ( < 1/1000 and >= 1/10,000) Chills, chronic fatigue

If interested please contact Moora Health Centre Speak to Jeanette, our lovely staff Nurse Australian Q fever register www.qfever.org

Acknowledgement Australian Q fever register CSL Biotherapies. A guide to Q fever and Q fever vaccination

Questions ?