Surveillance system enhancements for Q fever in NSW, 2005-2015.

ABSTRACT

INTRODUCTION: Q fever remains an important notifiable, zoonotic disease in Australia. Previous epidemiological reviews have noted increased importance of non-abattoir contact with livestock and native/feral animals. Changes to surveillance in New South Wales (NSW) have provided enhanced surveillance data with which to examine exposure pathways. METHODS: Descriptive analysis of NSW Q fever notification data for the period 2005-2015, with detailed analysis of exposures for the period 2011-2015 (after introduction of improvements to surveillance). RESULTS: Between 2005 and 2015, 1,653 confirmed cases of Q fever were notified in NSW residents who acquired the disease in this state. For the period 2011-2015, a high-risk occupation was reported in 345/660 (52.3%) of notifications with a known occupation. Of 641 cases with a known animal exposure, 345 (53.8%) had direct contact with livestock, while 62 (9.7%) had indirect contact with livestock (e.g. proximity to livestock, livestock holding areas or trucks). Direct or indirect contact with native/feral animals was reported in 111/641 (17.3%) cases. Mowing and close proximity to kangaroos/wallabies were commonly reported indirect exposure pathways, particularly in urban areas. CONCLUSIONS: Enhancements to the state based surveillance database in NSW introduced in 2010 have resulted in improved collection of surveillance data for Q fever. Further refinement of Q fever surveillance can be achieved through continuing to improve data quality, standardising data collection and better elucidating exposure pathways of cases.