Q-fever in the Netherlands: health status, fatigue status and quality of life .

Background Q fever is a zoonosis caused by the bacterium Coxiella burnetii which is common in a wide range of wild and domestic animals. Until 2007 there were roughly 15-20 cases of Q fever notified in the Netherlands each year but during the past three years, the number of cases in the Netherlands has increased each summer adding up to a total of over 3000 cases. The Netherlands has now experienced the largest outbreak of Q fever documented in Europe and Q fever has become an important national public health problem. Up until 2009, control measures implemented in the Netherlands have not shown a major effect on the human prevalence of Q fever. The vaccination of dairy goats and sheep in high prevalence regions, might lead to a reduction in human prevalence in that area. However, the geographical enlargement of the affected area since 2007, will probably continue for 2010 and later. Since Q fever will most likely remain a high-prevalent disease in the Netherlands, it is urgent both for medical doctors as for patients to gain detailed knowledge on the progress of this disease. Considering Q fever is normally a rare infectious disease, there is currently limited information regarding health outcomes (including fatigue status and quality of life) related to Q fever. Objectives It is the primary aim of the Q-quest II study is to gain knowledge on the health status, fatigue status and quality of life of Q fever patients during the first year after infection in order to collect adequate and detailed health information on the progress of Q fever disease. This information will be used to enable Municipal Health Services, general practitioners, and other health professionals to provide more adequate guidance on the Q-fever illness. The progress during the 2nd year post infection for those patients who appear to state complaints on health, fatigue or quality of life at 12 months´ after their first day of illness will also be determined. The relation between serological status at 3, 6 and 12 months post initial infection with patients’ health status, fatigue status and quality of life at these same time-moments will be analyzed. Methods A prospective cohort study will be started of Q fever patients reported to the Municipal Health Services in 2010 and 2011. The health status of patients (which covers eight different domains including fatigue status and quality of life) will be collected at regular intervals (3, 6, 9 and 12 months) using the validated Nijmegen Clinical Screening Instrument questionnaire. Serological samples will be collected at 3, 6 and 12 months. In addition, for patients that still have symptoms 12 months after their infection, the questionnaire will be collected after 18 and 24 months. Dissemination of results Through publications in peer-reviewed journals and presentations at scientific symposia and conferences, results will be presented to health care providers. Finally, a Q fever symposium is planned to communicate the findings to the scientific community, Municipal Health Services, Ministries, GP associations and other public health organizations.