BackgroundIn September 2015, the Public Health Unit of the South Western Sydney Local Health District was notified of two possible Q fever cases. Case investigation identified that both cases were employed at an abattoir, and both cases advised that co-workers had experienced similar symptoms. Public Health Unit staff also recalled interviewing in late 2014 at least one other Q fever case who worked at the same abattoir. This prompted an outbreak investigation.MethodsThe investigation incorporated active case finding, microbiological analysis, field investigation and a risk factor survey. Included cases were laboratory definitive or suspected cases occurring from October 2014 to October 2015, residing or working in south-western Sydney. A suspected case had clinically compatible illness, high-risk exposure and was epidemiologically linked to another confirmed case. A confirmed case included laboratory detection of C. burnetti.ResultsEight cases met the case definition with seven confirmed (including a deceased case) and one suspected. The eight cases were all males who had been employed at an abattoir in south-western Sydney during their incubation period; symptom onset dates ranged from November 2014 to September 2015. Field investigation identified multiple potential risk factors at the abattoir, and the majority (75%) of employees were not vaccinated against Q fever despite this high-risk setting.ConclusionThis cluster of Q fever in a single abattoir confirms the significance of this zoonotic disease as an occupational hazard among persons working in high-risk environments. Implementation of Q fever vaccination programmes should eliminate Q fever in high-risk occupational settings.
The location of properties holding livestock is fluid; edging towards the boundaries of urban Australia, increasing the likelihood that veterinarians will be exposed to livestock as part of the provision of routine veterinary services. This study was conducted to ascertain the challenges, knowledge level and training needs of veterinarians working within this landscape, with the ultimate aim of informing the development of resources and training to better equip them in this capacity. For this purpose, a cross-sectional study, using a self-administered questionnaire was conducted among Australian veterinarians. The questionnaire comprised a mixture of 47 short closed, semi-closed and open-ended questions and was available for electronic distribution. Data was analysed descriptively and logistic regression analysis was used to identify potential factors associated with knowledge and practices of veterinarians in relation to smallholders. Complete responses were obtained from 91 veterinarians. The main livestock species kept by smallholder clients were sheep, goats, and cattle; with on-farm visits reported the most frequent interaction type, and responding to emergency situations the most frequently performed activity. The challenges experienced by veterinarians when working with smallholders were mostly related to external factors such as; lack of facilities, lack of client knowledge on animal health management and client's financial constraints. Over 95% of respondents provided some level of biosecurity advice and zoonotic disease information as part of their routine veterinary service. Although veterinarians provide advice and support to smallholders, only 14.5% considered themselves to be highly influential on smallholder practices. Confidence level in investigating disease differed by livestock species, with lower confidence reported in pigs, poultry and alpaca. Respondents were open to receiving assistance to support smallholders on matters related to disease, welfare or biosecurity, with other veterinarians (government and private), reported as the most frequently utilised resource. Having access to materials that could be distributed to smallholders was considered to be an effective way in which to provide information. While the risk of zoonotic disease was considered a challenge associated with working with smallholders, respondent's use of personal protective equipment (PPE), whilst performing common veterinary activities, was in many instances inadequate. Similarly, vaccination levels among veterinarians and other workers within the veterinary practice to prevent zoonotic diseases were variable. This study provides an insight into the way in which veterinarians engage with smallholders and highlight the importance of providing both groups with the tools necessary to manage the livestock to which are exposed.
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