Q fever for health professionals

Q fever is a bacterial zoonotic disease. It mainly spreads to people through inhalation of contaminated dust. It is a nationally notifiable disease. We monitor and report on national case numbers and epidemiological trends. We publish case definitions and guidelines to support health professionals.

For health professionals For everyone

Disease

  • Q fever is caused by the bacterium Coxiella burnetii.

    It is highly infectious and can survive for long periods in the air, water, soil and dust.

    The primary reservoirs for C. burnetii are cows, sheep and goats, but many domestic and wild animals and ticks can carry the bacterium.

  • At least half of Q fever infections in people are asymptomatic.

    Initial symptoms can be similar to influenza including:

    Less common symptoms can include:

    Most people recover completely from acute Q fever within a few weeks, but serious complications can include:

    • pneumonia
    • myocarditis
    • granulomatous hepatitis
    • central nervous system complications.

    Some people develop long-term, persistent fatigue following acute Q fever – called Q fever fatigue syndrome.[1]

    A small proportion (less than 5%) of infected people develop chronic infection, with some groups of people at increased risk. Chronic Q fever most often manifests as endocarditis, but can affect other organs.

    Infection during pregnancy can lead to:

    • miscarriage
    • stillbirth
    • premature birth
    • low birth weight.

    Read about the diagnosis and treatment of Q fever.

Public health importance

  • Although most cases are mild, Q fever can cause serious disease and long-term health impacts.

    Q fever fatigue syndrome can impact people’s quality of life and ability to engage in day-to-day activities.

    Chronic Q fever can persist for months or years, requiring long-term medical support. 

    Q fever during pregnancy can lead to severe consequences for the fetus.

    The disease disproportionately affects people in some occupations – including farming, veterinary work and meat processing – due to their greater risk of exposure.

    Coxiella burnetii can survive in the environment for many weeks and can travel long distances in the wind. A very low dose can cause infection. This means that even small outbreaks can have major impacts.

    Because of this, we:

  • Q fever cases occur in many parts of the world. It is endemic in Australia. 

    Typically, several hundred people are diagnosed with Q fever each year in Australia, with infections more common in males. In 2024, 878 Q fever cases were notified in Australia – a significant increase compared with previous years.

    Cases are reported year-round but often peak in warmer months due to drier conditions and increased outdoor and farming activities.

    Most cases occur in regions with high livestock density, particularly in parts of Queensland and New South Wales. 

    Vaccination of people at risk of exposure has reduced the incidence of Q fever in Australia.[2]

    For the latest information on Q fever incidence in Australia, see the National Notifiable Diseases Surveillance System (NNDSS) data visualisation tool.

Spread of infection

  • Animals shed Coxiella burnetii into the environment. This can be through their:

    • birthing materials
    • milk
    • faeces
    • urine.

    People can become infected by inhaling contaminated dust or aerosols, or through contact with infected animals or contaminated materials.

    C. burnetii can survive in the environment for months to years. It can also spread over very long distances, so people can be infected even when they haven’t been around animals. 

    While rare, infections from ticks have been documented in people. Ticks remain an important vector in animal infections. 

  • Symptoms, if present, usually start 1 to 3 weeks after exposure to the bacterium.[3]

  • Coxiella burnetii does not normally transmit person to person.

Priority populations

  • The risk of chronic Q fever is greater for people who:

    • are immunocompromised
    • have a history of valvular heart disease, arterial aneurysm or vascular graft
    • are infected during pregnancy.[4]

    Read more about measures people can take to protect themselves.

  • People are at greater risk of being infected if they are exposed to dust, soil, grass or other materials contaminated with fluids from infected animals.[5]

    People at risk of exposure include those who work or have contact with:

    • animals that can carry the bacterium – including cows, sheep, goats, camels and kangaroos and less commonly, cats and dogs
    • animal materials – such as raw wool, meat, hides or birthing materials
    • animal fluids – including milk, faeces, urine, blood or amniotic fluid
    • items contaminated with animal fluids – such as clothing, boots or equipment.

    See what measures people can take to protect themselves.

  • Q fever outbreaks in Australia can occur in settings where animals are present – including farms or meat processing facilities.

    Read more about the prevention, control and public health management of outbreaks.

Prevention

  • Q fever is vaccine preventable. Vaccination is recommended for people aged 15 years and older who are at greater risk of exposure through their jobs or other activities.

    Vaccination is contraindicated in people who have:

    • already received a Q fever vaccine
    • previously had Q fever.

