title: A Q fever cluster among workers at an abattoir in south-western Sydney, Australia, 2015.
abstract: BACKGROUND
  In September 2015, the Public Health Unit of the South Western Sydney Local Health District was notified of two possible Q fever cases. Case investigation identified that both cases were employed at an abattoir, and both cases advised that co-workers had experienced similar symptoms. Public Health Unit staff also recalled interviewing in late 2014 at least one other Q fever case who worked at the same abattoir. This prompted an outbreak investigation.
  
  
  METHODS
  The investigation incorporated active case finding, microbiological analysis, field investigation and a risk factor survey. Included cases were laboratory definitive or suspected cases occurring from October 2014 to October 2015, residing or working in south-western Sydney. A suspected case had clinically compatible illness, high-risk exposure and was epidemiologically linked to another confirmed case. A confirmed case included laboratory detection ofC. burnetti.
  
  
  RESULTS
  Eight cases met the case definition with seven confirmed (including a deceased case) and one suspected. The eight cases were all males who had been employed at an abattoir in south-western Sydney during their incubation period; symptom onset dates ranged from November 2014 to September 2015. Field investigation identified multiple potential risk factors at the abattoir, and the majority (75%) of employees were not vaccinated against Q fever despite this high-risk setting.
  
  
  CONCLUSIONS
  This cluster of Q fever in a single abattoir confirms the significance of this zoonotic disease as an occupational hazard among persons working in high-risk environments. Implementation of Q fever vaccination programmes should eliminate Q fever in high-risk occupational settings.
authors.affiliation: Public Health Unit, South Western Sydney Local Health District.
authors.forename: Heidi
authors.initials: H
authors.lastname: Lord
authors.affiliation: Public Health Unit, South Western Sydney Local Health District.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Fletcher-Lartey
authors.affiliation: Greater Sydney Local Land Services.
authors.forename: Guy
authors.initials: G
authors.lastname: Weerasinghe
authors.affiliation: Public Health Unit, South Western Sydney Local Health District.
authors.forename: Meena
authors.initials: M
authors.lastname: Chandra
authors.affiliation: Public Health Unit, South Western Sydney Local Health District.
authors.forename: Nilva
authors.initials: N
authors.lastname: Egana
authors.affiliation: Greater Sydney Local Land Services.
authors.forename: Nicole
authors.initials: N
authors.lastname: Schembri
authors.affiliation: Public Health Unit, South Western Sydney Local Health District.
authors.forename: Stephen
authors.initials: S
authors.lastname: Conaty
mesh_terms: D000003:Abattoirs; D000293:Adolescent; D000328:Adult; D000818:Animals; D001315:Australia / Q000453:epidemiology; D002417:Cattle / Q000382:microbiology; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D000067565:Farmers / Q000706:statistics & numerical data*; D006041:Goats / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology; D011778:Q Fever / Q000453:epidemiology* / Q000635:transmission; D012189:Retrospective Studies; D012307:Risk Factors; D012756:Sheep / Q000382:microbiology; D011795:Surveys and Questionnaires; D000078329:Workforce; D015047:Zoonoses / Q000453:epidemiology