Gert van der Hoek
In Memoriam - Editor, Senior Moderator
Table of Contents - April 2016 - Volume 144, Issue 06
The health status of a village population, 7 years after a major Q fever outbreak
G. MORROY[SUP]a1[/SUP][SUP]a2[/SUP] [SUP]c1[/SUP], W. VAN DER HOEK[SUP]a3[/SUP], Z. D. NANVER[SUP]a1[/SUP], P. M. SCHNEEBERGER[SUP]a4[/SUP], C. P. BLEEKER-ROVERS[SUP]a5[/SUP], J. VAN DER VELDEN[SUP]a2[/SUP] and R. A. COUTINHO[SUP]a6[/SUP]
[SUP]a1 [/SUP]Department of Infectious Disease Control, Municipal Health Service Hart voor Brabant, 's-Hertogenbosch, The Netherlands
[SUP]a2 [/SUP]Academic Collaborative Centre AMPHI, Department of Primary and Community Care, Radboud university medical center, Nijmegen, The Netherlands
[SUP]a3 [/SUP]Department for Respiratory Infections, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
[SUP]a4 [/SUP]Department of Medical Microbiology, Jeroen Bosch Hospital, The Netherlands
[SUP]a5 [/SUP]Department of Internal Medicine, Division of Infectious Diseases, Radboud Expertise Center for Q fever, Radboud university medical center, Nijmegen, The Netherlands
[SUP]a6 [/SUP]Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands
SUMMARY
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.
The health status of a village population, 7 years after a major Q fever outbreak
G. MORROY[SUP]a1[/SUP][SUP]a2[/SUP] [SUP]c1[/SUP], W. VAN DER HOEK[SUP]a3[/SUP], Z. D. NANVER[SUP]a1[/SUP], P. M. SCHNEEBERGER[SUP]a4[/SUP], C. P. BLEEKER-ROVERS[SUP]a5[/SUP], J. VAN DER VELDEN[SUP]a2[/SUP] and R. A. COUTINHO[SUP]a6[/SUP]
[SUP]a1 [/SUP]Department of Infectious Disease Control, Municipal Health Service Hart voor Brabant, 's-Hertogenbosch, The Netherlands
[SUP]a2 [/SUP]Academic Collaborative Centre AMPHI, Department of Primary and Community Care, Radboud university medical center, Nijmegen, The Netherlands
[SUP]a3 [/SUP]Department for Respiratory Infections, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
[SUP]a4 [/SUP]Department of Medical Microbiology, Jeroen Bosch Hospital, The Netherlands
[SUP]a5 [/SUP]Department of Internal Medicine, Division of Infectious Diseases, Radboud Expertise Center for Q fever, Radboud university medical center, Nijmegen, The Netherlands
[SUP]a6 [/SUP]Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands
SUMMARY
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.
