Persistence of impaired health status of Q fever patients 4 years after the first Dutch outbreak.
A significant proportion of Q fever patients from the first Dutch Q fever outbreak in 2007 showed impairment in health status up to 1 year after infection. Interested in whether this decrease in health status persisted, we set out to determine the health status in the same cohort of patients, 4 years after primary infection and to compare health status scores at the individual patient level between 1 and 4 years follow-up. Health status was assessed with the Nijmegen Clinical Screening Instrument (NCSI). Patients were serologically tested to exclude patients with possible, probable or proven chronic Q fever. Results on the NCSI sub-domains at group level [2008 (n = 54) and 2011 (n = 46)] showed a persistent significant percentage of patients exhibiting clinically relevant ('severe') scores for all NCSI sub-domains. After 4 years, undue fatigue was present in 46% and exactly half of all patients experienced a severely impaired general quality of life. Patients with NCSI scores available in both 2008 and 2011 (n = 37) showed no difference in all sub-domain scores, except for a small decrease in dyspnoea emotions in 2011. In this group, a significant proportion of patients either improved or worsened in one or more sub-domains of health status. We conclude that at the group level, health status of Q fever patients remained impaired 4 years after primary infection. At the individual patient level, health status may change.
Department of Pulmonary Diseases,Diakonessenhuis,Utrecht,The Netherlands.
G J M
GJ
Limonard
Department of Medical Psychology,Radboud University Nijmegen Medical Centre,Nijmegen,The Netherlands.
J B
JB
Peters
GP Practice Herpen (Huisartsenpraktijk Herpen),Herpen,The Netherlands.
R
R
Besselink
Department of Pulmonary Diseases,Bernhoven Hospital,Oss,The Netherlands.
C A R
CA
Groot
Department of Pulmonary Diseases,Radboud University Nijmegen Medical Centre,Nijmegen,The Netherlands.
P N R
PN
Dekhuijzen
Department of Medical Psychology,Radboud University Nijmegen Medical Centre,Nijmegen,The Netherlands.
J H
JH
Vercoulen
Department of Medical Microbiology,Canisius-Wilhelmina Hospital,Nijmegen,The Netherlands.
M H
MH
Nabuurs-Franssen
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004417:Dyspnea / Q000453:epidemiology / Q000209:etiology; D005221:Fatigue / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011778:Q Fever / Q000150:complications* / Q000453:epidemiology*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D055815:Young Adult
Coxiella burnetii; Q fever; health status; quality of life