From BMC Infectious Diseases, open access journal, 18 April 2011.
Gabriella Morroy, Jeannette B Peters, Malou van Nieuwenhof, Hans HJ Bor , Jeannine LA Hautvast , Wim van der Hoek, Clementine J Wijkmansand Jan H Vercoulen.
BMC Infectious Diseases 2011, 11:97doi:10.1186/1471-2334-11-97
Published: 18 April 2011
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.
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.
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.
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.