Q fever is caused by Coxiella burnetii bacteria.^1,2 Animals such as cattle, sheep, goats, and kangaroos are the primary carriers of the bacteria, and can spread it through birth fluids, milk, urine and faeces.² The bacteria can survive for a long time in the environment and infect humans who breathe in contaminated droplets and dust.^1,2 Humans are vulnerable to getting the disease, but it is rare for it to spread between individuals.

Majority of people who get infected do not have any symptoms, but for those who do, it often presents as a severe flu-like illness.¹ There may be extremely rare complications associated with the heart, muscles or nervous system.³ Infections during pregnancy have been associated with miscarriages, fetal growth retardation and premature births.³ Early recognition and immediate treatment of Q fever are essential. Whilst the infections are usually acute, it can develop into a chronic infection with various other complications.^1,3 Those at increased risk of developing chronic Q fever include immunosuppressed individuals, pregnant women and people with heart disease or complications.^1,3

A Q fever vaccine is available to protect people who are at risk; however, screening and testing of Q fever immunity status is required prior to vaccination.³ People who have had Q fever should not be vaccinated as it can result in severe reactions. Preventative measures (good hygiene, personal protective equipment and safe, immediate disposal of animal birth materials and manure) can also reduce the risk of disease.¹

Synonyms: Coxiella Burnetii fever, Coxiellosis, Q fever pneumonia, Query fever, Quadrilateral fever, Nine Mile fever.²

Universal rare disease classifications provide a common language for recording, reporting and monitoring diseases. Please visit the Rare Disease Classifications page for more information about these internationally recognised classifications.

ORPHA:781 Q fever

ICD-11: 1C33 Q fever

Symptoms of Q fever include a severe flu-like illness, such as fever and chills, sweats, severe headache (particularly behind the eyes), cough, muscle pain, weakness, fatigue and weight loss.^1,3 The time for symptoms to first appear can vary between 4 days to 6 weeks from exposure, but in most cases it is after 2-3 weeks.¹

In rare cases, Q fever can develop into a chronic form, with complications affecting the heart, bone and joints, or chronic fatigue.^1,3

It is best to speak to your medical team to learn more about the symptoms and complications of Q fever.

Additional information can be found in the Australian Government Department of Health factsheet on Q Fever.

Rare diseases are often serious and progressive, exhibiting a high degree of symptom complexity, leading to significant disability. Majority of the estimated two million Australians living with a rare disease meet the Australian Government’s definition for disability (in accordance to the Australian Public Service Commission and Australian Bureau of Statistics), and many experience severe and permanent disability impacts. If you or someone you care for is experiencing disability-related impacts from a rare condition, please speak with a health or disability professional for advice. Information about relevant disability support can be found at the RARE Portal’s Disability Support Information page.

Infection usually occurs by inhalation of the Coxiella burnetii bacteria from air that contains airborne barnyard dust contaminated by dried placental material, birth fluids and waste products of infected animals.^1,2 Other modes of transmission to humans, which include tick bites, ingestion of unpasteurized milk or dairy products, and human to human transmission (through blood transfusion or mother-to-fetus), are possible but rare.^1,2

Diagnosis of Q fever can be based on symptoms, clinical examination and laboratory tests on blood samples (two or more blood samples on separate occasions may be required). If you suspect you have Q fever, please see your medical practitioner as early diagnosis and treatment of Q fever is essential.¹

Acute Q fever is often treated with antibiotics. Early diagnosis and treatment are important to reduce the risk of long-term complications. Prolonged antibiotics treatment may be required to treat those with chronic Q fever.¹

Please speak to your medical team to learn more about the possible treatment or management options for your condition. Treatment will depend on an individual’s specific condition and symptoms. It is also important to stay connected to your medical team so that you can be made aware of any upcoming clinical trial opportunities.

Clinical care for rare diseases often involves a multidisciplinary team of medical, care and support professionals. Please note that the information provided here is as a guide and that RVA does not necessarily monitor or endorse specific clinics or health experts.

