Open AccessControl strategies for Q fever based on results of pre‐vaccination screening in Victoria, 1988 to 2001
Author(s) -
Greig Jane E.,
Patel Mahomed S.,
Clements Mark S.,
Taylor N. Kathleen
Publication year - 2005
Publication title -
australian and new zealand journal of public health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.946
H-Index - 76
eISSN - 1753-6405
pISSN - 1326-0200
DOI - 10.1111/j.1467-842x.2005.tb00749.x
Subject(s) - vaccination , medicine , immunity , q fever , demography , immunology , environmental health , immune system , sociology
Objective:Data from Q fever prevaccination screening were analysed to determine the level of agreement between the two tests of immunity and between disease or vaccination history and immunity, trends in proportion of participants immune to Q fever, and the annual risk of infection.Method:Data from nearly 10,000 screening episodes between July 1988 and June 2001 on Victorian workers at high risk were assessed.Results:Most participants were male (86%) and employed in Victorian abattoirs (81%). Agreement between results of tests for immunity was ‘fair’ ( k =0.52). Selfreported history of vaccination or infection was a poor predictor of immunity. The proportion of positive blood and skin tests increased with years of exposure to animals/meat, but decreased over the 13‐year period with shorter exposures. Hence the percentage requiring vaccination increased from 50% in 1998 to 90% in 2001. The average annual risk of infection among abattoir workers was 45.0 per 1,000 (95% CI 42.3–47.6), and 62.6 per 1,000 (95% CI 57.5–67.7) over the first 10 years of exposure.Conclusions:This is the first Australian study to estimate the annual risk of Q fever infection in abattoir workers. The study confirmed previous findings of poor agreement between screening tests and predictive value of history of vaccination/exposure. Up to 90% of new entrants in high‐risk workplaces will be susceptible to Q fever and require vaccination.Implications:Systematic post‐marketing surveillance is needed to monitor adverse events to the vaccine, duration of protection and possible reasons for vaccine failures.