Q fever

About Q fever

Q fever is a disease caused by infection with Coxiella burnetii bacteria. It is mainly spread to humans from cattle, sheep and goats, but can also spread from other domestic and wild animals such as kangaroos, camels, rodents, cats, dogs, birds and wallabies. The bacteria can stay in the environment for long periods of time and survive disinfection and harsh conditions. This means dust, hay and other small particles may also carry the bacteria.

Symptoms of Q fever

Many people with Q fever have no symptoms. Some people may have a flu-like illness and symptoms can include:

• fever
• sweats or chills
• headaches
• muscle aches or pains
• fatigue
• cough
• weight loss.

Some people with Q fever may also develop hepatitis (inflammation of the liver) and pneumonia (infection of the lungs).

Symptoms usually start 2 to 3 weeks after being infected with the bacteria but can sometimes start from as early as 4 days or as many as 6 weeks.

Complications of Q fever

While most people with Q fever make a full recovery, occasionally it can cause long-term complications such as heart disease, bone and joint infections and vascular infections. These complications are more common for pregnant women, people with weakened immune systems or previous heart problems.

Approximately 10 to 15 per cent of people with severe infections develop chronic fatigue, also known as Q fever fatigue syndrome, which can last for many years.

Spread of Q fever

Q fever can spread from animals to humans by:

• breathing in bacteria in the air or dust during:
  • animal birthing
  • animal slaughter, skinning and meat processing
  • herding
  • shearing and wool processing
  • work with animal manure
  • transport of infected animals
  • veterinary procedures
• contact with animal faeces, urine or birth products
• contact with contaminated wool or hides, or presence during slaughtering
• drinking unpasteurised (raw) milk from infected cows, sheep and goats which may carry a risk of infection
• infection can also occur through direct contact with infected animal tissue or fluids on broken skin - for example, through cuts with contaminated knives or needle-stick injuries when working with animals.

Q fever is rarely spread from person-to-person.

People at risk of Q fever

People who work with animals, animal products and animal waste are most at risk of Q fever. These include people in the following occupations:

• abattoir and meat workers (such as workers involved in slaughtering, skinning, meat processing, rendering; by-products workers; meat inspectors and packers; administration staff; and maintenance workers)
• agriculture, livestock and dairy farm workers
• stockyard/feedlot workers and transporters of animals, animal products and animal waste
• shearers, wool classers/sorters, pelt and hide processors
• knackery workers
• tannery workers
• laundry workers handling clothing from at-risk workplaces
• pet food manufacturing workers
• veterinarians, veterinary nurses/students/researchers, and others who work with veterinary specimens
• agriculture college staff and students (working with high-risk animals).
• animal shooters/hunters
• laboratory personnel who work with materials containing viable C. burnetii (e.g. birth products of infected animals/humans, tissue culture)
• wildlife/zoo workers and animal trainers (working with high risk animals)
• dog/cat breeders, and anyone regularly exposed to parturient animals
• other people exposed to high-risk animals and/or products derived from these animals.

Other groups at increased risk of Q fever include:

• family members of workers in high risk occupations listed above (from exposure to contaminated clothes, boots or equipment)
• people living on or in close proximity to a high risk industry (e.g. neighbouring livestock farms, stockyards housing cattle, sheep or goats, meatworks, land being fertilised by untreated animal manure)
• People living within 1 kilometre downwind of an abattoir
• visitors to at risk environments (e.g. farms, abattoirs, animal saleyards, agricultural shows)
• people living or working near livestock transport routes with the potential to be exposed to contaminated dust form the passing animals
• people exposed to aerosolised dust that is potentially contaminated by animal products or waste (e.g. while mowing the lawn).

Prevention of Q fever

Vaccination

There is a safe and effective vaccine, called Q-Vax ®, which gives a high level of protection against Q fever. The vaccine takes approximately 15 days to be effective. People should avoid high risk areas during this period or undertake additional preventative measures as listed below. The vaccine is not routinely recommended for children under 15 years of age, pregnant women or those with a known egg allergy.

It is highly recommended for workers at risk of Q fever to be vaccinated before starting work. Employers should arrange vaccination with Q-Vax ®, for workers in high risk occupations. Refer to WorkSafe Q fever guidance note for further advice for employers.

People must be screened and tested for Q fever antibodies before being vaccinated with Q-Vax ®. Those with evidence of previous infection or vaccination for Q fever do not need to be vaccinated. These people are at risk of severe reaction from receiving the vaccine.

To check if you have previously been vaccinated against Q fever, see the:

• Australian Immunisation Register, if vaccinated after 15 April 2024
• Australian Q Fever Register (only available until 30 June 2025).

For historical records on the Australian Q Fever Register, you can ask your immunisation provider to update the Australian Immunisation Register with information from your Q Fever eStatement. Workers may need to provide proof of vaccination if they change jobs so it’s important to keep a record. Testing involves a skin test and a blood test. Results of the skin test are ready 7 days later. If both tests are negative, and you’re not allergic to eggs or have not already been vaccinated, then you can have the Q fever vaccine, Q Vax.

Contact your General Practitioner (Doctor) to discuss the Q fever vaccine or your Local Public Health Unit to find a vaccine provider.

Good hygiene and other preventive measures

Good hygiene practices and other prevention measures can reduce the risk of Q fever, such as:

• washing hands and arms thoroughly in soapy water after any contact with animals.
• wearing a properly fitted P2 mask (available from pharmacies and hardware stores) and gloves when handling and disposing animal products and waste.
• covering wounds with waterproof dressings when handling and disposing of animal products and waste.
• wearing a properly fitted P2 mask when mowing or gardening in areas where there are livestock or native animals
• washing animal products and waste such as urine, faeces, blood and other body fluids from equipment and surfaces where possible
• removing and washing dirty clothing, coveralls and boots worn during high-risk activities in outdoor wash areas. Avoid taking these items home to reduce the risk of infection to your household. If you do take them home, bag and wash them separately (these items should only be handled by those who have had Q fever before or are vaccinated against Q fever).

These measures should not be considered a substitute for Q fever vaccination.

Diagnosis of Q fever

Q fever is diagnosed based on symptoms in people who may have come into contact with the bacteria in the previous 6 weeks. Make sure you tell your doctor if you belong to one of the groups that are most at risk of Q fever described above.

Treatment of Q fever

Q fever is treated with antibiotics. Early treatment can help reduce the risk of long-term complications. It is important to seek early medical care if symptoms develop.

Chronic Q fever infection may require long-term antibiotics.

Where to get help

• In an emergency, always call triple zero (000)
• Your GP (doctor)
• Your Local Public Health Unit
• Emergency department of your nearest hospital
• Victorian Virtual Emergency Department
• NURSE-ON-CALL Tel. 1300 60 60 24 – for expert health information and advice (24 hours, 7 days)
• National Immunisation Infoline Tel. 1800 671 811
• Q fever facts - information for the general public to help protect against Q Fever.