Q fever and Australia's veterinary workforce: research to inform vaccine policy.

Abstract

Q fever is a zoonotic disease of worldwide importance, causing significant and prolonged morbidity, low mortality, and burdening health systems with an enhanced requirement for diagnostics and disease surveillance. Most infections are attributed to livestock, though other species may harbour the causative pathogen, Coxiella burnetii. Australia is currently the only country with a licensed Q fever vaccine, where it is recommended for workers considered to have a high risk for C. burnetii exposure. Veterinarians are routinely vaccinated, usually at the commencement of university studies. However, veterinary support staff including nurses and kennel hands are not, and recent outbreaks in small animal clinics in Sydney highlighted potential under-vaccination of these workers. The need for a greater understanding of Q fever epidemiology among Australia’s veterinary personnel was also evident, as this unique population is inadequately described in the existing body of knowledge. This research investigated the knowledge, attitudes, and practices of Australian veterinary personnel regarding Q fever disease and vaccination, and quantified Q fever vaccine uptake while identifying barriers to and drivers of vaccine uptake. Coxiella burnetii seroprevalence was determined in Australia’s unvaccinated veterinary workforce as an indicator of exposure risks, while the presence of markers of immunity among vaccinated veterinary workers were also studied post-vaccination. Adverse events following Q fever vaccination were also investigated in veterinary students to provide a greater representation of younger adults and females, who predominate the demographic entering the veterinary workforce yet remain under-represented in adverse events data to date. While this research is intended to provide veterinary specific insights for the continued improvement of workplace health and safety practices in Australia, the findings have implications for the wider community both within Australia and abroad.