title: Detailed analysis of health status of Q fever patients 1 year after the first Dutch outbreak: a case-control study.
abstract: 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.
authors.affiliation: Department of Pulmonary Diseases, Canisius-Wilhelmina Hospital, Weg door Jonkerbos 100, 6525 SZ Nijmegen, The Netherlands. gjmlimonard@gmail.com
authors.forename: G J M
authors.initials: GJ
authors.lastname: Limonard
authors.forename: J B
authors.initials: JB
authors.lastname: Peters
authors.forename: M H
authors.initials: MH
authors.lastname: Nabuurs-Franssen
authors.forename: G
authors.initials: G
authors.lastname: Weers-Pothoff
authors.forename: R
authors.initials: R
authors.lastname: Besselink
authors.forename: C A R
authors.initials: CA
authors.lastname: Groot
authors.forename: P N R
authors.initials: PN
authors.lastname: Dekhuijzen
authors.forename: J H
authors.initials: JH
authors.lastname: Vercoulen
mesh_terms: 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