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1984 Incline Village chronic fatigue syndrome outbreak
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==Possible causes== === Herpes viruses === [[Gary Holmes]] found that patients in Nevada near the outbreak with what his team hypothesized was [[chronic Epstein-Barr virus]] had elevated antibody titers to several [[herpesviruses]] including [[Epstein-Barr virus]], [[cytomegalovirus]], and [[herpes simplex]], as well as [[measles]] viruses than age-matched controls.<ref>{{Cite journal | last = Holmes | first = Gary P | author-link = Gary Holmes | date = May 1, 1987 | title = A Cluster of Patients With a Chronic Mononucleosis-like Syndrome Is Epstein-Barr Virus the Cause? | url = https://jamanetwork.com/journals/jama/article-abstract/365861 | journal = Journal of the American Medical Association | volume = 257 | pages = 2297-2302|via=}}</ref> However, the study cohort was defined as patients who had experienced excessive fatigue between January 1 and September 15. In 1992, Buchwald, Cheney, Peterson and others published a study of 259 patients who fell ill during the outbreak, with 29% of these [[Severe and very severe ME|severely ill]]. They concluded: {{Quote|text=Patients had a higher mean (+/- SD) [[CD4+ T cell|CD4]]/[[CD8+ T cell|CD8-cell]] ratio than matched healthy controls (3.16 +/- 1.5 compared with 2.3 +/- 1.0, respectively; P < 0.003). [[Magnetic resonance imaging|Magnetic resonance scans]] of the brain showed punctate, subcortical areas of high signal intensity consistent with edema or demyelination in 78% of patients (95% Cl, 72% to 86%) and in 21% of controls (Cl, 11% to 36%) (P < 10-9). Primary cell culture of [[lymphocyte]]s showed active replication of HHV-6 in 79 of 113 patients (70%; CI, 61% to 78%) and in 8 of 40 controls (20%; Cl, 9% to 36%) (P < 10-8), a finding confirmed by assays using monoclonal antibodies specific for HHV-6 proteins and by polymerase chain reaction assays specific for HHV-6 DNA.<br /> <br /> Conclusions: [[:Category:Neurological signs and symptoms|Neurologic symptoms]], MRI findings, and lymphocyte phenotyping studies suggest that the patients may have been experiencing a chronic, immunologically mediated inflammatory process of the central nervous system. The active replication of [[Human herpesvirus 6|HHV-6]] most likely represents reactivation of latent infection, perhaps due to immunologic dysfunction.<ref name="Buchwald1992" />|sign=Buchwald et al. (1992)|source=Annals of Internal Medicine 116(2) pp. 103β113}} Dr. [[Paul Cheney]] theorizes that a particularly virulent strain of [[Human herpesvirus 6]] swept the population.<ref>Unreleased Canary in a Coal Mine interview, 2015.</ref> He found that the sufferers were "mass-producing antibodies to [[Epstein-Barr virus]], the herpes virus that causes infectious [[mononucleosis]]."<ref name="newsweek" /><ref name="Buchwald1992">{{Cite journal | last = Buchwald | first = Dedra | author-link = Dedra Buchwald | last2 = Cheney | first2 = Paul R. | author-link2 = Paul Cheney | last3 = Peterson | first3 = Daniel L. | author-link3 = Daniel Peterson | last4 = Henry | first4 = Berch | author-link4 = | last5 = Wormsley | first5 = Susan B. | author-link5 = | last6 = Geiger | first6 = Ann | author-link6 = | last7 = Ablashi | first7 = Dharam V. | last8 = Salahuddin | first8 = S. Zaki | last9 = Saxinger | first9 = Carl | date = 1992-01-15 | title = A Chronic Illness Characterized by Fatigue, Neurologic and Immunologic Disorders, and Active Human Herpesvirus Type 6 Infection | url =https://www.acpjournals.org/doi/abs/10.7326/0003-4819-116-2-103 | journal = Annals of Internal Medicine | volume = 116 | issue = 2 | pages = 103β113|doi=10.7326/0003-4819-116-2-103|issn=0003-4819|pmc=|pmid=|access-date=|quote=|via=}}</ref> Dr. Cheney contacted the [[Centers for Disease Control and Prevention|CDC]] to report the outbreak.<ref name="newsweek">{{Cite web | url = https://www.newsweek.com/chronic-fatigue-syndrome-205712 | title = Chronic Fatigue Syndrome | last = | first = | author-link = | date = 1990-11-11 | website = Newsweek|language=en|archive-url=|archive-date=|url-status= | access-date = 2021-03-24}}</ref> ===Biotoxin exposure=== [[Erik Johnson]], a patient who pioneered [[mold avoidance]] for [[chronic fatigue syndrome]], theorizes that an outbreak of toxic [[cyanobacteria]] (blue green algae) on Lake Tahoe located near Incline Village, combined with other biotoxins such as toxic mold, may have created susceptibility to a viral infection and caused the outbreak.<ref>[http://paradigmchange.me/avoidance/ Paradigm Change - Avoidance]</ref> It has been observed that the outbreak in Tahoe shared some but not all features with Sick Building Syndrome, and that the cluster of teachers who became sick at Truckee high school involved teachers who all used the same lounge, which may have had a chemical or biotoxin. <ref name="Chester" />
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