    Pre-vaccination testing must be done before vaccination. 

    See the Australian Immunisation Handbook for more information.

  • In addition to vaccination, the best protection against Q fever is to:

    • wash your hands after contact with animals or materials contaminated with animal fluids
    • wear a properly fitted P2 or N95 respirator and gloves when interacting with livestock or wildlife, or when mowing or gardening where livestock or wildlife might have been
    • bag and separately wash clothing, boots or other items contaminated with animal fluids or faeces, and avoid these being handled by anybody who isn’t immune to Q fever
    • keep wounds covered with a waterproof dressing when around animals
    • not drink unpasteurised milk.

  • People who may be at greater risk of exposure through their work or activities should:

    • know the symptoms of Q fever
    • discuss Q fever vaccination with their health professional if they aren’t vaccinated
    • follow their employer’s work health and safety advice.

Diagnosis and clinical management

  • Q fever is diagnosed by laboratory testing. Because of the risk associated with laboratory acquired infection, specimens are not set up for culture.

    Nucleic acid testing requires a blood sample, ideally collected within a week of symptom onset. 

    Serology testing requires 2 or more blood samples (acute and convalescent) collected at least 7 days apart. 

  • Read more about laboratory testing and the laboratory case definition.

  • Q fever is treated with antibiotics. Early treatment reduces the risk of developing chronic Q fever.

    Ongoing monitoring with repeat blood testing is recommended for people with Q fever to identify chronic Q fever early. Chronic Q fever requires long-term antibiotic treatment and multidisciplinary care.

Notification and reporting

Public health response

  • The CDNA national guidelines for public health units inform the public health response to Q fever.

  • Public health units investigate all confirmed cases of Q fever in people, with a focus on determining the likely source of the infection.

    The person affected should be provided with information about:

    Cases are advised to seek medical care if symptoms don’t resolve following treatment, or if new symptoms develop.

    People with Q fever do not need to isolate.

    Read more about case management in the CDNA national guidelines for public health units.

  • Public health authorities follow up people who might have been exposed to the same source as a confirmed Q fever case. This can include people who:

    • have the same animal exposures
    • have the same occupational exposures
    • have shared the same environment
    • have been exposed to contaminated items – such as clothing
    • live in the same household.

    Public health authorities provide people who might have been exposed with information about:

    Read more in the CDNA national guidelines for public health units.

  • Public health authorities respond to Q fever outbreaks as a high priority.

    Control measures used during outbreaks can include:

    • urgent testing of people with symptoms
    • assessing the vaccination status of people who might have been exposed
    • restricting access to an area by unvaccinated people
    • environmental control measures – such as deep burial of animal birth materials
    • extra infection prevention and control measures – such as personal protective equipment
    • collaboration between public health authorities, animal health authorities and local work health and safety regulators.

    Read more in the CDNA national guidelines for public health units.

  • An unexplained increase in Q fever cases in the community might trigger:

    • investigations into potential sources of infection
    • targeted vaccination programs
    • alerts to local health services.

    Public health units should refer to the CDNA National guidelines for public health units.

Resources

References

  • 1 G Morroy, SP Keijmel et al., 'Fatigue following acute Q fever: A systematic literature review', PLOS ONE, 2016, 11(5):e0155884, doi:10.1371/journal.pone.0155884.
  • 2 HF Gidding, C Wallace et al.,'Australia's national Q fever vaccination program',Vaccine, 2009,27(14):2037–2041, doi:10.1016/j.vaccine.2009.02.007.
  • 3 DL Knobel, AN Maina et al., 'Coxiella burnetii in humans, domestic ruminants, and ticks in rural western Kenya', The American Journal of Tropical Medicine and Hygiene, 2013, 88(3):513–518, doi:10.4269/ajtmh.12-0169.
  • 4 JL Pérez-Arellano, J Curbelo et al., 'A comprehensive review of the mechanisms of human Q fever: Pathogenesis and pathophysiology',Pathogens, 2025, 14(6):589, doi:10.3390/pathogens14060589.
  • 5 K Eastwood, SR Graves et al., 'Q fever: A rural disease with potential urban consequences',Australian Journal of General Practice, 2018, 47(3):5555, doi:10.31128/AFP-08-17-4299.

We are adding new content to this website and expanding these pages, including a suite of disease-related information. In the meantime, information about diseases in Australia is available on the Department of Health, Disability and Ageing’s website.

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