One shearer’s experience with Q-fever prompts a warning for those dealing with sheep to be vaccinated

Life took a turn when Brad Butcher woke in the early hours of the morning — drenched in sweat, shivering and barely able to stand up.

It was 2002, and the Moora shearing contractor owner had a temperature of 41.3C and was aching from head to toe.

At the age of 29, he’d never had a sick day in his life, not even a day off school.

His wife and business partner Natasha contacted Health Direct and was advised take him to hospital but Brad was determined to be at work and on the boards in a few hours’ time.

By 6am, it was evident he was very unwell.

In the time it took the pair to drive to Moora Doctor’s Surgery, Brad’s clothes had become drenched and he was shaking.

Over the next week, the doctor called him back to take bloods several times to try and determine what was making him so sick.

A chest X-ray showed he had pneumonia.

Blood tests showed an infection but nothing else and it was deemed he had pneumonia and a viral infection.

Fast-forward six months, and the Federal Government announced an incentive for agricultural businesses to be reimbursed for the cost of having their staff vaccinated for Q fever.

The vaccination process involves two appointments.

At the first, the doctor completes serology and skin tests to ensure that the patient has not been previously infected with Q fever.

During the second visit, if the tests come back negative, the vaccination is administered.

Brad couldn’t have the vaccine, because a diagnosis of the respiratory infection was confirmed.

He was surprised, given he had tested negative when he was sick but the disease can fail to show during the early stages.

Brad and Natasha were stunned to find of the 10 staff they sent to get vaccinated in 2003, half tested positive.

None could remember being sick, other than with the odd flu-like illness, which is classic symptom of Q fever.

About half of those who contract the disease have symptoms.

These usually start within two to three weeks of getting infected, and last from a few days to six weeks.

The zoonotic disease is transmitted predominantly from goats, sheep and cattle and is caused by the bacterium Coxiella burnetii.

It is released through faeces, urine, milk and birth products from infected animals but can spread through the air and dust.

The first symptom in farm animals is usually an abnormal number of spontaneous abortions, and Coxiella burnetti can sit in the soil or bedding straw for years despite heat and cold.

The disease turned into a nightmare for Brad, who copped the full brunt of the symptoms and suffered shocking long-term effects.

“We’d just launched our business and we had so much happening but we just had to get on with life,” he said.

“I still suffer night sweats and fatigue.”

About half of human infections involve flu-like symptoms and about 40 per cent of that group end up requiring hospital care.

Symptoms can vary, including a fever, chills, sweating, aching muscles and joints, extreme tiredness and confusion, blurred vision, weight loss and a rash.

Q fever can also lead to chronic fatigue syndrome, chronic heart conditions, chronic hepatitis, and in children can cause bone necrosis.

The most severe cases involve heart-valve failure, which can be fatal.

Brad went on to experience several complications in the years that followed, including night sweats, fatigue, joint and muscle pain. After nagging from Natasha, he reluctantly visited the doctor to get checked out a few years after his original diagnosis.

Blood tests excluded other illnesses and the doctor diagnosed him with Chronic Q Fever and Post Q Fever.

A few years ago — long after his diagnosis — Brad fell ill again and discovered he had an infected colon caused by bacteria from sheep.

While being treated for this, doctors picked up an anomaly with his heart.

He was referred to a cardiologist and discovered he had developed atrial fibrillation.

Brad went on to have three surgeries, known as ablations, and during the last surgery doctors found he had developed an atrial flutter.

Doctors were stumped.

It made little sense for him to be suffering these heart conditions, as someone in his early 40s, fit, and still shearing every day.

In 2020, a physician advised the Butchers that Brad’s heart conditions and other symptoms related to the Q fever infection.

The majority of reported cases are Queensland and New South Wales each year, followed by South Australia, while WA has next to none.

The Butchers believe the actual WA number is much higher, and that Q fever is severely under reported because so little is known about it and the presumption is: “it isn’t a problem”.

“I think there is more of it around than people think,” Brad said.

“The symptoms can vary so often, people put it down to a virus or the flu.”

Australia is the only country where a Q fever vaccine is available to those working in the livestock industry, with farmers and shearers among the long list recommended to get the jab. University of Sydney researchers in April joined forces with industry to understand the impact Q fever has on farmers’ business and find scientific grounds to back the domestic manufacturing of a vaccine for animals.

Meat and Livestock Australia is funding the project through a matching grant from the Federal Government.

The Butchers have spoken to dozens of people about Q fever in the past few years — including doctors, farmers and shearers.

Most are unaware of the disease and its potential consequences.

“I have spoken to our local GP recently about this as well as the fact that according to the register, there are apparently so few reported cases in WA,” Natasha said.

“Our GP said to me that firstly, understandably, most people are unlikely to attend a doctor or hospital with what could be put down in most people to a bad flu-particularly these days with the existence of COVID-19.He also said that many doctors were not likely to test for it when a patient presents with symptoms as they will more likely put it down to a virus since it is not widely known about in our State. They are only likely to test in the more extreme cases.”

If a person tests positive to Q fever while it is active in the body, the laboratory is required to notify the WA Department of Health. In the case of a positive result for an historical case, it is up to the patient whether they report the result.

Brad and Natasha have placed high importance on having their long-term staff vaccinated.

A few years ago, their wool classer became very ill with very similar symptoms to Brad’s.

He was tested for Q fever which came back negative and so he was diagnosed as having a virus.

Brad and Natasha realised it had been a few years since they had sent anyone in for the vaccination and so a few months later, when the next Q fever vaccination clinic was held in Moora, they sent him in.

Sure enough, his serology showed that he too had actually had Q fever.

Another Moora shearer has also developed endocarditis as a complication of Q fever, while another they know has developed atrial fibrillation and is no longer in the shearing industry.

Vaccination costs about $300 a person. For Natasha, it is money well spent.

“I understand employers could look at this as a costly exercise but I’d encourage them to consider it, especially for long-term staff,” she said.

“If we could turn back the clock to pre-2000 and spend $300 on a vaccination to prevent the past 20 years of health problems, we’d do it in a heartbeat.”

There are more than 70 clinics in WA offering Q fever vaccinations, but a snap poll of some showed many did not know what the Q fever was.

Brad and Natasha believe raising awareness of Q fever is important.

The earlier patients are treated with antibiotics, the sooner they recover and the likelihood of long-term complications be-comes much less.

“If doctors are aware of it, it may mean they treat quickly ... their prognosis going forward may be far less complicated that what ours has been,” Natasha said.