Netherlands - The health status of Q-fever patients after long-term follow-up.

[Gert van der Hoek]

The health status of Q-fever patients after long-term follow-up.

Gabriella Morroy , Jeannette B Peters , Malou van Nieuwenhof , Hans HJ Bor , Jeannine LA Hautvast , Wim van der Hoek , Clementine J Wijkmans and Jan H Vercoulen

BMC Infectious Diseases 2011, 11:97doi:10.1186/1471-2334-11-97

Published: 18 April 2011

Abstract (provisional)

Background
In the Netherlands, from 2007 to 2009, 3,522 Q-fever cases from three outbreaks were notified. These outbreaks are the largest documented outbreaks in the world. Previous studies suggest that symptoms can persist for a long period of time, resulting in a reduced quality of life (QoL). The aim of this study is to qualify and quantify the health status of Q-fever patients after long-term follow-up.

Methods
870 Q-fever patients of the 2007 and 2008 outbreaks were mailed a questionnaire 12 to 26 months after the onset of illness. We assessed demographic data and measured health status with the Nijmegen Clinical Screening Instrument (NCSI). The NCSI consists of eight sub-domains of functional impairment, symptoms, and QoL. The NCSI scores of Q-fever patients older than 50 years were compared with patients younger than 50 years, and with norm data from healthy individuals and patients with chronic obstructive pulmonary disease.

Results
The response rate was 65.7%. The long term health status of two thirds of Q-fever patients (both younger and older then 50 years) was severely affected for at least one sub-domain. Patients scores were most severely affected on the sub-domains general QoL (44.9%) and fatigue (43.5%). Hospitalization in the acute phase was significantly related to long-term behavioural impairment (OR 2.8, CI 1.5-5.1), poor health related QoL (OR 2.3,CI 1.5-4.0), and subjective symptoms (OR 1.9, CI 1.1-3.6). Lung or heart disease, depression and arthritis significantly affected the long-term health status of Q-fever patients.

Conclusions
Q-fever patients present 12 to 26 months after the onset of illness with severe -clinically relevant-: subjective symptoms, functional impairment, and impaired QoL. All measured domains of the health status are impaired. Especially patients that have been hospitalized and those with chronic co-morbidity score worse. Our unique data underline that more attention is needed not only to prevent exposure to Q fever but also for the prevention and treatment of the long-term consequences of this zoonosis.

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[Shiloh]

Re: Netherlands - The health status of Q-fever patients after long-term follow-up.

Source: http://www.prohealth.com/library/showarticle.cfm?libid=16814

Dutch Q Fever Outbreak: 40% had post infective chronic fatigue syndrome 1 to 2 years later
ProHealth.com
February 11, 2012

Article:
Self-reported sick leave and long-term health symptoms of Q-fever patients
? Source: European Journal of Public Health, Feb 7, 2012

By G Morroy, et al.

[Note: Q fever is a disease caused by Coxiella burnetti bacteria. It begins with flu-like symptoms (but can be inapparent) and is known to produce a ?post-Q chronic fatigue syndrome? lasting 5 to 10 years or more in 15% to 20% of cases. Q fever is worldwide, carried mostly by grazing stock and ticks but also pets and animals in the wild. Mostly contracted via inhalation of dried excretions in airborne dust, but also tick bites, infected milk, skin abrasions.]

Abstract:
Background: In The Netherlands, 1,168 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...