Question

A friend of mine who lives on a farm had a short-lived flu-like illness last year and has failed to recover. She now has severe fatigue and a lot of ME-type symptoms. Following a GP referral to an infectious disease specialist she has been diagnosed as having Q fever fatigue syndrome.

Is this the same as ME? And is there any treatment?

Answer

Q fever is an infection caused by a bacterial organism called Coxiella burnetii, which is present in many farm animals – sheep, goats, cattle.

The bacteria can be breathed in or caught by close regular contact with animal fur, blood, urine or faeces. So it tends to be an infection that is picked up by people who live or work on farms.

In some cases Q fever causes no symptoms at all. But other people have a flu-like illness with a raised temperature, fatigue, muscle pain and swollen glands.
The acute infection tends to last about two weeks – after which a full recovery is the norm.

However, around 10% of people with an acute episode go on to have persisting symptoms – often including fatigue and other ME/CFS-like symptoms.
Some doctors then make a diagnosis of Q fever fatigue syndrome. In my opinion, providing the symptoms meet NICE diagnostic criteria for ME/CFS, this is probably Q fever ME/CFS.

Two important points about Q fever are that the infection can affect a lining membrane inside the heart that also covers the heart valves. This can cause inflammation and serious heart problems.

Q fever can also cause a miscarriage and harm an unborn child.
Unfortunately, as with ME/CFS, there is no really effective treatment for the chronic form of Q fever. However, the use of an antibiotic is worth considering in more severe cases.

The important take-home message here is that if someone with farming connections develops an ME/CFS-like illness after an infective episode then the possibility of Q fever should always be considered.
There is a blood test that can be used to confirm the infection.

• Research into Q fever fatigue syndrome, and the overlap with ME/CFS, is summarised and referenced in the Research Chapter of the MEA purple book (see page 6)