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Vaccine prophylaxis of abattoir-associated Q fever: eight years' experience in Australian abattoirs

Published online by Cambridge University Press:  15 May 2009

B. P. Marmion ,
R. A. Ormsbee ,
M. Kyrkou ,
J. Wright ,
D. A. Worswick ,
A. A. Izzo ,
A. Esterman ,
B. Feery  and
R. A. Shapiro
B. P. Marmion*
Affiliation:
Division of Medical Virology, Institute of Medical and Veterinary Science; Department of Pathology, University of Adelaide; South Australia Health Commission, Adelaide; Commonwealth Serum Laboratories, Melbourne; Department of Social and Preventive Medicine, University of Queensland, Australia
R. A. Ormsbee
Affiliation:
Division of Medical Virology, Institute of Medical and Veterinary Science; Department of Pathology, University of Adelaide; South Australia Health Commission, Adelaide; Commonwealth Serum Laboratories, Melbourne; Department of Social and Preventive Medicine, University of Queensland, Australia
M. Kyrkou
Affiliation:
Division of Medical Virology, Institute of Medical and Veterinary Science; Department of Pathology, University of Adelaide; South Australia Health Commission, Adelaide; Commonwealth Serum Laboratories, Melbourne; Department of Social and Preventive Medicine, University of Queensland, Australia
J. Wright
Affiliation:
Division of Medical Virology, Institute of Medical and Veterinary Science; Department of Pathology, University of Adelaide; South Australia Health Commission, Adelaide; Commonwealth Serum Laboratories, Melbourne; Department of Social and Preventive Medicine, University of Queensland, Australia
D. A. Worswick
Affiliation:
Division of Medical Virology, Institute of Medical and Veterinary Science; Department of Pathology, University of Adelaide; South Australia Health Commission, Adelaide; Commonwealth Serum Laboratories, Melbourne; Department of Social and Preventive Medicine, University of Queensland, Australia
A. A. Izzo
Affiliation:
Division of Medical Virology, Institute of Medical and Veterinary Science; Department of Pathology, University of Adelaide; South Australia Health Commission, Adelaide; Commonwealth Serum Laboratories, Melbourne; Department of Social and Preventive Medicine, University of Queensland, Australia
A. Esterman
Affiliation:
Division of Medical Virology, Institute of Medical and Veterinary Science; Department of Pathology, University of Adelaide; South Australia Health Commission, Adelaide; Commonwealth Serum Laboratories, Melbourne; Department of Social and Preventive Medicine, University of Queensland, Australia
B. Feery
Affiliation:
Division of Medical Virology, Institute of Medical and Veterinary Science; Department of Pathology, University of Adelaide; South Australia Health Commission, Adelaide; Commonwealth Serum Laboratories, Melbourne; Department of Social and Preventive Medicine, University of Queensland, Australia
R. A. Shapiro
Affiliation:
Division of Medical Virology, Institute of Medical and Veterinary Science; Department of Pathology, University of Adelaide; South Australia Health Commission, Adelaide; Commonwealth Serum Laboratories, Melbourne; Department of Social and Preventive Medicine, University of Queensland, Australia
*
Professor B. P. Marmion, Department of Pathology, University of Adelaide, GPO Box 498, Adelaide, South Australia, 5000.
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Summary

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During the period 1981–8 a clinical trial of a Q fever vaccine (Q-vax; Commonwealth Serum Laboratories, Melbourne) has been conducted in abattoir workers and other at-risk groups in South Australia. Volunteers in four abattoirs and visitors to the abattoirs were given one subcutaneous dose of 30 μg of a formalin-inactivated, highly-purified Coxiella burnetii cells, Henzerling strain, Phase 1 antigenic state, in a volume of 0·5 ml.

During the period, over 4000 subjects have been vaccinated and the programme continues in the abattoirs and related groups. ‘Common’ reactions to the vaccine comprised tenderness and erythema, rarely oedema at the inoculation site and sometimes transient headache. Two more serious ‘uncommon’ reactions, immune abscess at the inoculation site, were observed in two subjects, and two others developed small subcutaneous lumps which gradually dispersed without intervention.

Protective efficacy of the vaccine appeared to be absolute and to last for 5 years at least. Eight Q fever cases were observed in vaccinees, but all were in persons vaccinated during the incubation period of a natural attack of Q fever before vaccine-induced immunity had had time (≥ 13 days after vaccination) to develop. On the other hand, 97 Q fever cases were detected in persons working in, or visiting the same abattoir environments.

Assays for antibody and cellular immunity showed an 80–82% seroconversion after vaccination, mostly IgM antibody to Phase 2 antigen, in the 3 months after vaccination. This fell to about 60%, mostly IgG antibody to Phase 1 antigen, after 20 months. On the other hand, 85–95% of vaccinees developed markers of cell mediated immunity as judged by lymphoproliferative responses with C. burnetii antigens; these rates remained elevated for at least 5 years.

The Q fever vaccine, unlike other killed rickettsial vaccines, has the property of stimulating long-lasting T lymphocyte memory and this may account for its unusual protective efficacy as a killed vaccine.

Type
Research Article
Information
Epidemiology & Infection , Volume 104 , Issue 2 , April 1990 , pp. 275 - 287
Copyright
Copyright © Cambridge University Press 1990

References

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