Gallas and Comcare

Administrative Appeals Tribunal

DECISION AND REASONS FOR DECISION [2008] AATA 198

ADMINISTRATIVE APPEALS TRIBUNAL      )

)          No S 200500134

GENERAL ADMINISTRATIVE DIVISION		)
Re		PAUL GALLAS

Applicant

And COMCARE

Respondent

DECISION

Tribunal Deputy President D G Jarvis, Senior Member R W Dunne and
Dr J D Campbell, Member

Date13 March 2008

PlaceAdelaide

Decision The tribunal sets aside the decisions under review, and in place of those decisions, decides that the applicant is entitled to compensation pursuant to the Safety, Rehabilitation and Compensation Act 1988 (Cth) in respect of the injuries which he sustained in 2001 and 2002 for which he has claimed compensation.

D G Jarvis
  (Signed)
  Deputy President

20.     In various subsequent reports, Professor Marmion confirmed his opinion and further explained the basis of it.  In a report of 12 December 2005 (exhibit A2) Professor Marmion, after referring to periodic incapacitating episodes of acute symptoms, said:

“… Such intense episodes of illness are “hyper-allergic” or hyper-sensitivity responses of a previously sensitised cellular immune system, in a minority of immuno-genetically disposed individuals, to a re-exposure to the Q fever organism in the environment.

Our clinical trials of the Q fever vaccine in 1981 – 89 involved a much closer contact with abattoir workers and their medical officers than any other group studying Q fever in Australia.  This experience led to my conclusion that reports of second, third or repeated attack of “Q fever”, as described by a minority of abattoir workers (such as Paul Gallas) in our 4 study abattoirs were not de novo invasive, blood-stream infections with the coxiella.  Rather that they were more likely to be intense cell-mediated immune (CMI) hypersensitivity reactions to a heavy re-exposure to the organism.  Such re-exposures may perhaps involve limited replication of the coxiella at the portal of entry for the organism via the lung, but in essence are reactions to antigen rather than a generalised systemic invasion of the body by the coxiella, as in a primary acute attack.” (exhibit A2, page 2).

21.     In the course of considering Mr Gallas’ claim for compensation, Comcare sought an opinion from Professor Andrew Lloyd, a consultant infectious diseases physician.  Professor Lloyd expressed the view that it was more likely than not that the symptoms experienced by Mr Gallas in June 2002 were directly attributable to the Q fever infection acquired initially in 1980, and to an episodic post-Q-fever fatigue syndrome relating specifically to that original infection, rather than a new infection, by which he meant a re-infection with Coxiella Burnetii, the causative agent of Q fever.  Professor Lloyd pointed out that many other infections and some non-infective conditions may cause identical symptoms to those caused by acute Q fever and the secondary disease of post-Q-fever fatigue syndrome.

22.     We arranged for Professors Marmion and Lloyd to give evidence concurrently.  Both doctors accepted that Mr Gallas had been infected with primary Q fever in 1980, and that from 1982 onwards he had suffered from post-Q-fever fatigue syndrome, and that this had given…