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Onset of ME/CFS
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== Is ME always caused by a virus? == A small number of [[Myalgic encephalomyelitis|ME]] patient charities, for example [[The Hummingbirds' Foundation for ME]] hold the view that ME is always caused by a [[virus]], but [[chronic fatigue syndrome]] (CFS) may have non-viral triggers, and do not recognize [[Bacterial infection|bacterial infections]] or non-infectious events as a potential cause or trigger.<ref name="hfme">{{Cite web|url=http://www.hfme.org/methemedicalfacts.htm | title = M.E.: The medical facts | last = Bassett | first = Jodi | authorlink=Jodi Bassett | date = 2010 | website = [[The Hummingbirds' Foundation for ME]]|archive-url=|archive-date=|access-date=2019-02-09|quote=Myalgic encephalomyelitis is a systemic acutely acquired illness initiated by a virus infection which is characterised by post encephalitic damage to the brain stem; a nerve centre through which many spinal nerve tracts connect with higher centres in the brain in order to control all vital bodily functions β this is always damaged in M.E. (Hence the name Myalgic Encephalomyelitis.) The CNS is diffusely injured at several levels, these include the cortex, the limbic system, the basal ganglia, the hypothalamus and areas of the spinal cord and its appendages. This persisting multilevel central nervous system (CNS) dysfunction, and in particular, inconsistent CNS dysfunction is undoubtedly both the chief cause of disability in M.E. and the most critical in the definition of the entire disease process.}}</ref> The onset events recognized as potential causes or triggers in the ICC are based on events prior to illness that have been reported by patients meeting the diagnostic criteria for ICC ME or based on the consensus of experts. The exact cause has not yet been identified in research. [[Lily Chu|Chu]] et al. (2019) reported on pre-onset events for patients meeting the CFS [[Fukuda criteria]] only.<ref name="Chu" /> {{See also|Viral onset hypothesis}}
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