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Risk factors and burden of acute Q fever in older adults in New South Wales: a prospective cohort study

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Q fever is a highly infectious zoonotic disease caused by the bacterium Coxiella burnetii.13 The main reservoirs for this bacterium are domestic and wild animals, and it can be excreted in their urine, faeces, milk and products of conception, and can survive in harsh environmental conditions.1 Transmission to humans occurs mainly through direct contact with infected animal products or by inhalation of contaminated dust or aerosols.4 In humans, Q fever manifests as an acute flu-like illness or, less frequently, with pneumonia or hepatitis; infection is often asymptomatic.1 Chronic Q fever, most frequently presenting as endocarditis, occurs in about 5% of symptomatic cases.1 Q fever fatigue syndrome is the most frequently reported sequela of acute infection (10%–20% of cases).5

A Q fever vaccine is available in Australia and is recommended for those at high occupational risk of infection.6,7 During 2001–2006, the federal government funded the National Q Fever Management Program (NQFMP) in various states, including New South Wales; under this program, people at high risk were screened and…