Status:
Resolved
Health advisory:
130012
Date Issued:
03 Dec 2013
Issued by:
Dr Rosemary Lester, Chief Health Officer, Victoria
Issued to:
Health professionals

Key messages

  • Q fever is a zoonotic disease that infects both wild and domestic animals and their ticks. It is generally transmitted via inhalation or contact with contaminated materials.
  • There have been several confirmed cases of Q fever in the Grampians Region in 2013, although sporadic cases occur throughout Victoria.
  • Consider the possibility of Q fever in patients with a febrile or flu-like illness, pneumonia or hepatitis with a history of residence in, or travel to the Grampians Region.
  • This is especially important in those over 65 years of age, smokers, individuals with a history of heart disease or heart valve surgery, and pregnant women.
  • Q fever is a notifiable condition to the Department of Health. Notify the Communicable Disease Prevention and Control Section at the Department of Health immediately on 1300 651 160 of all suspected and confirmed cases.

What is the issue?

Recent transmission of Q fever in the Grampians Region means that clinicians should be aware of the possibility and test individuals with compatible illness and potential exposures.

Who is at risk?

The primary means of transmission in Victoria is through close contact with infected animals or their contaminated birth and other products, such as can occur in abattoirs and farms. Q fever also has the ability to transmit over longer distances, and can therefore pose a risk especially within five kilometres of infected animals or their products, especially in dry and windy conditions. Therefore individuals who reside or have spent considerable time close to farms or other similar settings (especially in the Grampians Region) should be considered for Q fever testing.

Features which increase risk if exposed:

  • over 65 years of age
  • smokers
  • a history of heart disease or heart valve surgery
  • pregnant women (increased risk is uncertain, and probably not large)

Symptoms and transmission

Clinical features include fever, headaches, chills and muscle pains. Acute illness usually presents as a flu-like illness, pneumonia or hepatitis. The illness occasionally causes other complications such as cardiac infection, rash, or aseptic meningitis.

Testing

Use the most appropriate tests for diagnosis depending on timing of symptoms and presentation:

  • Take blood for serological testing. A titre ≥200 for IgG and ≥50 for IgM against phase II indicates an acute/recent Q fever infection, while an IgG titre >800 against phase I suggests chronic infection. 
  • In order to definitively confirm a patient as a case of Q fever, we recommend you arrange for a second (convalescent) bleed to be collected. The serum sample should be collected at least two weeks after the original serum sample and should ideally be sent to the same laboratory, so that the samples can be tested in parallel.
  • For assistance with interpreting serological results, please contact either a microbiologist or an Infectious Diseases physician.

Prevention/treatment

  • There is a vaccine called Q-Vax, which gives a high level of protection against Q fever. It is recommended that all workers at risk of contracting Q fever be immunised before starting work. Skin testing should be arranged prior to vaccination in order to test for existing immunity. This vaccine is not suitable for children under 15 years of age.
  • Employers at workplaces where there is a high risk of Q fever should arrange for everyone to be immunised with Q-Vax. This will give a high level of protection against Q fever infection.
  • Notify the Communicable Disease Prevention and Control Section at the Department of Health immediately on 1300 651 160 of all suspected and confirmed cases.

Contacts

For further information please contact the Communicable Disease Prevention and Control section at the Department of Health on 1300 651 160 (business hours) or 1300 790 733 (after hours).