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Nightingale Research Foundation definition
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====1. M.E. is an acute onset biphasic epidemic or endemic (sporadic) infectious disease process==== Both [[Epidemic]] and Non-Epidemic cases are often preceded by a series of repeated minor infections in a previously well patient that would suggest either a vulnerable [[immune system]], or an immune system subject to overwhelming stressors such as: <ol start="1" type="a"> <li> repetitive contact with a large number of infectious persons, <li> unusually long hours of exhausting physical and / or intellectual work, <li> physical traumas, <li> immediate past immunizations, particularly if given when the patient has concurrent allergic or autoimmune or [[infectious disease]] or if the patient is leaving for a third world country within three weeks of receiving the immunization, <li> epidemic disease cases whose onset and periodicity appear to occur cyclically in a susceptible population, <li> the effect of travel, as in exposure to a new subset of virulent infections, or <li> the effects of starvation diets. </ol> (It should be noted that subsets c, d, e, f and g are all stressors associated with decreased immune adaptability plus an associated infection with an appropriate neurovascular infectious [[virus]] or other infectious agent. This may be due either to an immediate preexisting infectious disease or to a closely following infection, either of which may or may not be recognized.)
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