Australia's national Q fever vaccination program

Gidding, Heather F.; Wallace, Cate; Lawrence, Glenda; McIntyre, Peter

doi:10.1016/j.vaccine.2009.02.007

Cited by 122 publications

(142 citation statements)

References 18 publications

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“…Intensified surveillance after vaccination revealed no unexpected AE, although higher AE rates than previously published [16,20,30]. Rates, however, are not easily comparable as studies differ in target population and design of surveillance [27].…”

Section: Discussionmentioning

confidence: 62%

“…A recent report on passive surveillance of the Australian national Q fever vaccination campaign 2001-2004, showed a very low number of reported AEFI (86 AEFI in 48,986 vaccinees; 0.002%). These included mostly local reactions, with only one SAE [16].…”

Section: Skin-testmentioning

confidence: 99%

“…The value of antibiotic prophylaxis after initial infection for the prevention of chronic Q fever in these patients has been debated [14,15]. An effective Q fever vaccine is registered in Australia, where -mostly healthy young -people at occupational risk are vaccinated [16].…”

Section: Introductionmentioning

confidence: 99%

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Adverse events and association with age, sex and immunological parameters of Q fever vaccination in patients at risk for chronic Q fever in the Netherlands 2011

Schoffelen

Wong

Rümke³

et al. 2014

Vaccine

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Section: Discussionmentioning

confidence: 62%

Section: Skin-testmentioning

confidence: 99%

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Adverse events and association with age, sex and immunological parameters of Q fever vaccination in patients at risk for chronic Q fever in the Netherlands 2011

Schoffelen

Wong

Rümke³

et al. 2014

Vaccine

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“…Q-Vax is a monovalent vaccine developed by the Commonwealth Serum Laboratories (CSL) from formalin-inactivated purified phase I C. burnetii whole cells and has been available in Australia since 1989 (Parker et al, 2006). Q fever vaccination in high-risk groups such as abattoir workers has been responsible for a large reduction in Q fever notifications, especially since a national funded programme commenced in 2002 in Australia (Gidding et al, 2009). Vaccine-induced immunity takes approximately 13 days to develop, and vaccination more than 10 days after exposure offers no protection (Gilroy et al, 2001).…”

Section: Discussionmentioning

confidence: 99%

Coxiella burnetii endocarditis after Q fever vaccination

Trubiano

Holmes

Williams

et al. 2012

Journal of Medical Microbiology

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Coxiella burnetii is the causative bacterium of Q fever, a vaccine-preventable infection. C. burnetii is an unusual cause of culture-negative endocarditis. Here, we present a case of Q fever native valve endocarditis that developed in a young man despite prior vaccination. Definitive diagnosis was difficult and required C. burnetii-specific PCR testing. Case reportA 29-year-old Australian man was admitted in April 2012 for elective aortic and mitral valve replacement for progressive severe aortic and mitral regurgitation with mild aortic root dilatation from Marfan's syndrome. His past medical history included a meticillin-susceptible Staphylococcus aureus-colonized chronic left leg ulcer requiring oral flucloxacillin 500 mg four-times daily, chronic fatigue syndrome and recent partial dental clearance. He denied intravenous drug use. He lived in a country town where he worked as a house painter.A St Jude mitral and aortic valve replacement was performed with preservation of the aortic root. An intraoperative diagnosis of native valve infective endocarditis was suspected due to the appearance of concurrent healed aortic and mitral valve vegetations. Interestingly, his preoperative transoesophageal echocardiogram was normal.Post-operatively, further history of occupational and environmental exposures relevant to endocarditis was obtained. Cat scratches, farm animal exposure, ingestion of unpasteurized milk and abattoir work raised the possibility of Bartonella spp., Brucella spp. and Coxiella burnetii (Q fever) as infectious aetiologies. Twelve years earlier (late March 2000), he commenced work at a local abattoir. At commencement of employment, he underwent a medical review and was screened for Q fever on 28 March 2000: baseline serology was negative (immunofluorescence phase II antibody ,10, complement fixation test against phase II antigen ,2.5), and a skin test using 0.5 ml purified killed suspension of C. burnetii was also negative. Documentation illustrates that he was subsequently vaccinated 7 days later with Q-Vax (CSL Biotherapies Q fever vaccine 0.5 ml containing 25 mg purified killed suspension of C. burnetii). He worked at the abattoir for 8 months. Approximately 9 months later, he reported to his local medical officer with unexplained loss of weight (30 kg) and fatigue. In the intervening years prior to cardiac surgery, he also reported intermittent drenching night sweats; however, C. burnetii serology was not performed nor did he receive any antibiotic treatment other than flucloxacillin for his leg ulcer.Physical examination was remarkable for marfanoid features and chronic venous insufficiency of his left leg without active infection. An orthopantomogram excluded an odontogenic source of infection. Blood cultures performed intraand post-operatively revealed Staphylococcus hominis in 1 of 12 bottles; this was judged to represent contamination, and other culture bottles remained negative with extended incubation to 21 days. There were polymorphonuclear leukocytes on aortic and mitral valve tissue, b...

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“…However, up to 1994, this vaccine was not used extensively in both risk groups with contact to sheep and in sheep livestock, even though none of the vaccinated individuals in Australia developed Q fever [142]. An additional vaccination program was developed successfully in Australia in 2008, designed to reduce the risk of Q fever infection in persons with an infection risk such as workers in abattoirs or sheep farms [143]. In the Netherlands, health authorities also recommended vaccinating individuals at risk of severe illness following C. burnetii infection [57,144].…”

Section: Recipientsmentioning

confidence: 99%