The overarching aim of COFFI is to investigate biological, psychological and social factors influencing the development of longer-term symptoms (including fatigue) following acute infectious diseases. Pooling of resources, data and biological samples from post-infective cohort studies across the world is a prerequisite for achieving this aim.
The COFFI collaborative consists of a multidisciplinary team of investigators including epidemiologists, clinical researchers, psychologists, and laboratory-based immunology, virology and genetics researchers. Data from the nine prospective cohorts in COFFI indicates that post-infective fatigue is a common outcome from several different acute infections occurring predominantly in adolescents and young adults, with acute Epstein-Barr virus (EBV) infection being the best documented, but other viral and non-viral pathogens such as Q fever and giardiasis also implicated. The case rate for disabling, post-infective fatigue after exclusion of recognized medical and psychiatric causes was 7-9% at 12 months after onset. Investigations in these cohorts suggest that the host (rather than the pathogen) is the key determinant of the persistent illness, but the pathophysiology remains unresolved. The severity of the acute illness, lower physical fitness, female gender and autonomic dysfunction were among the predictors of prolonged illness.