Full Title: Detailed analysis of health status of Q fever patients 1 year after the first Dutch outbreak: a case-control study.
Authors: Limonard GJ, Peters JB, Nabuurs-Franssen MH, Weers-Pothoff G, Besselink R, Groot CA, Dekhuijzen PN, Vercoulen JH.
Publication: QJM: Monthly Journal of the Association of Physicians
Publication Date: 27th August 2010
From the Department of Pulmonary Diseases, Canisius-Wilhelmina Hospital, Department of Medical Psychology, Radboud University Nijmegen Medical Centre, Department of Pulmonary Diseases, Radboud University Nijmegen Medical Centre, Department of Medical Microbiology, Canisius-Wilhelmina Hospital, Department of Medical Microbiology, Radboud University Nijmegen Medical Centre, Nijmegen, Department of Medical Microbiology, Jeroen Bosch Hospital, 's-Hertogenbosch, GP Practice Herpen (Huisartsenpraktijk Herpen), Herpen and Department of Pulmonary Diseases, Bernhoven Hospital, Oss, The Netherlands.
Q fever is a zoonosis caused by the obligate intracellular bacterium Coxiella burnetii. The two long-term complications, after primary infection, are chronic Q fever in approximately 1% of patients, and a chronic fatigue syndrome in 10-20%. However, the existence of a protracted decreased health status after Q fever remains controversial.
To determine the health status of the patients of the Q fever outbreak in The Netherlands in 2007, 1 year after primary infection.
Cross-sectional case-control study.
Health status of the patients from the 2007 Dutch Q fever outbreak was compared to age-, sex- and geographically matched and Q fever seronegative controls. Health status of both patients and controls was assessed with the Nijmegen Clinical Screening Instrument (NCSI).
Fifty-four Q fever patients provided 34 years of age- and sex-matched controls from the same neighbourhood. Eleven controls had positive Q fever serology and were excluded. Q fever patients had significantly more problems on the subdomains of symptoms and functional impairment. Overall quality of life was decreased in both patients and controls, 59% vs. 39%, respectively, ns). Severe fatigue levels were present in 52% of patients vs. 26% in controls (P < 0.05).
These data support a sustained decrease in many aspects of health status in Q fever patients in The Netherlands, 1 year after primary infection.