Post-infection fatigue syndrome following Q fever

In 1989, 147 individuals in the West Midlands, UK, were infected with Qfever. Five years later, following anecdotal reports of fatigue, we used aquestionnaire-based case-control study to determine the prevalence ofchronic fatigue syndrome symptoms in this group. Replies from 71 patientswere compared with those from 142 age- and sex-matched controls. Increasedsweating (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. Thesefindings were similar to those in Australian abbatoir workersoccupationally exposed to Q fever. CDC criteria for chronic fatiguesyndrome were fulfilled by 42.3% of cases and 26% of controls. Using visualanalogue scores, symptoms were more severe in cases than in controls. Ourfindings support the existence of a chronic fatigue state following acute Qfever, in a group of patients exposed just once to the organism, and incircumstances free of such confounding factors as lawsuits overcompensation.