Preventing Q fever

About Q fever

Q fever is also called Query fever. It is an infectious disease caused by the bacteria Coxiella burnetii. It can spread from animals to humans through direct and indirect contact with:

• infected animals
• animal products
• contaminated material.

Infection in humans usually occurs by inhalation of the bacteria. The bacteria is contained in fine aerosol particles that come from the excreted material of infected animals.

Animals that may be infected and carry the bacteria include:

• farm animals, such as cattle, sheep and goats
• domestic animals, such as cats and dogs
• wild animals, such as kangaroos, wallabies, camels, birds and rodents.

Dust and hay contaminated by infected animals can also carry the bacteria. The bacteria can survive many disinfectants and harsh conditions. This means it can remain in the environment for a long time.

Symptoms of Q fever

The incubation period for Q fever is usually 12–14 days but can range from 4 days to 6 weeks. Some people with Q fever will show no symptoms. Others will have flu-like symptoms. For example:

• fever and sweating
• chills
• headaches
• nausea
• muscle pain and fatigue
• vomiting and diarrhoea.

These symptoms generally last for a few weeks. Most people will recover and develop immunity to future Q fever infections. Some people may develop chronic Q fever and have ongoing symptoms or complications for months or even years. These can include:

• heart disease
• bone and joint infections
• vascular infections.

Around 10–15% of people who are infected develop Q fever fatigue syndrome. This can last for years and may affect someone’s ability to work or live a normal life.

How Q fever is passed to humans

People usually get infected with Q fever by breathing in aerosols or dust from contaminated materials and animal products. This can happen while:

• birthing, handling, slaughtering or butchering infected animals
• handling infected animal faeces, urine, birth tissue or placentas
• handling infected clothing, wool, animal hides, straw or equipment
• herding, shearing or transporting infected animals
• mowing contaminated grass.

Infected animals often have no symptoms and can shed bacteria in their urine, faeces or milk.

You can also be infected with Q fever if you:

• drink infected unpasteurised milk
• touch infected animal tissue or fluids with broken skin.

The bacteria can survive in soil, dust and hay for a long time. It is very infectious. Even people who do not have contact with animals may be infected.

Q fever is not usually passed from person to person.

Who is at risk

People who work with animals, animal products and waste materials are at risk of Q fever. Some people have an increased risk of being infected. These include:

• abattoir workers and anyone attending or visiting an abattoir
• meat workers
• knackery workers
• tannery workers
• farm and dairy workers
• stockyard workers
• livestock transporters
• sheep shearers, wool classers, pelt and hide processors
• veterinarians, student vets, vet nurses and other animal handlers
• laboratory technicians who work with the bacteria or raw animal products
• workers at rendering plants
• council or road workers who collect roadkill
• wildlife, zoo and animal refuge workers
• agricultural college staff and students
• gardeners who mow grass contaminated with infected animal secretions
• professional dog and cat breeders
• workers at pet food manufacturers where animal products are used
• laundry workers who handle clothing worn by these workers.

Also at risk are:

• administration and maintenance staff at high-risk workplaces, such as abattoirs, knackeries and tanneries
• visitors to these workplaces including tradespeople or delivery drivers
• members of the public who are near these workplaces
• people who come into contact with contaminated clothing, boots or equipment, such as family members of at-risk workers
• people exposed to cattle, sheep, goats, camels and native wildlife
• people exposed to animal products and waste.

How to reduce the risk

You can eliminate or reduce the risk of exposure to Q fever at your workplace with risk control measures such as:

• Q fever screening and vaccination
• workplace design
• safe work practices
• workplace Q fever policy
• personal protective equipment (PPE).

Q fever screening and vaccination

A vaccine called Q-Vax gives a high level of protection against Q fever. Vaccination should be the first risk control you consider for Q fever risks. Immunity takes about 15 days to develop.

Only doctors with specific education about Q fever vaccination should provide these vaccinations. For help finding a doctor who can provide Q fever vaccinations:

• speak to your local GP
• contact your local Public Health Unit.

Workplace design

You should identify high-risk work areas where employees are more likely to be exposed to Q fever. These include:

• kill floors
• livestock transport vehicles
• yards and pens
• offal rooms
• skin sheds
• rendering areas
• slink rooms.

Install appropriate ventilation and dust suppression systems in these areas. This will help to limit the spread of dust and other airborne particles. Ventilation systems should have the intake and exhaust vents separated to prevent recirculation of contaminated air.

You should also provide appropriate washing and changing facilities near these areas to help to avoid cross-contamination. Washing and changing facilities may include:

• showers with appropriate drainage so contaminated water drains away quickly and without further risk
• enclosed laundry hampers or bins to secure potentially contaminated work clothing
• secure storage for personal clothing away from possible contamination
• an appropriate volume of sinks, showers and storage for the number of employees typically working at one time.

Safe work practices

Safe work practices help to eliminate or reduce the risk of Q fever transmission. For example:

• Store personal clothing away from any work clothing that may be contaminated. Work clothing should not be taken from the workplace.
• Ban eating, drinking, smoking and nail-biting in animal-holding or processing areas.
• Ensure employees thoroughly wash their hands:
  • before eating, drinking, smoking or vaping in designated areas
  • before and after going to the toilet
  • at the end of each shift.
• Instruct employees to shower at the end of their shift. This is particularly important for those working in high-risk areas.
• Clean and disinfect work areas regularly, and ensure drainage is adequate.
• Decompose with soda ash and bury any animal by-products that are not suitable for processing.
• Limit exposure to raw milk until pasteurised or boiled.
• Treat employees who have open wounds with proper and timely first aid. This includes ensuring wounds are appropriately covered.
• Muzzle dogs that move livestock.
• Use PPE such as gloves, respirators and protective clothing.
• Run an ongoing inspection and maintenance program. This should include regular inspection of:
  • ventilation and drainage systems
  • washing facilities.
• Give employees the information, instruction, training and supervision they need to work safely and without risks to health.

In the meat industry, you can further limit the risk of Q fever transmission by:

• Training staff to use knives properly so they minimise damage to the udder and rectum. This will limit the release of potentially contaminated airborne particles from milk and faeces.
• Maintaining the integrity of the animal organs such as the bladder, intestines and uterus when they are removed and put on the eviscerating table.
• Washing stock with low-pressure hoses on the race that leads to the kill floor. This will limit the release of potentially contaminated airborne particles.

Workplace Q fever policy

A Q fever policy ensures everyone in the workplace understands the risk of Q fever and how to control it. The policy should set out:

• What Q fever is, the symptoms and how it can be passed to humans.
• What information about Q fever will be included in the site induction for employees, contractors and visitors. This could include:
  • information about why Q fever is a risk at the workplace
  • details of the risk controls in place
  • providing a copy of this guidance.
• How and when Q fever screening and vaccinations will be carried out.
• A list of the Q fever high-risk areas at the workplace.
• Who can enter high-risk areas and what requirements must be met before they do. For example, vaccinations and PPE.
• What the indicators of possible Q fever infections are and how these will be monitored.
• How a suspected Q fever infection in an animal or human can be reported.
• How a suspected Q fever infection will be investigated.
• What will happen if a Q fever infection occurs. This should include a response process for both an infection in animals and humans. It should explain how the infection will be managed as well as any reporting requirements.

Personal protective equipment (PPE)

Appropriate PPE for reducing the risk of Q fever includes:

• P2 respirator that has been fit-tested
• boots that can be easily cleaned, such as gumboots with steel caps
• gloves
• coveralls that are bagged for cleaning after use or are disposable.