CFS after Giardia enteritis -Clinical Characteristics, Disability, Long-term Sickness Absence

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http://1.usa.gov/zL8Ddw

PubMed

US National Library of Medicine

National Institutes of Health

BMC Gastroenterol. 2012 Feb 8;12(1):13. [Epub ahead of

print]

Chronic fatigue syndrome after Giardia

enteritis: clinical characteristics, disability

and long-term sickness absence.

Naess H, Nyland M, Hausken T, Follestad I, Nyland

HI.

ABSTRACT:

BACKGROUND:

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.

PMID: 22316329 [PubMed - as supplied by publisher]