Q Fever in Rural Australia: Education Versus Vaccination.

Abstract

Q fever is an infection caused by Coxiella burnetii, a zoonotic disease acquired from both wild and domestic animals. Northern rural New South Wales (NSW) communities in Australia have an increased risk of exposure to this organism. Both the acute and chronic phases of the infection are associated with significant morbidity, which is often increased by delayed recognition and treatment. Recent termination of vaccination programs in Australia may increase the risk of infection in these populations. This cross-sectional study evaluated the current knowledge base and overall understanding of clinicians on the epidemiology, presentation, and diagnosis of Q fever in the Northern New South Wales Local Health District. Forty-five participants responded to the survey. Among those, 35 participants (78%) were hospital based and 10 (22%) were from doctors working in the community. Thirty-one (72%) clinicians answered bacteria as the cause of Q fever, 34 (79.1%) participants selected animals as the reservoir of Q fever infection, and 22 (51%) identified inhalation as the form of transmission. The majority identified livestock rearing occupations (84%) as a high-risk group; however, only 65-70% identified stock yard and meat workers as groups also at risk. Furthermore, 23 (51%) of the participants considered those living in rural and remote communities as high risk. Our results identified gaps in knowledge of clinicians in the epidemiology and diagnosis of acute Q fever infection. With the termination of vaccination programs, this study highlights the need for education programs that can increase Q fever awareness toward prompt identification and treatment.