{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T06:03:05Z","timestamp":1791266585170,"version":"4.1.0"},"reference-count":32,"publisher":"Cambridge University Press (CUP)","issue":"6","license":[{"start":{"date-parts":[[2015,11,12]],"date-time":"2015-11-12T00:00:00Z","timestamp":1447286400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["journals.cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2016,4]]},"abstract":"<jats:title>SUMMARY<\/jats:title><jats:p>From 2007 to 2010, The Netherlands experienced a major Q fever outbreak with more than 4000 notifications. Previous studies suggested that Q fever patients could suffer long-term post-infection health impairments, especially fatigue. Our objective was to assess the<jats:italic>Coxiella burnetii<\/jats:italic>antibody prevalence and health status including fatigue, and assess their interrelationship in Herpen, a high-incidence village, 7 years after the outbreak began. In 2014, we invited all 2161 adult inhabitants for a questionnaire and a<jats:italic>C. burnetii<\/jats:italic>indirect fluorescence antibody assay (IFA). The health status was measured with the Nijmegen Clinical Screening Instrument (NCSI), consisting of eight subdomains including fatigue. Of the 70\u00b71% (1517\/2161) participants, 33\u00b78% (513\/1517) were IFA positive. Of 147 participants who were IFA positive in 2007, 25 (17%) seroreverted and were now IFA negative. Not positive IFA status, but age &lt;50 years, smoking and co-morbidity, were independent risk factors for fatigue. Notified participants reported significantly more often fatigue (31\/49, 63%) than non-notified IFA-positive participants (150\/451, 33%). Although fatigue is a common sequel after acute Q fever, in this community-based survey we found no difference in fatigue levels between participants with and without<jats:italic>C. burnetii<\/jats:italic>antibodies.<\/jats:p>","DOI":"10.1017\/s0950268815002472","type":"journal-article","created":{"date-parts":[[2015,11,12]],"date-time":"2015-11-12T11:35:03Z","timestamp":1447328103000},"page":"1153-1162","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":18,"title":["The health status of a village population, 7 years after a major Q fever outbreak"],"prefix":"10.1017","volume":"144","author":[{"given":"G.","family":"MORROY","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.","family":"VAN DER HOEK","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Z. 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