Post-infection fatigue syndrome following Q fever

In 1989, 147 individuals in the West Midlands, UK, were
infected with Q fever. Five years later, following anecdotal
reports of fatigue, we used a questionnaire-based case-control
study to determine the prevalence of chronic fatigue syndrome
symptoms in this group. Replies from 71 patients were compared
with those from 142 age- and sex-matched controls. Increased
sweating (52.9% vs. 31.6%, p = 0.006), breathlessness (50.7%
vs. 30.6%, p = 0.006), blurred vision (34.3% vs. 17.8%, p =
0.016) and undue tiredness (68.7% vs. 51.5%, p = 0.03) were
found in controls compared to cases. These findings were
similar to those in Australian abbatoir workers occupationally
exposed to Q fever. CDC criteria for chronic fatigue syndrome
were fulfilled by 42.3% of cases and 26% of controls. Using
visual analogue scores, symptoms were more severe in cases
than in controls. Our findings support the existence of a
chronic fatigue state following acute Q fever, in a group of
patients exposed just once to the organism, and in
circumstances free of such confounding factors as lawsuits
over compensation.

Ayres JG, Flint N, Smith EG, Tunnicliffe WS, Fletcher TJ, Hammond K, Ward D, Marmion BP

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