Objective: To explore animal science and veterinary students' and livestock farmers' perceptions concerning Q fever prevention.Design: An online survey with an open-ended question seeking knowledge and perceptions about Q fever prevention was distributed among participants during March-September 2019. We applied thematic analysis to identify emerging themes. Setting: Animal science and veterinary students enrolled at the University of Adelaide and members of Livestock South Australia representing cattle, sheep and goat farmers in South Australia. Participants: A total of56 animal science and veterinary students and 154 livestock farmers responded to the open-ended question. Interventions: Not applicable.Main outcome measures: Perceived challenges and opportunities for a coordinated Q fever prevention approach including human vaccination reported by the participants.Results: Two major themes arose in each group. Students and farmers viewed Q fever vaccination as important. However, excessive cost for students was a barrier and for farmers, it was general practitioners' lack of knowledge of Q fever and access to an accredited immunisation provider. Similarly, both groups highlighted the need for education and increasing public and community awareness of Q fever. Conclusion:Our findings underscore that a sector-wide approach involving community awareness programmes, education and training for general practitioners, and subsidised vaccination as well as commitment from government and industry partners may contribute to reducing the burden of Q fever among at-risk populations.

fever caused by Coxiella burnetii is present in Australian livestock, wildlife and ticks, 1,2 and is a persistent problem for high-risk occupations in Australia. 3 Clinical presentation of Q fever includes flu-like symptoms. Complications such as endocarditis are uncommon; however, chronic fatigue syndrome is well-reported and may contribute to a high workforce turnover incurring substantial compensation claims in livestock and meat industries. 4,5 Q fever vaccine for humans is licensed in Australia. 4 Vaccination involves prescreening and must be provided by a trained general practitioner (GP). 3,6 Q fever is of particular concern in regional and remote communities. 7 Identified barriers to vaccination include costs; 6,8 to overcome this the National Q Fever Management Program was a successful, but short-term, subsidised vaccination campaign. 9 Evidence suggests that this type of vaccination campaign should be accompanied by sustainable system change. 10 To facilitate such change, a multi-sectoral approach known as a One Health framework is advocated as a means of connecting human, animal and environmental domains in a Q fever prevention program. 11 A thorough understanding of Q fever burden and potential solutions from the perspective of stakeholders including GPs, health officials and policymakers has rarely been sought. Bringing together cross-disciplinary stakeholders allows for examination of practical, on-the-ground concerns of those with an understanding of the pragmatics of policymaking and health system functionality. Further, it allows factors identified by stakeholders as essential to Q fever prevention to inform policy responses. This study provides an in-depth analysis of these factors and a discussion of stakeholder perspectives on the potential of a One Health approach to Q fever prevention and control.

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