Abstract: Introduction: The causative agent of Q fever, Coxiella burnetti, is found in a wide variety of animals and does not require direct animal-to-human contact for infection. Q fever is contracted by inhaling contaminated dust particles or bacteria shed from infected animals. Q fever has traditionally been associated with rural workers in primary production, abattoirs and veterinary occupations; however cases linked to non-traditional sources are increasingly reported. The diversity of clinical symptoms and range of severity at presentation often leads to Q fever being misdiagnosed or not reported. Early identification, appropriate treatment and follow-up following acute Q fever are essential for the health and wellbeing of patients. Serious long-term complications occur in 5% of all acute Q fever cases yet there is no Australian guideline or global consensus on what follow-up should be provided to patients. Aim: This study explored the knowledge of Q fever, Q fever vaccination and usual clinical follow-up practices among rural general practitioners. Relevance: Rural practitioners are likely to have patients present with Q fever and assume responsibility for managing their short and long-term care. However there is little known about Australian rural general practitioners’ knowledge of Q fever and Q fever vaccination. Method: Far North Queensland rural general practitioners were invited to complete an anonymous survey either online or in hard copy. Descriptive analysis about knowledge of Q fever, recommendations for vaccination, post graduate education on Q fever and follow up practices was undertaken (IBM SPSSv22) on 16 responses (16/52, 31% response rate). Results: Nearly all respondents were aware of the traditional sources (contaminated livestock and soil) of Q fever and at-risk occupations (farmers, veterinarians, abattoir workers) requiring vaccination. Less obvious sources of infection (wildlife and domestic pets) were not as well recognized. Most respondents would consult with an Infectious Disease or Public Health colleague. Appropriate follow-up practices were described by a small number of respondents: treatment with doxycycline (n=4), follow-up over a period longer than one year (n=2), specific cardiac follow-up (n=3). Conclusion: This study identified a range of self-reported usual clinical practice and follow-up (if any) of Q fever cases by rural general practitioners, including consultation with a specialist. The lack of consensus found in this study reflects differing opinions about the best practice of Q fever management. These results further highlight the need for the development of evidence-based Q fever management guidelines.
Hollins, Aaron, Abernethy, Gail, Smyth, Wendy, Ray, Robin, Harte, Jane, 2019, Q fever knowledge and follow-up practices of northern Australian rural general practitioners, Conference Paper, viewed 24 February 2020, https://www.nintione.com.au/?p=15810.