LAUSR

Q fever is a zoonotic disease that can cause prolonged and debilitating illness in humans. Australia has the highest number of cases reported in the world and animal-human outbreaks would require a coordinated response from both animal and public health authorities. Expert opinion workshops are conducted across several states in Australia. Discussions were audio recorded and transcribed for thematic analysis to elicit sources and routes of transmission that would lead to a large human outbreak, risk factors for outbreaks and variations between states. Sources of Q fever for human infection differ between jurisdictions, influenced by disease occurrence and case infection source. Risk factors include aggregation of animals, environmental effects and naïve human contact. Community acquired infection is perceived as a greater outbreak risk than occupationally acquired due to lack of awareness, absence of vaccination and increased exposure of the public. Disease occurrence and sources of infection are variable across jurisdictions and a generalised outbreak plan is not the solution. The framework for action must reflect differences identified between jurisdictions. Expert opinion regarding sources and routes of transmission for a large human Q fever outbreak highlights prevailing differences between jurisdictions, for which a one size fits all outbreak response plan will not be effective.