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Q fever prevention strategy needed

At the NSW Farmers’ Annual Conference in July 2016, conference delegates voted to lobby the NSW and federal governments to conduct free Q fever clinics (testing and vaccination) for all Australians in rural and animal industries.

This is a key issue for rural health; not just for producers, but also for vets and vet nurses, saleyard operators, livestock agents, meat processors, and rural residents around Australia.

Q fever is caused by a bacterium (Coxiella burnetti) carried by animals and transmitted to humans. It is usually an acute infection but it can sometimes lead to a chronic illness, and it is considerably under-diagnosed and under-reported. Infection risk is not confined to people working in livestock industries; Q fever can be contracted by people living near abattoirs, saleyards, and working with cats, dogs, and wildlife.

Australia has one of the highest rates of Q fever in the world, mostly in NSW and Queensland. Between 2011 and 2015, notifications of Q fever in NSW have doubled. Cases of Q fever related to high-risk industries, including farming, continue to be reported in significant numbers.

The National Q Fever Management program, which commenced in 2001, provided vaccinations for people at risk of contracting Q fever. In the years following introduction of the program, the number of Q fever cases reported to the National Notifiable Diseases Surveillance System declined by over 50 per cent. However, significant barriers to accessing vaccination mean that people working with livestock are highly exposed to Q fever risk, and immunisation coverage of farmers is currently inadequate.

Getting tested and vaccinated means two visits to a qualified doctor. For many farmers, this means two long round-trips and too much time away from the farm. The vaccination isn’t covered if you’re at risk of contracting Q fever through your employment. The combined cost of testing and vaccination can be over $400.

Practitioners who carry out testing and vaccination need to be well-trained to interpret screening tests and previous exposure to Q fever. This is a barrier to the vaccine being offered in more rural practices. It can also be difficult to find a local GP to administer the screening test and vaccination - almost half of the NSW practitioners listed on the National Q Fever register are based in Sydney.

NSW Farmers is calling on the state government to fund free testing and vaccination clinics in NSW. We need to upskill rural practitioners and remove travel and cost barriers for people seeking testing and vaccination.

We’re proposing an awareness program to increase diagnosis and reporting, increase immunisation coverage, and ensure that everyone is aware of the risks of Q fever. We suggest that governments should also be looking into trialling new technology that allows for faster and more objective testing for Q fever.

Farmers and rural residents are frustrated that their exposure to Q fever is overlooked by city-focused health policy. Ministers have promised watching briefs on Q fever, but the time has come to take action. In the face of the rural health gap, governments can no longer afford to ignore a health risk that impacts so many rural constituents.

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