Q fever infection is a preventable risk associated with pet food manufacturing.

OBJECTIVE: This paper highlights the occupational risk of Q fever from exposure to raw animal products in the context of multiple notified Q fever cases from 2020 to 2023 linked to four pet food manufacturing facilities in South-East Queensland, Australia. METHODS: The Queensland Government Notifiable Conditions System was used to identify Q fever cases linked to pet food manufacturing in the Metro North and Gold Coast Hospital and Health Service areas of Brisbane, Australia. Data on each case from routine public health follow-up were collected and descriptively analysed. RESULTS: Between 2020 and 2023, 12 confirmed Q fever infections (17% of total cases) were linked to four pet food manufacturing facilities. Eleven cases reported direct or environmental exposure to raw meat and animal products. None were previously vaccinated for Q fever. CONCLUSION: These cases demonstrate the increased risk of Q fever infection as part of the pet food manufacturing process, highlighting an underappreciated preventable occupational risk, which can be mitigated with the use of pre-screening and vaccination of workers. All occupations should conduct workplace-based risk assessments to identify risks such as Q fever to prevent adverse negative health outcomes.

Yersiniosis outbreaks in Gold Coast residential aged care facilities linked to nutritionally-supplemented milkshakes, January-April 2023.

Abstract: In January 2023, an outbreak of Yersinia enterocolitica in residential aged care facilities (RACF) was identified by the Gold Coast Public Health Unit and confirmed using whole genome sequencing. During the outbreak period there were 11 confirmed and 14 probable cases of Y. enterocolitica notified in RACF and 30 suspected cases with compatible illness. Eleven cases (20%) were confirmed as Biotype 1A non-typable (BT1A NT) sequence type (ST) 278 within 4-15 single nucleotide polymorphisms (SNP) of each other. Combined epidemiological, trace-back and laboratory investigations identified nutritional milkshakes, stored at ideal growing conditions for Yersinia and given to vulnerable RACF residents, as the likely outbreak vehicle. This highlights that Y. enterocolitica Biotype 1A can be pathogenic in humans and transmission via atypical sources should be considered in outbreak investigations. This report outlines the response and challenges associated with investigating outbreaks in aged care.

Wave of COVID-19 outbreaks in Gold Coast residential aged care facilities after easing travel restrictions into Queensland.

Objective: This paper describes outbreaks of coronavirus disease 2019 (COVID-19) in Gold Coast residential aged care facilities (RACFs), in the two months following the easing of travel restrictions at Queensland's domestic border on 13 December 2021. Methods: This audit reviewed all RACF COVID-19 outbreaks notified to the Gold Coast Public Health Unit between 13 December 2021 and 12 February 2022. An outbreak was defined by the Communicable Diseases Network Australia guidelines current at the time. Results: There were 60 COVID-19 outbreaks across 57 RACFs during this period. In 44 outbreaks (73.3%), a staff member was identified as the primary or co-primary case. Transmission amongst residents occurred in 48 outbreaks (80.0%). The attack rates in staff and residents were 17.0% (n = 1,060) and 11.7% (n = 645) respectively. A higher number of males were hospitalised (n = 39: 57.4%) or died (n = 28: 66.7%) than were females (n = 29: 42.6%; n = 14: 33.3% respectively). Most resident cases (n = 565: 87.6%) had received two or more doses of a COVID-19 vaccine. In resident cases who were under-vaccinated (n = 76), twenty (26.3%) required hospitalisation and nine (11.8%) died. In resident cases who received two doses of vaccine (n = 484), forty-three (8.9%) were hospitalised and 27 (5.8%) died. In resident cases who had received three doses (n = 80), four (5.0%) were hospitalised and five (6.3%) died. Conclusions: COVID-19 caused significant morbidity and mortality in Gold Coast RACFs following the easing of border restrictions. Higher rates of hospitalisation and death occurred in males than in females, and in under-vaccinated resident cases than in those vaccinated with at least two doses of a COVID-19 vaccine. Implications for public health: These data support the need for up-to-date COVID-19 vaccination of residents in RACFs, continued surveillance and timely and appropriate implementation of public health guidelines to manage COVID-19 outbreaks in RACFs.