There has been a significant decline in the number of Q fever cases reported so far this year compared to the same period last year.
There have been 118 cases reported from January to April to the Australian Government’s National Notifiable Diseases Surveillance System (NNDSS) down from 210 cases for the first third of 2019.
The Department of Health has suggested that the drop cases reported, in the year to date, could be related to COVID-19.
The Department said that COVID-19 response activities might also be impacting on laboratory testing capacity, information which it does not hold.
Figures extracted from the NNDSS reveals no continual decline in Q fever cases in the five years prior: 605 in 2015, 560 in 2016, 478 in 2017 and 513 in 2018, and 563 in 2019.
Are fewer people being tested?
President of the Rural Doctors Association of Australia (RDAA), Dr John Hall, is not surprised by the reduction in Q fever cases reported this year.
“We could imagine, and this is only a best guess, that a number of people that had mild illnesses with Q fever are probably not getting tested in the current climate and being told to stay at home and to manage themselves symptomatically,” he said.
Dr Hall said as a result it was likely that fewer people were getting tested for Q fever.
“We know that people who get the severe form of Q fever often are hospitalised, those people would still be being tested … and that’s why we’re still seeing a number of tests coming through.”
Reduction in dust and livestock possibly behind decline
While the Rural Doctor’s Association of Australia presents a plausible explanation for the decline in cases reported, the NSW Farmers’ Association has pointed to several other potential factors.
The Association’s president James Jackson said a reduced number of Q fever cases could be due to a reduction in cattle and sheep, and less dust, which can carry the Q fever bacteria, present as a result of rain.
“Contact with stock or domestic animals is a significant risk factor, so there would be reasons why it could be down on last year.”
While agreeing it could be in part be COVID-19 related, he hoped another reason was awareness programs run by the farmer peak body, and the NSW Government, had led to an increase in vaccination rates.
The sheep and cattle producer from Guyra in the New England region spent a week in Armidale Hospital’s intensive care unit in 1992 after contracting Q fever.
Steady uptake of the Q fever vaccine
Despite the decline in cases, the uptake of the Q fever vaccine, Q-Vax, has remained steady, according to its manufacturer Seqirus.
Seqirus Asia Pacific’s senior medical director Dr Jonathan Anderson said that the fall in cases reported this year was encouraging.
“What we don’t know yet is why this has occurred,” he said.
“What I do know though is that there’s been a tremendous amount of work put in by a whole range of different stakeholder groups to try to create more awareness around Q fever, both in the general community and in the health care system to make sure we can properly prevent and treat Q fever.”
“We’ll continue to work with the Australian Government to make sure that there’s adequate supplies of the vaccine into the future.”