Premium
Seroprevalence of Q fever among metropolitan and non‐metropolitan blood donors in New South Wales and Queensland, 2014–2015
Author(s) -
Gidding Heather F,
Faddy Helen M,
Durrheim David N,
Graves Stephen R,
Nguyen Chelsea,
Hutchinson Penny,
Massey Peter,
Wood Nicholas
Publication year - 2019
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/mja2.13004
Subject(s) - seroprevalence , coxiella burnetii , metropolitan area , medicine , q fever , odds ratio , demography , veterinary medicine , risk factor , cross sectional study , antibody , immunology , virology , serology , pathology , sociology
Objectives To estimate the prevalence of exposure to the causative agent of Q fever ( Coxiella burnetii ) and of current infections among blood donors in Australia. Design, setting Cross‐sectional study in metropolitan Sydney and Brisbane, and in non‐metropolitan regions with high Q fever notification rates (Hunter New England in New South Wales; Toowoomba in Queensland). Participants Blood donors attending Red Cross collection centres during October 2014 – June 2015 who provided sera and completed a questionnaire on Q fever vaccination status, diagnosis and knowledge, and exposure history. Main outcome measures Age‐ and sex‐standardised seroprevalence of phase II IgG antibodies to C. burnetii (indicating past exposure) and independent risk factors for seropositivity; presence of C. burnetii DNA (indicating current infection and risk of transmission by blood transfusion). Results 2740 donors (94.5% response rate) completed the questionnaire and supplied sera for analysis. Crude antibody seroprevalence was 3.6%. Standardised seroprevalence was higher in non‐metropolitan than metropolitan regions ( NSW , 3.7% v 2.8%; Queensland, 4.9% v 1.6%; statistically significant only in Queensland). Independent predictors of antibody seropositivity were regular contact with sheep, cattle, or goats (adjusted odds ratio [ aOR ], 5.3; 95% CI , 2.1–14), abattoir work ( aOR , 2.2; 95% CI , 1.2–3.9), and assisting at an animal birth ( aOR , 2.1; 95% CI , 1.2–3.6). Having lived in a rural area but having only rare or no contact with sheep, cattle or goats was itself a significant risk factor ( v never lived rurally: aOR , 2.5; 95% CI , 1.1–5.9). 40% of people in groups recommended for vaccination were aware of the vaccine; 10% of people in these groups had been vaccinated. C. burnetii DNA was not detected in 1681 non‐metropolitan samples, suggesting that transmission by blood donation is unlikely. Conclusions Given their exposure to multiple risk factors, vaccination against Q fever should be considered for all rural residents.