Volume 95, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Q fever is endemic in Australia, and during the period 2005–2013 our laboratory diagnosed 379 cases in New South Wales. To evaluate clinical symptoms, epidemiology, mode of diagnosis, antibody profiles, and treatment, a subset of 160 (42%) Q fever cases were analyzed in detail following the return of a questionnaire by the patient's doctor and from their laboratory reports. Overall, 82% patients were male and predominantly middle aged. The majority of patients (89%) had animal contact among which 63% were with cattle, 11% with sheep, and 7% with kangaroos. Clinical symptoms were nonspecific: myalgia (94%), fever (91%), headache (80%), acute fatigue (64%), and arthralgia (55%). Most cases (93%) were acute, and serology (immunofluorescence) was the main diagnostic modality. Positive real-time polymerase chain reaction results were useful in the diagnosis of both acute and chronic Q fever, as was the isolation of in cell culture. Doxycycline was the antibiotic most commonly used.


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  1. Derrick EH, , 1937. “Q” fever, a new fever entity: clinical features, diagnosis and laboratory investigation. Med J Aust 21: 281299.
  2. Davis GE, Cox HR, Parker RR, Dyer RE, , 1938. A filter-passing infectious agent isolated from ticks. 1. Isolation from Dermacentor andersoni, reactions in animals and filtration experiments. Public Health Rep 53: 22592282.[Crossref]
  3. Hilbink F, Penrose M, Kovacova E, Kazar J, , 1993. Q fever is absent from New Zealand. Int J Epidemiol 22: 945949.[Crossref]
  4. Musso D, Broult J, Parola P, Raoult D, Fournier PE, , 2014. Absence of antibodies to Rickettsia spp, Bartonella spp., Ehrlichia spp. and Coxiella burnetii in Tahiti, French Polynesia. BMC Infect Dis 14: 255259.[Crossref]
  5. Powell O, , 1960. “Q” fever: clinical features in 72 cases. Australas Ann Med 9: 214223.
  6. Derrick EH, , 1973. The course of infection with Coxiella burnetii . Med J Aust 1: 10511057.
  7. Spelman DW, , 1982. Q fever: a study of 111 consecutive cases. Med J Aust 1: 547553.
  8. Buckley B, , 1980. Q fever epidemic in Victorian general practice. Med J Aust 1: 593595.
  9. Graves S, Stenos J, Unsworth N, Nguyen C, , 2006. Laboratory diagnosis of rickettsial infection. Aust J Med Sci 27: 3944.
  10. Stenos J, Graves S, Lockhart M, Carter IWJ, Schuller M, James GS, Sloots TP, Halliday CL, , 2010. Chapter 14: Coxiella burnetii . , eds. PCR for Clinical Microbiology. Berlin, Germany: Springer Science + Business Media BV, 145148.[Crossref]
  11. Burnet FM, Feeman M, , 1937. Experimental studies on the virus of “Q” fever. Med J Aust 21: 299305.
  12. Derrick EH, , 1944. The epidemiology of Q fever. J Hyg (Lond) 43: 357361.[Crossref]
  13. Derrick EH, , 1953. The epidemiology of “Q” fever: a review. Med J Aust 1: 245253.
  14. Dyer RE, , 1938. A filter-passing agent isolated form ticks. IV. Human infection. Public Health Rep 53: 22772282.
  15. Maurin M, Raoult D, , 1999. Q fever. Clin Microbiol Rev 12: 518553.
  16. Anderson A, Bijlmer H, Founier PE, Graves S, Hartzell J, Kersh GJ, Limonard G, Marrie TJ, Massung RF, McQuiston JH, Nicholson WL, Paddock CD, Sexton DJ, , 2013. Diagnosis and management of Q fever—United States, 2013: recommendations from the CDC and the Q fever working group. MMWR Recomm Rep 62: 130.
  17. Marmion B, , 2007. Q fever: the long journey to control by vaccination. Med J Aust 186: 164166.
  18. Raoult D, Tissot-Dupont H, Foucault C, Gouvernet J, Fournier PE, Bernit E, Stein A, Nesri M, Harle JR, Weiller PJ, , 2000. Q fever 1985–1998. Clinical and epidemiologic features of 1,383 infections. Medicine (Baltimore) 79: 109123.[Crossref]
  19. Johnson DW, , 1966. Epidemiology of Q fever in Queensland: a seven-year survey. Med J Aust 1: 121125.
  20. Boland PJ, Parker NR, , 1999. Q fever in south west Queensland. Med J Aust 171: 446.
  21. Harris P, Eales KM, Squires R, Govan B, Norton R, , 2013. Acute Q fever in northern Queensland: variation in incidence related to rainfall and geographical location. Epidemiol Infect 141: 10341038.[Crossref]
  22. Paymard M, Nicotra L, Dettrick A, Bell B, Chaudhuri A, Cody D, Tesar P, Hamilton-Craig C, , 2015. Chronic Q fever prosthetic valve endocarditis—an important cause of prosthetic valve dysfunction in Australia. Med J Aust 202: 212213.[Crossref]
  23. Garner MG, Longbottom HM, Cannon RM, Plant AJ, , 1997. A review of Q fever in Australia 1991–1994. Aust N Z J Public Health 21: 722730.[Crossref]
  24. Australian Government Department of Health and Ageing, 2010. Vaccine preventable diseases in Australia, 2005 to 2007. Q fever. Communicable Diseases Intelligence 34: S84S93.
  25. Duggan JM, Hunter WF, , 1956. Q fever: a report of three cases. Med J Aust 43: 645647.
  26. Henson J, Hansman D, , 1963. Q fever among abattoir workers in New South Wales. Med J Aust 50: 343346.
  27. Massey P, Taylor K, , 2004. Q fever cluster in a shearing team. N S W Public Health Bull 15: 1112.[Crossref]
  28. Karki S, Gidding H, Newall T, McIntyre P, Liu B, , 2015. Risk factors and burden of acute Q fever in older adults in New South Wales: a prospective cohort study. Med J Aust 203: 438448.[Crossref]
  29. Islam A, Ferguson J, Givney R, Graves S, , 2011. Seroprevalence to Coxiella burnetii among residents of the Hunter New England region of New South Wales, Australia. Am J Trop Med Hyg 84: 318320.[Crossref]
  30. Lowbridge CP, Tobin S, Seale H, Ferson MJ, , 2012. EpiReview: notification of Q fever in NSW, 2001–2010. N S W Public Health Bull 23: 3135.[Crossref]
  31. Massey P, Irwin M, Durrheim D, , 2009. Enhanced Q fever risk exposure surveillance may permit better informed vaccination policy. Commun Dis Intell Q Rep 33: 4145.
  32. Parker N, Robson J, Bell M, , 2010. A serosurvey of Coxiella burnetii infection in children and young adults in south west Queensland. Aust N Z J Public Health 34: 7982.[Crossref]
  33. Nourse C, Allworth A, Jones A, Horvath R, McCormack J, Bartlett J, Hayes D, Robson JM, , 2004. Three cases of Q fever osteomyelitis in children and a review of the literature. Clin Infect Dis 39: e61e66.[Crossref]
  34. Britton PN, Macartney K, Arbuckle S, Little D, Kesson A, , 2015. A rare case of Q fever osteomyelitis in a child form regional Australia. J Pediatric Infect Dis Soc 4: e28e31.[Crossref]
  35. Derrick EH, Pope JH, Smith DJW, , 1959. Outbreaks of Q fever in Queensland associated with sheep. Med J Aust 46: 585588.
  36. Pope JH, Scott W, Dwyer R, , 1960. Coxiella burnetii in kangaroos and kangaroo ticks in western Queensland. Aust J Exp Biol 38: 1727.[Crossref]
  37. Beaman M, Hung J, , 1989. Pericarditis associated with tick-borne Q fever. Aust N Z J Med 19: 254256.[Crossref]
  38. Cooper A, Barnes T, Potter A, Ketheesan N, Govan B, , 2012. Determination of Coxiella burnetii seroprevalence in macropods in Australia. Vet Microbiol 155: 317323.[Crossref]
  39. Cooper A, Stephens J, Ketheesan N, Govan B, , 2013. Detection of Coxiella burnetii DNA in wildlife and ticks in northern Queensland, Australia. Vector Borne Zoonotic Dis 13: 1216.[Crossref]
  40. Turra M, Chang G, Whybrow D, Higgins G, Qiao M, , 2006. Diagnosis of acute Q fever by PCR on sera during a recent outbreak in rural south Australia. Ann N Y Acad Sci 1078: 566569.[Crossref]
  41. Gilroy N, Formica N, Beers M, Egan A, Conaty S, Marmion B, , 2001. Abattoir-associated Q fever: a Q fever outbreak during a Q fever vaccination program. Aust N Z J Public Health 25: 362367.[Crossref]

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  • Received : 16 Nov 2015
  • Accepted : 22 Mar 2016

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