Please see your general practitioner (GP) as soon as possible if you suspect you have Q fever. GPs who have diagnosed or are managing a patient with Q fever are encouraged to consult infectious disease specialists and medical microbiologists for further guidance.^4-6

Communicable Diseases Network Australia (CDNA) have developed the Q Fever – CDNA National Guidelines for Public Health Units.

Further information about the treatment of Q Fever is detailed in the Debilitating Symptom Complexes Attributed to Ticks (DSCATT) Clinical Pathway 2020.

Additional information for medical practitioners:

• Q fever: A rural disease with potential urban consequences (article in Australian Journal of General Practice)
• Diagnosis and management of zoonoses – a tool for general practice (article in Australian Family Physician)

Individuals living with rare diseases may have complex medical issues and disabilities, which are not always visible. It is often useful to refer to their medical history as well as personal information such as a medical card, doctor’s letter, or if available, a rare disease passport, for relevant information.

There are specific considerations around participating in rare disease research, including clinical trials. It is important to be mindful of issues such as data privacy, research ethics, consent and differences in research regulations between Australia and other countries.

If you are interested in finding clinical trials for your condition, please visit the following websites; however, there may not be any clinical trials available:

• Australian Clinical Trials
• ClinicalTrials.gov

It is best to discuss your interest in any clinical trials with your medical team to determine suitability and eligibility.

Please note that RVA does not necessarily monitor or endorse each group/organisation’s operational governance and activities.

We are not aware of any rare disease organisations for Q fever in Australia.. If you know of any rare disease organisation supporting people living with Q fever, please let us know via the Contribute page. If you are interested in starting an Australian organisation for people living with Q fever, please see Engaged, Ethical and Effective: A Guide for Rare Disease Organisation Leaders in Australia.

Please note that RVA does not monitor or endorse each group/organisation’s operational governance and activities. When engaging with a group, please consider the information on the RARE Portal’s Finding Helpful Peer and Community Supports page.

Q fever vary between individuals, and each person’s experience is unique.

If you would like to share your personal story with RVA, please visit the Rare Voices Australia: Share Your Story page. RVA will consider your story for publishing on our website and inclusion on the RARE Portal.

For information on available government and social services that provide support for individuals with a rare disease, please visit the National and State Services pages.

People living with a rare disease, including families and carers, often face unique challenges such as diagnostic delays, misdiagnoses, limited treatment options, and limited access to rare disease specialists and support. These challenges may impact people’s emotional wellbeing and quality of life. Many people find it helpful to seek mental health and wellbeing support to cope with ongoing stress and uncertainty. Connecting with people who have shared experiences through a support group may also be helpful. Information about relevant mental health and wellbeing support can be found at:

• Mental Health and Wellbeing Support for Australians Living with a Rare Disease
• The National and State Services pages underneath the ‘Mental Health’ sections listed

Q fever is a nationally notifiable disease, which means medical practitioners or laboratories are required, by law, to report cases of Q fever to their local health.

Further information on Q fever can be found at:

• Australian Immunisation Handbook: Q fever, vaccines, and recommendation for vaccination
• healthdirect: Q fever
• NSW Health: Aboriginal people and Q fever
• Animal Management in Rural and Remote Indigenous Communities: Macquarie University Factsheet – Q Fever
• Australian Q Fever Register
• Genetic and Rare Diseases (GARD) Information Center: Q Fever

• Australian Government Department of Health factsheet on Q Fever
• Australian Immunisation Handbook: Q fever, vaccines, and recommendation for vaccination
• Orphanet: Q Fever
• Human Phenotype Ontology (HPO): Q Fever

This page has been developed by Rare Voices Australia (RVA)’s RARE Portal team.

If you are aware of any additional information that may benefit stakeholders with an interest in this page, or if you notice any broken links or inaccurate information, please let us know via the Contribute page.