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Is chronic fatigue syndrome an infectious disease?
Mawle AC, Reyes M, Schmid DS.Is Chronic Fatigue Syndrome an infectious disease?
Infectious Agents and Disease, vol. 2, pages 387-389, 1994
Summary
This review article examines the epidemiologic and immunologic evidence for and against CFS as an infectious illness. It summarizes and contrasts the published evidence on elevated titers to various infectious agents, cytokine evidence, immunologic function results, and immune cell surface marker evidence. The overall conclusion is that, among all the conflicting reports in these areas, the evidence that CFS might be caused by an infectious agent is somewhat weak, but cannot be ruled out at the present time. For example, it remains possible that a number of different infectious agents might trigger the development of CFS. The authors also conclude that future CFS studies should be conducted with a view to compare a number of control groups to CFS patients, rather than just healthy controls. Such groups might include, for example, persons with acute infectious illness, autoimmune disease, or clinical depression.
Abstract
Over the past decade, chronic fatigue syndrome (CFS) has emerged as an important social and public health issue in the United States. In 1984 and 1985 three reports described clusters of patients with symptoms of chronic relapsing fatigue, recurrent low grade fever, sore throat, lymphadenopathy, myalgia, arthralgia, headaches, sleep disturbances, impaired ability to concentrate, and various other non-specific symptoms. Similar cases were also recognized throughout the United States, Europe, and Australia. They were not associated with a cluster, but occurred sporadically, predominantly in women. The disease was recognized as a single clinical entity with no known etiology. In response, a group of experts convened at the Centers for Disease Control to develop a case definition to be used by researchers investigating this chronically fatiguing illness. The research case definition was deliberately designed to be restrictive in order to ensure that patients selected for studies would be relatively homogeneous, thus increasing the likelihood of identifying the cause of the illness.
Epidemiologic and immunologic evidence suggests that CFS may be an infectious disease. Data from epidemiologic studies provide evidence that an infection may be responsible, and several candidate agents have been identified. Evidence of ongoing infection also comes from immunologic studies, and perturbations of the immune response may account for some of the symptoms experienced by these patients.
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