Self-reported sick leave and long-term health symptoms of Q-fever patients.
BACKGROUND
In The Netherlands, 1168 Q-fever patients were notified in 2007 and 2008. Patients and general practitioners (GPs) regularly reported persisting symptoms after acute Q-fever, especially fatigue and long periods of sick leave, to the public health authorities. International studies on smaller Q-fever outbreaks demonstrate that symptoms may persist years after acute illness. Data for the Dutch outbreaks were unavailable. The aim of this study is to quantify sick leave after acute Q-fever and long-term symptoms.


METHODS
Our study targeted 898 acute Q-fever patients, notified in 2007 and 2008 residing in the Province Noord-Brabant. Patients from the 2008 cohort were mailed a questionnaire at 12 months and those of the 2007 cohort at 12-26 months after onset of illness. Patients reported underlying illness, Q-fever-related symptoms and sick leave.


RESULTS
The response rate was 64%. Forty percent of the working patients reported long-term (>1 month) sick leave. Pre-existent heart disease odds ratio (OR) 4.50; confidence interval (CI) 1.27-16.09), hospitalization in the acute phase (OR 3.99; 95% CI 2.15-7.43) and smoking (OR 1.69; 95% CI 1.01-2.84) were significant predictors for long-term absence. Of the patients who resumed work, 9% were-at the time of completing the questionnaire-still unable to function at pre-infection levels due to fatigue or concentration problems. Of the respondents, 40% reported persisting physical symptoms at the time of follow-up. Fatigue (20%) was most frequently reported. Daily activities were affected in 30% of cases.


CONCLUSIONS
Q-fever poses a serious persisting long-term burden on patients and society.
Department of Infectious Disease Control, Municipal Health Service Hart voor Brabant, 's-Hertogenbosch, The Netherlands. g.morroy@ggdhvb.nl
Gabriella
G
Morroy
Hans H J
HH
Bor
Johan
J
Polder
Jeannine L A
JL
Hautvast
Wim
W
van der Hoek
Peter M
PM
Schneeberger
Clementine J
CJ
Wijkmans
D000203:Activities of Daily Living; D000208:Acute Disease; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D017281:Cost of Illness; D005221:Fatigue / Q000209:etiology; D005260:Female; D005334:Fever / Q000209:etiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009426:Netherlands / Q000453:epidemiology; D011778:Q Fever / Q000453:epidemiology*; D057566:Self Report; D018582:Sick Leave / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult