Last Updated: 16/04/2018
The purpose of this safety alert is to highlight the risk of acquiring Q fever from work with parturient (birthing) cats and dogs.
Seven workers associated with an animal shelter recently acquired Q fever, a zoonotic disease of animals. This included animal attendants and veterinary staff. Two of the workers were hospitalised due to their illness.
The likely source of infection was a pregnant cat that aborted her litter. The cat was attended to by workers from the animal shelter and by veterinary staff from a local veterinary clinic.
None of the infected workers had undergone Q fever screening and vaccination.
Q fever is a zoonotic disease of animals caused by the bacteria Coxiella burnetii. Infected animals generally do not show signs of illness, but may display reproductive issues such as miscarriage and stillbirth. Infected animals shed the bacteria in urine, faeces, milk and in especially large numbers in birth products (placenta and birth fluids). The bacteria can persist in the environment for prolonged periods, including in soil, dust and straw.
People most commonly become infected with Q fever from contact with livestock (cattle, sheep and goats). However, other animals can also infect people. These include native wildlife (kangaroos, wallabies and bandicoots), camels and companion animals (cats and dogs). Birthing and aborting animals are especially high risk.
People become infected with Q fever from inhaling aerosols and dust containing infectious urine, faeces, raw (unpasteurised) milk and birth products. Infection also occurs from handling animal bedding, hides and wool. Less commonly, infection occurs from drinking raw milk and from tick bites.
People who become unwell from Q fever generally have a flu-like illness. In some people, this can be severe and require hospital treatment. About 10-20 per cent of infected people develop post-Q fever chronic fatigue syndrome which causes prolonged and debilitating illness. About three per cent of infected people develop chronic infection which most commonly presents as endocarditis, a serious heart disorder. Chronic infection can also cause lesions of bone, tissues and organs. People with a pre-existing heart valve disorder, a weakened (immunocompromised) immune system or who are pregnant are at highest risk of developing chronic infection. Infection during pregnancy can cause complications such as miscarriage, still birth and premature birth, and this may recur in subsequent pregnancies.
Q fever is preventable by vaccination. Workers who work with high risk animals, including parturient cats and dogs, should undergo Q fever screening (involving a skin and blood test) and vaccination. This includes veterinarians and veterinary nurses, professional dog and cat breeders and other workers who work with high risk animals. A list of doctors who provide Q fever screening and vaccination is available from the Q fever register.
Other control measures may be used in addition to Q fever vaccination. This includes keeping the workplace clean to minimise animal waste and dust, minimising exposure to aerosols (e.g. avoiding high pressure water systems when cleaning animal waste) and ventilation systems to contain potentially infectious airborne contaminants. A properly fitted particulate respirator (e.g. disposable P2 respirator) may be used as a short term control measure. Because Q fever is spread in the air, standard infection prevention and control practices such as hand hygiene, although essential where there is a risk of exposure to blood and body fluids, are not sufficient to prevent infection with Q fever.
A person conducting a business or undertaking (PCBU) that provides veterinary services to parturient cats and dogs or performs other activities that may expose workers to contact with high risk animals including parturient cats and dogs (such as at animal shelters) must eliminate or minimise, so far as is reasonably practicable, the risk of Q fever.
The management of Q fever risks includes implementing a Q fever screening and vaccination program for workers who are at risk of infection, and ensuring that suitable personal protective equipment is available and used correctly. A PCBU who fails to comply with a duty to manage the risks associated with Q fever may be liable for an offence under the Work Health and Safety Act 2011.
Further information can be obtained from the following: