The Northern Territory Disease Control Bulletin
Territory Health Services, Centre for Disease Control
Northern Territory disease control bulletin; E-Journals; PublicationNT; Northern Territory disease control bulletin
Date:2002-03; This publication contains may contain links to external sites. These external sites may no longer be active.; Made available via the Publications (Legal Deposit) Act 2004 (NT).
Communicable diseases; Reporting; Northern Territory; Statistics; Periodicals
Northern Territory Government
Northern Territory disease control bulletin
v. 9 no. 1
Attribution International 4.0 (CC BY 4.0)
Northern Territory Government
The Northern Territory Disease Control Bulletin Vol 9, No.1, March 2002 11 Figure 1 The distribution of cases of Q fever, Australia, 1991-19946 Figure 2 Number of cases of Q fever in Australia by year, 1991-1994 Clinical features Q fever can present as a pyrexia of unknown origin, pneumonia or acute hepatitis. Frequently all features are present to varying degrees. The case fatality rate in untreated cases is less than 2% and sub-clinical infection is recognised.4 Rarely, culture negative chronic endocarditis or neurological features are the main manifestations. Clinicians need to be vigilant in their consideration of this diagnosis particularly now that the first case has been identified. Diagnosis is confirmed by serology and not culture. Public health action An inactivated whole-cell vaccine against Q fever (Q-Vax) was developed in Australia in the late 1980s and released in 1990 by CSL. Despite evidence of efficacy5 it was not actively promoted until a Commonwealth government funded program was commenced in 2000 targeting veterinarians and abattoir workers and expanded in 2001 to include all sheep and cattle farmers. This case would not have been prevented by such a program. Because there had been no cases of Q fever, no vaccination program was established in the NT. The most likely source of infection in this case was the cattleyards past which the patient drove every morning on his way to work. It is interesting that this is a busy road and it is perhaps surprising that there havent been other cases if our theory is correct. CDC has alerted specialist adult physicians in the Top End of the occurrence and has planned meetings with the NT Department of Primary Industry and Fisheries. References 1. Q fever outbreak Germany, 1996. MMWR 1997;46(2):29-32. 2. Hawker JI, Ayres JG, Blair I et al. A large outbreak of Q fever in the West Midlands: windborn spread into a large metropolitan area? Commun Dis Public Health 1998;1(3):180-7. 3. Tissot-Dupont H, Torres S, Nezri M, Raoult D. Hyperendemic focus of Q fever related to sheep and wind. Am J Epidemiol 1999;150(1):67-74. 4. Chin J. (ed) Control of Communicable Diseases Manual. 2000 (17th ed) American Public Health Association. Washington. 5. Ackland JR, Worswick DA, Marmion BP. Vaccine prophylaxis of Q fever. A follow-up study of the efficacy of Q-vax (CSL) 1985-1990. Med J Aust 1994;160:704-708. 6. Garner MG, Longbottom HM, Cannon RM, Plant AJ. A review of Q fever in Australia 1991-1994. Aust N Z J Public Health 1997;21(7):722-30. ************ 0 100 200 300 400 500 600 700 800 900 1000 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 Year N u m b er o f ca se s Source: National Notifiable Diseases Database
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