Chronic fatigue following infection by Coxiella burnetii (Q fever): ten‐year follow‐up of the 1989 UK outbreak cohort

ICF was found in 25 (32.5%) of Q-exposed patients and 11(14.3%) of controls (p= 0.01). There were 36 (46.8%) GHQ cases in Q-exposed subjects, vs. 18 (23.4%) controls (p =0.004). A matched analysis of those more intensively studied showed fatigue in 48 (66.7%) Q-exposed patients and 25 (34.7%) controls, (p-0.0001), ICF in 25 (34.7%) Q-exposed and 10 (13.9%) controls (p =0.004), and chronic fatigue syndrome (CFS) in 14 (19.4%) Q-exposed patients and three (4.2%) controls (p= 0.003). Thirty-four (47.2%) Q-exposed patients were GHQ cases compared to 17 (23.6%) controls (p =0.004). Discussion: Subjects who were exposed to Coxiella in 1989 had more fatigue than did controls, and some fulfilled the criteria for CFS. Whether this is due to ongoing antigen persistence or to the psychological effects of prolonged medical follow-up is uncertain.