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Q Fever – comment on The Quiet Curse

July 13th, 2015

The ABC program Landline The Quiet Curse” recently featured the disease Q fever. This has generated a lot of enquiries about Q Fever to our clinic.

Q Fever rarely attracts media attention and yet it is among the most costly and severe infectious diseases in Australia. Persons at occupational risk should be vaccinated.

Our specialised Q FEVER website has a great deal more information on the disease.

The questions we have been getting from the recent program are are along the lines of

1. QUESTION ” Am I ( or my family) at risk? ”

ANSWER – It really depends on your exposure. In Australia, cattle, sheep and goats are the main resevoir, although bandicoots, kangaroos and dogs can be infected. Man can also be infected with the germ (Coxiella Burnetti) following contact with infected animals or products from these animals, urine, faeces or milk birth products, or even contaminated dust.

2 QUESTION – “Should my children be vaccinated ?”

ANSWER – For most children, we would say no. The official guidelines say Q fever vaccine is not recommended in children aged under 15 years of age. There are no data on the safety or efficacy of Q fever vaccine in this age group.

However that is because there is no research one way or the other on the vaccine in children. It is not that the vaccine has been demonstrated to be a problem, it is just that undertaking vaccine trials on children is difficult, and expensive, and children are not said to be at high risk of Q fever. No-one has done the research. Children are said to get less sick with Q fever, but research does report cases of sick kids: e.g. here, here, and here.

The last study above ( where children likely caught Q fever was from eating cheese in Greece,) found Q fever was found more commonly as children aged “In particular, acute Q fever was diagnosed in 0.15% (1 of 654) of patients < 5 years of age, in 0.77% (3 of 391) of patients 5-10 years of age, and in 2.58% (4 of 155) of patients 11–14 years of age (P = 0.005).

The scary thing is that some people with no obvious risk factors, contract Q fever : There was an outbreak in the Netherlands – with a total of 3,523 human cases notified between 2007 and 2009. Many patients were only living ‘downwind’ from a goat farm.

There really needs to be more research.

Sometimes children ( especially those over the age of 10 years ) who live on farms and are deemed to be at high risk of Q fever may be vaccinated after discussion between the doctor and the parents about the risks and benefits. If you live on or near a farm, it is worth having a chat to a doctor with expertise in Q fever. (Not all GP’s are familiar with Q fever or able to do the vaccine.) More info about the vaccine is here.

Comments welcome below

 

 

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