A Q fever cluster among workers at an abattoir in south-western Sydney, Australia, 2015

Abstract

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.

Seroprevalence of Q fever among metropolitan and non‐metropolitan blood donors in New South Wales and Queensland, 2014–2015

“…During 2013–2017, more than 2500 cases of Q fever were notified in Australia; studies have found that in 40–50% of notified cases patients were hospitalised for a median 4–6 days . A recent death linked to Q fever underscores the importance of preventing this infection …”

Molecular characterization of Coxiella burnetii in the slaughtered animals of Southern Iran

“…Considering the highly resistant nature of the bacterium and repeated reports on isolation of the microorganism from soil after six months removal of an infected animal, frequent shedding of the microorganism in the milk of infected animals and difficulties in identification of the disease in a routine meat inspection program make it essential to pay more attention to the disease as a neglected zoonotic disease [29]. In a report recently published by World Health Organization, an aggregate presence of Q fever in an Australian abattoir has also confirmed the importance of this zoonotic disease as a neglected occupational hazard to the slaughterhouse workers and to set a preventive program by using a potent vaccine [6].…”

“…The main causative agent of Q fever, C. burnetii, is an obligate intracellular Gram-negative bacterium which may infect a variety rang of vertebrate and invertebrate populations and is also assumed as a biological terrorist organism [2][3][4]. The reports have implied that farm animals including cattle, sheep, and goats, play a major role as reservoir of the infection, with high risk to the vulnerable populations including ranchers, veterinarian, butchers and personnel of slaughterhouses [5][6][7]. Transmission routes of the infection to human are including infected ticks, aerosols, direct contact with the infected animal fluids such as milk, urine, seminal fluid, contaminated tissues such as kidneys, mammary glands and lymph nodes [2,[8][9][10][11][12].…”

The epidemiology of Q fever in Queensland, Australia and effectiveness of vaccination for prevention

“…This is possible because a recent small study showed that only 25% (2/8) of Q fever cases from one abattoir had previously received Q fever vaccination (Lord et al 2016). The immune status (i.e.…”

“…Similarly, an investigation of Q fever cluster among workers at an abattoir in South-Western Sydney, Australia, 2015, reported that the majority (75%) of employees were not vaccinated against Q fever despite the high-risk setting (Lord et al 2016). Further field investigation revealed that management and staff lacked knowledge and awareness of Q fever (Lord et al 2016).…”