Q Fever Knowledge, Attitudes and Vaccination Status of Australia's Veterinary Workforce in 2014.

Emily Sellens,Katrina L Bosward,Jacqueline M Norris,Jane Heller,Nicholas Wood,Navneet K Dhand,Harold Willaby,Heather F Gidding,Lynne Hayes,Ulrike Gertrud Munderloh

doi:10.1371/journal.pone.0146819

Abstract

Q fever, caused by Coxiella burnetii, is a serious zoonotic disease in humans with a worldwide distribution. Many species of animals are capable of transmitting C. burnetii, and consequently all veterinary workers are at risk for this disease. An effective Q fever vaccine has been readily available and used in Australia for many years in at-risk groups, and the European Centre for Disease Prevention and Control has recently also called for the use of this vaccine among at-risk groups in Europe. Little is known about attitudes towards this vaccine and vaccine uptake in veterinary workers. This study aimed to determine the Q fever vaccination status of veterinarians and veterinary nurses in Australia and to assess and compare the knowledge and attitudes towards Q fever disease and vaccination of each cohort. An online cross-sectional survey performed in 2014 targeted all veterinarians and veterinary nurses in Australia. Responses from 890 veterinarians and 852 veterinary nurses were obtained. Binary, ordinal and multinomial logistic regression were used to make comparisons between the two cohorts. The results showed that 74% of veterinarians had sought vaccination compared to only 29% of veterinary nurses. Barriers to vaccination among those not vaccinated did not differ between cohorts, and included a lack of perceived risk, financial expense, time constraints, and difficulty in finding a vaccine provider. Poor knowledge and awareness of Q fever disease and vaccination were additional and notable barriers for the veterinary nursing cohort, suggesting veterinary clinics and veterinarians may not be meeting their legal responsibility to educate staff about risks and risk prevention. Further evaluation is needed to identify the drivers behind seeking and recommending vaccination so that recommendations can be made to improve vaccine uptake.

Highlights

Q fever is a serious zoonotic disease capable of causing chronic debilitating and life threatening, illness in humans [1]
The major barriers to vaccine uptake among the veterinary nurses participating in the study included a lack of knowledge and awareness of Q fever disease and availability of vaccination
Veterinarians and clinic protocols were reported as the main source of biosecurity information to veterinary nurses, the low levels of knowledge and uptake of the Q fever vaccine suggests that veterinarians and clinics were not providing adequate workplace health and safety (WH&S) information and training, in relation to Q fever, as is required by Australian law

Summary

Introduction

Q fever is a serious zoonotic disease capable of causing chronic debilitating and life threatening, illness in humans [1]. Following infection by the causative bacterium Coxiella burnetii, about 40% of patients become symptomatic in the acute phase, with symptoms most often limited to a flu-like illness. Chronic Q fever may develop months or years after acute infection, with immunocompromised or pregnant patients predisposed, as are those with pre-existing heart valve lesions, vascular disease or prosthetic joints [8,9]. Women with chronic Q fever may experience recurrent miscarriage or pre-term deliveries [7]. Due to the non-specific and variable presentations of both acute and chronic Q fever, diagnosis may be delayed in the absence of a high index of suspicion, prolonging illness and endangering the lives of those affected [14,15]

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