title: The health status of a village population, 7 years after a major Q fever outbreak.
abstract: From 2007 to 2010, The Netherlands experienced a major Q fever outbreak with more than 4000 notifications. Previous studies suggested that Q fever patients could suffer long-term post-infection health impairments, especially fatigue. Our objective was to assess the Coxiella burnetii antibody prevalence and health status including fatigue, and assess their interrelationship in Herpen, a high-incidence village, 7 years after the outbreak began. In 2014, we invited all 2161 adult inhabitants for a questionnaire and a C. burnetii indirect fluorescence antibody assay (IFA). The health status was measured with the Nijmegen Clinical Screening Instrument (NCSI), consisting of eight subdomains including fatigue. Of the 70·1% (1517/2161) participants, 33·8% (513/1517) were IFA positive. Of 147 participants who were IFA positive in 2007, 25 (17%) seroreverted and were now IFA negative. Not positive IFA status, but age <50 years, smoking and co-morbidity, were independent risk factors for fatigue. Notified participants reported significantly more often fatigue (31/49, 63%) than non-notified IFA-positive participants (150/451, 33%). Although fatigue is a common sequel after acute Q fever, in this community-based survey we found no difference in fatigue levels between participants with and without C. burnetii antibodies.
authors.affiliation: Department of Infectious Disease Control,Municipal Health Service Hart voor Brabant, 's-Hertogenbosch,The Netherlands.
authors.forename: G
authors.initials: G
authors.lastname: Morroy
authors.affiliation: Department for Respiratory Infections,Centre for Infectious Disease Control,National Institute for Public Health and the Environment (RIVM),Bilthoven,The Netherlands.
authors.forename: W
authors.initials: W
authors.lastname: Van Der Hoek
authors.affiliation: Department of Infectious Disease Control,Municipal Health Service Hart voor Brabant, 's-Hertogenbosch,The Netherlands.
authors.forename: Z D
authors.initials: ZD
authors.lastname: Nanver
authors.affiliation: Department of Medical Microbiology,Jeroen Bosch Hospital,The Netherlands.
authors.forename: P M
authors.initials: PM
authors.lastname: Schneeberger
authors.affiliation: Department of Internal Medicine,Division of Infectious Diseases,Radboud Expertise Center for Q fever,Radboud university medical center,Nijmegen,The Netherlands.
authors.forename: C P
authors.initials: CP
authors.lastname: Bleeker-Rovers
authors.affiliation: Academic Collaborative Centre AMPHI,Department of Primary and Community Care,Radboud university medical center,Nijmegen,The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Van Der Velden
authors.affiliation: Julius Center for Health Sciences and Primary Care,University Medical Center,Utrecht,The Netherlands.
authors.forename: R A
authors.initials: RA
authors.lastname: Coutinho
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000097:blood*; D016997:Coxiella burnetii / Q000276:immunology*; D004196:Disease Outbreaks; D005221:Fatigue / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D011778:Q Fever / Q000150:complications* / Q000453:epidemiology*; D012307:Risk Factors; D012423:Rural Health; D012621:Seasons; D016036:Seroepidemiologic Studies; D055815:Young Adult
chemical_list: D000907:Antibodies, Bacterial
keywords: Coxiella burnetii; IFA; NCSI; Q fever; post-infection fatigue