What exactly is Q Fever?

Q Fever is basically a disease that is caused due to bacterium Coxiella burnetii. It infects humans and spreads from cattle, sheep and goats as well as a number of different domestic or wild animals. Those that have no contact with animals could also get infected.

What are the symptoms of Q Fever like?

Those that are infected can have no or little indicators of the fever. Severe flu-like symptoms can be seen in people that often fall sick. Symptoms of Q Fever usually begin around 2-3 weeks once getting in contact with the virus.

A person may feel:

• Fever with high degree of chills
• Excessive ‘drenching’ sweats as well as headaches (usually behind or around the eyes)
• Pain pertaining to the muscles or joints
• A feeling of extreme fatigue

Development of hepatitis (burning of the liver) or pulmonia (liver infection) can also occur in patients. If not treated, symptoms could last anywhere around 2-6 weeks.

The illness can often lead to time off from work which can be from some days to more than 3 weeks. However, many do recover fully and can gain immunity against repeated infections. Occasionally, people can develop chronic infections after 2 years, causing a series of health problems such as endocarditis. This commonly develops among women that are pregnant, people with previous heart issues, or those that have an immune system which is weak. A rare number of patients, about 10%, that are infected with acute Q Fever can suffer from many chronic fatigue-like disorders which can weaken the patient for years.

How does Q Fever spread?

People are usually infected by Q Fever when they intake the Q Fever bacteria present in the air or dust through breathing.

The main sources of infection include cattle, sheeps, and goats, but can also include other types of animals such as domestic as well as feral animals like dogs, cats, horses, pigs, rabbits, alpacas, rodents, llamas, camels, and foxes. Other animals native to the Australian wildlife like kangaroos, bandicoots and wallabies among others can spread the Q Fever virus to human beings.

The infected animals usually show no symptoms. The bacteria is present in the birth fluids and the placenta (in high numbers). It can even be found in the blood, urine, feaces, or even milk of those animals that are infected or who carry the Q Fever bacteria. The Q Fever bacteria can stay in the dust and soil for years and, by the wind, can travel several kilometers across.

A person can get infected if they:

• Breathe the bacteria through the air or dust.
• Birth or slaughter affected animals such as cattle, goats, sheeps. A high risk of infection is possible in such activities.
• Handle diseased animals, their tissues, fluids or excretion, products or materials of such animals like straw, hides, wool, manure fertilisers, clothes. (for e.g. washing clothes that are worn when butchering or birthing).
• Herd, sher, or transport infected animals.
• Mow grass that is polluted with infected animal waste.
• Visit, live or work near high-risk industries.
• Come in direct contact with animal fluids on teared skin or tissues (for e.g. cuts or injuries while in contact with such infected animals).
• Drink cow, sheep or goat milk that is unpasteurised.

Who is the most at risk?

Those mentioned below are possibly at a higher risk of contracting Q Fever.

• People working in an abattoir.
• Dairy and livestock farmers as well as workers.
• Wool classers/sorters, hide and pelt processors as well as shearers.
• Stockyard workers, animals and animal products transporters, waste veterinarians, vet nurses/students or assistants or anyone handling veterinary specimens.
• Wildlife workers, those handling animals with high-risk (includes animals native to Australian wildlife).
• Students and college staff belonging to the agriculture division (with high-risk animal contact).
• Lab workers (those who work with bacteria or other high-risk specimens).
• Animal hunters or shooters.
• Animal breeders or those who are regularly exposed to birth-giving animals.
• People whose job includes regular mowing in or around areas that are followed by livestock or animals (people working near golf courses, council employees, people in the mowing business falling under rural or regional areas).

Any person entering workplaces that is infected with Q Fever is at the risk of getting contracted by the bacteria. These can be anyone from tradespeople to labour hires, contractors, sales personnel, consumers, and council workers.

Some people might also have a risk of contracting Q Fever through animals potentially contaminated with the virus outside work.

In rural or regional areas, infections are also said to have occurred by intaking contaminated dust particles present in the surroundings.

Those at an increased risk of Q Fever can be:

• Family members belonging to people from occupations having high-risk of infections (usually through clothes, equipnet, or footwear)
• People that live near high-risk zones (for e.g. from nearby livestock farms, stockyards for cattle/goats/sheeps), areas near meatworks, land utilising fertilisers with untreated animal dung.
• Visitors present nearby risk-prone areas (for e.g. farms, animal saleyards, abattoirs, or agricultural events)

Those who are gardners, horticulturists or someone who works where dust or contaminated animal urine and faeces is aerosolised.

How to prevent Q Fever?

The best and effective vaccination (Q-VAX) is regarded as the ideal way to prevent Q Fever. This type of vaccination is recommended for those who work or plan to work in risk-prone occupations. The vaccine is also meant for those with age 15 and above who can potentially get contracted with the Q Fever during outdoor activities or in areas where they reside or visit.

For those that aren’t immune (either through vaccines or previous infections), the below measures can help you eliminate the risks of infection.

• Try to wash your hands properly using soap and water post contact with any animal.
• Wear a perfectly fitting P2 Mask and gloves.
• If you have any wounds, make sure you cover them with waterproof coverings when disposing or handling any type of animal products, placentas, and aborted foetuses. (This shouldn’t be thought of as an alternative for Q Fever vaccines).
• Wear a neatly fitting P2 mask during gardening or mowing areas with a presence of native animals or livestock.
• Eliminate any type of animal faeces, urine, blood or other types of bodily fluids off equipment and surfaces where necessary.
• Wash dirty clothes, any form of coverall and footwear that is worn at the time of risk-prone jobs around outdoor areas for washing.
• Discard bringing such items in your home to minimise the risk of contamination. If needed, place them in a bag and use a different washing equipment. (This is recommended to be done by those immune to the infection).

How is Q Fever diagnosed?

The diagnosis of Q Fever depends on the initial symptoms and understanding the possibility of one’s getting in contact with the Q Fever bacteria in the last 6 weeks. Ensure your doctor is aware whether you fall under any of the risk categories mentioned above. Blood tests are needed with recurrent testing 2 to 3 weeks post the symptoms confirm the detection.

How is Q Fever treated?

An early treatment using antibiotics can help you feel better earlier and eliminate the risks of any long-term difficulties. Therefore, it’s vital to seek immediate medical help once developing the symptoms or when one belongs to a group at the risks of any infections. Those with chronic Q Fever infections could need long-term antibiotics for effective treatment.

What about public health?

When it comes to public health, laboratories need to notify the public health units in their local areas upon detecting confirmed Q Fever cases. The staff can then investigate particular cases in order to determine any infection source and people at risk, ensuring the preventive measures are followed and necessary information is provided to the cases.