title: Trends and risk factors for human Q fever in Australia, 1991-2014.
abstract: Australian abattoir workers, farmers, veterinarians and people handling animal birthing products or slaughtering animals continue to be at high risk of Q fever despite an effective vaccine being available. National Notifiable Diseases Surveillance System data were analysed for the period 1991-2014, along with enhanced risk factor data from notified cases in the states of New South Wales and Queensland, to examine changes in the epidemiology of Q fever in Australia. The national Q fever notification rate reduced by 20% [incident rate ratio (IRR) 0·82] following the end of the National Q fever Management Program in 2006, and has increased since 2009 (IRR 1·01-1·34). Highest rates were in males aged 40-59 years (5·9/100 000) and 87% of Q fever cases occurred in New South Wales and Queensland. The age of Q fever cases and proportion of females increased over the study period. Based on the enhanced risk factor data, the most frequently listed occupation for Q fever cases involved contact with livestock, followed by 'no known risk' occupations. More complete and comparable enhanced risk factor data, at the State/Territory and national levels, would aid in further understanding of the epidemiology of Q fever.
authors.affiliation: Office of Health Protection, Department of Health,Woden,ACT,Australia.
authors.forename: T S
authors.initials: TS
authors.lastname: Sloan-Gardner
authors.affiliation: Hunter New England Population Health,NSW,Australia.
authors.forename: P D
authors.initials: PD
authors.lastname: Massey
authors.affiliation: Darling Downs Public Health Unit,QLD,Australia.
authors.forename: P
authors.initials: P
authors.lastname: Hutchinson
authors.affiliation: Office of Health Protection, Department of Health,Woden,ACT,Australia.
authors.forename: K
authors.initials: K
authors.lastname: Knope
authors.affiliation: National Centre for Epidemiology & Population Health, Research School of Population Health, Australian National University,ACT,Australia.
authors.forename: E
authors.initials: E
authors.lastname: Fearnley
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000818:Animals; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D016273:Occupational Exposure; D011778:Q Fever / Q000453:epidemiology*; D011793:Queensland / Q000453:epidemiology; D012307:Risk Factors; D012737:Sex Factors; D055815:Young Adult
keywords: Australia; Q fever; public health surveillance; risk factors; vaccination