From herd to human: Lessons from containing a Q Fever outbreak in Gippsland

Abstract Issue Q fever, caused by Coxiella burnetii, is a zoonotic disease transmitted through inhalation of contaminated aerosols from livestock. Gippsland, a rural region in south-eastern Victoria, is home to significant dairy and agricultural activity. The Gippsland Region Public Health Unit (GRPHU) managed a Q fever outbreak across three interconnected goat farms from 2024 to 2025. This investigation aimed to identify gaps in outbreak prevention and coordination and inform One Health preparedness in agricultural settings. Description of the problem An outbreak investigation was conducted among 57 at-risk individuals across three goat farms. Confirmed cases were identified via serology and PCR. Active case finding detected undiagnosed cases among farm workers and household contacts. WorkSafe conducted workplace assessments, and Agriculture Victoria provided livestock movement data to support epidemiological investigation. Results Twenty-four confirmed cases were identified (attack rate: 42.1%), of whom 22 (91.7%) were symptomatic and five (20.1%) were hospitalised. Most cases (62.5%) were male, with a median age of 29 years (range: 19-56); none had prior Q fever vaccination. GRPHU arranged post-outbreak vaccination for six individuals through local general practices. The investigation identified challenges in coordinating a One Health response, balancing public and occupational health priorities, and addressing vaccination gaps. Testing delays impeded timely case identification. Communication barriers and unclear inter-agency roles complicated response efforts. PPE use and vaccination promotion were limited by logistical and cost barriers. Lessons This outbreak highlights the need to strengthen coordination between human and animal health sectors. Enhanced surveillance, integration of occupational health into farm biosecurity, and improved access to Q fever vaccination for high-risk workers are critical to future prevention efforts. Key messages • Stronger interagency co-ordination is essential to managing Q fever outbreaks in high risk agricultural settings. • Targeted surveillance and expanded vaccination access strengthen the response.