Q fever

Q fever is an infectious disease caused by the bacteria Coxiella burnetii and is transmitted to humans from indirect or direct contact with animals. The main sources of infection arise from:

Sheep
Cattle
Goats

Although, other less common sources of infection can include:

Kangaroos
Bandicoots
Camels
Dogs
Cats

The identification of infected animals can be challenging as animals generally do not show signs of being sick but may display reproductive issues such as miscarriage and stillbirth. Infected animals shed the bacteria in faeces, milk, and predominantly in placental membranes and birthing fluids.

Sheep walking in a cloud of dust in the Australian outback

How is Q fever spread?

Infection can occur from inhaling contaminated aerosols and dust arising from:

Animal products (milk, wool, hides, fur, urine, faeces, and birthing products)
Animal environments (soil, bedding, straw, hay, grass)
Other contaminated items (machinery, equipment, clothing)

Transmission of Q fever by tick bites and drinking unpasteurised milk from infected cows and goats is possible, but uncommon. Person-to-person transmission is also rare.

Close up of sheep shearing

Who is most at risk?

Occupations and workers at risk of contracting Q fever include:

Abattoir workers
Agricultural, farm and dairy workers
Stockyard workers
Livestock transporters
Sheep shearers, wool classers, pelt and hide processors
Veterinarian workers
Dog and cat breeders
Wildlife workers, zookeepers, and volunteers (as well as animal rescue workers who handle injured fauna)
People that work with raw animal products (such as reproductive organs), which may include laboratory personnel
Rendering deceased livestock/animals
Workers who collect roadkill

Q fever can also infect others that are either visiting, living, or working near a high-risk industry.

Health effects

Q fever symptoms

Approximately half of all people with a Q fever infection show signs of clinical illness, with some people displaying flu-like symptoms. This is known as acute Q fever, although, most people will recover in several months.

However, some people may develop chronic Q fever where infection can persist for more than 6 months and may not be apparent until many years after the initial infection. Some people may also develop ongoing, long-term fatigue after the initial disease has resolved, known as Post Q Fever Fatigue Syndrome.

For more information on the health effects of a Q fever infection, visit the SA Health Q fever webpage.

Duty of PCBU

Under the Work health and Safety Act 2012, it is the duty of the PCBU to ensure, as far as reasonably practicable, that the health and safety of the workers is not put at risk by carrying out the work. A PCBU must ensure SafeWork SA is notified immediately once aware of a Q fever case (see “Duty to notify the regulator”).

If workers, contractors, and other visitors at your workplace are at risk of contracting Q fever, risk control measures must be made available. It is therefore necessary to identify, assess, and control the risks to prevent infections. To implement this, a PCBU must:

Identify areas, rooms, and yards within the workplace where there is a risk of contracting Q fever, as well as other workplaces workers are required to travel to
Assess the risk by performing risk assessments for each high-risk area
Control the risk by implementing controls in accordance with the hierarchy of controls (see below), with elimination being the highest order of control

Training must be delivered to workers in a manner that is readily understandable to the person (for example, by presentation, toolbox meetings, written information or translated to their primary language) and should contain information on:

Vaccination programs
Pathogens
Workplace cleanliness
PPE
The identification of areas where infection by Q fever is a risk
How to assess the risk of Q fever
Eliminating hazards and controlling risks

Workers should also be made aware to monitor themselves for symptoms and to seek medical attention if necessary.

Vaccination against Q fever is recommended for people aged 15 years and over who are at risk of infection with C. burnetii and have not had Q fever infection or vaccination.

Prior to immunisation, a blood and skin test are recommended to see if the individual already has immunity to Q fever – either naturally or by previous vaccination. Vaccinating those already immune to Q fever can result in severe reactions.

Vaccinations are a high-level control measure and can eliminate the risk of contracting Q fever - protecting workers from developing illness.

For more information, see the Australian Immunisation Handbook on Q fever.

In the case of individuals who are not able to receive the vaccine, either by declining to be vaccinated or are ineligible to receive the vaccine following medical advice, the following control measures should be implemented:

Provide respiratory protection (P2 respirator)
Provide appropriate personal protective clothing (e.g. overalls/coat and rubber boots)
Encourage appropriate personal hygiene procedures
Only allow the person access to low-risk Q fever work areas

Duty to notify the regulator

Under the WHS Act 2012 and WHS Regulations 2012, a PCBU must ensure the regulator (SafeWork SA) is notified immediately after becoming aware that a case of Q fever has occurred, either by:

Filling out SafeWork SA’s Notifiable Incident Reporting Form
Phone call: 1300 365 255
Email: help.safework@sa.gov.au

SafeWork Australia’s incident notification information sheet provides more information about mandatory reporting requirements.

For more information on other notifiable infectious diseases, see SafeWork SA’s webpage on Zoonoses.

Relevant legislation

Regulations, section 699 (b)(i): For the purposes of section 36 of the act, each of the following is a serious illness: the following occupational zoonoses contracted in the course of work involving handling or contact with animal products: Q fever.