Chronic fatigue syndrome after Giardia enteritis: clinical characteristics, disability and long-term sickness absence.
A waterborne outbreak of Giardia lamblia gastroenteritis led to a high prevalance of long-lasting fatigue and abdominal symptoms. The aim was to describe the clinical characteristics, disability and employmentloss in a case series of patients with Chronic Fatigue Syndrome (CFS) after the infection.
Methods:
Patients who reported persistent fatigue, lowered functional capacity and sickness leave or delayed education after a large community outbreak of giardiasis enteritis in the city of Bergen, Norway were evaluated with the established Centers for Disease Control and Prevention criteria for CFS.
Fatigue was self-rated by the Fatigue Severity Scale (FSS). Physical and mental health status and functional impairment was measured by the Medical Outcome Severity Scale-short Form-36 (SF-36).
The Hospital Anxiety and Depression Scale (HADS) was used to measure co-morbid anxiety and depression. Inability to work or study because of fatigue was determined by sickness absence certified by a doctor.
Results:
A total of 58 (60%) out of 96 patients with long-lasting post-infectious fatigue after laboratory confirmed giardiasis were diagnosed with CFS.
In all, 1262 patients had laboratory confirmed giardiasis. At the time of referral (mean illness duration 2.7 years) 16 % reported improvement, 28 % reported no change, and 57 % reported progressive course with gradual worsening.
Mean FSS score was 6.6. A distinctive pattern of impairment was documented with the SF-36.
The physical functioning, vitality (energy/fatigue) and social functioning were especially reduced. Long-term sickness absence from studies and work was noted in all patients.
Conclusion:
After giardiasis enteritis at least 5% developed clinical characteristics and functional impairment comparable to previously described post-infectious fatigue syndrome.
Author: Halvor NaessMorten NylandTrygve HauskenInghild FollestadHarald I Nyland
Credits/Source: BMC Gastroenterology 2012, 12:13
Published on: 2012-02-08
Copyright by the authors listed above - made available via BioMedCentral (Open Access). Please
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