Detailed analysis of health status of Q fever patients 1 year after the first Dutch outbreak: a case-control study.
BACKGROUND
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 ∼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.


OBJECTIVE
To determine the health status of the patients of the Q fever outbreak in The Netherlands in 2007, 1 year after primary infection.


METHODS
Cross-sectional case-control study.


METHODS
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).


RESULTS
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).


CONCLUSIONS
These data support a sustained decrease in many aspects of health status in Q fever patients in The Netherlands, 1 year after primary infection.
Limonard
G J M
GJ
Department of Pulmonary Diseases, Canisius-Wilhelmina Hospital, Weg door Jonkerbos 100, 6525 SZ Nijmegen, The Netherlands. gjmlimonard@gmail.com
Peters
J B
JB
Nabuurs-Franssen
M H
MH
Weers-Pothoff
G
G
Besselink
R
R
Groot
C A R
CA
Dekhuijzen
P N R
PN
Vercoulen
J H
JH
D016997:Coxiella burnetii / Q000276:immunology; D004196:Disease Outbreaks; D004812:Epidemiologic Methods; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D011778:Q Fever / Q000453:epidemiology / Q000276:immunology / Q000503:physiopathology*; D013997:Time Factors