摘要：We investigated an outbreak of Q fever in aremote rural town in New South Wales, Australia.Cases identified through active and passive casefinding activities, and retrospective laboratoryrecord review were interviewed using a standardquestionnaire. Two sets of case–case analyseswere completed to generate hypotheses regardingclinical, epidemiological and exposure riskfactors associated with infection during theoutbreak. Laboratory-confirmed outbreak cases(n=14) were compared with an excluded casegroup (n=16) and a group of historic Q fevercases from the region (n=106). In comparisonwith the historic case group, outbreak cases weresignificantly more likely to be female (43% vs.18% males, P = 0.04) and identify as Aboriginal(29% vs. 7% non-Aboriginal, P = 0.03). Similarly,very few cases worked in high-risk occupations(21% vs. 84%, P < 0.01). Most outbreak cases(64%) reported no high-risk exposure activitiesin the month prior to onset. In comparison withthe excluded case group, a significantly increasedproportion of outbreak cases had contact withdogs (100% vs. 63%, P = 0.02) or sighted kangarooson their residential property (100% vs. 60%,P = 0.02). High rates of tick exposure (92%) werealso reported, although this was not significantlydifferent from the excluded case group. While asource of this outbreak could not be confirmed,our findings suggest infections likely occurredvia inhalation of aerosols or dust contaminatedby Coxiella burnetii, dispersed through the townfrom either an unidentified animal facility orfrom excreta of native wildlife or feral animals.Alternatively transmission may have occurred viacompanion animals or tick vectors.
