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Prognosis for myalgic encephalomyelitis and chronic fatigue syndrome
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=== Bell’s 3 stages === Based on the experience of adolescents he followed up for many years, [[David Bell]] subdivides the course of ME/CFS into three stages.<ref name=":22" /> At the first stage, there is an acute illness where [[Epstein-Barr virus|EBV]] is likely responsible for most adolescents but there is no standard viral illness. The initial virus likely fades away in a week and the patient feels better and is ready for regular activities. Bell adds "in a person with a gradual onset of symptoms, this stage would be different." The second stage "occurs when the symptoms do not disappear, but persist for months to years in roughly the same severity. There is little variation day-to-day, and this time is very confusing. Many medical providers are contacted, most giving conflicting opinions varying from psychological disorders to possible exotic infections, but the tests come back normal." In the third stage, patients will have mild, gradual improvements over years and patients adjust their lives to the symptoms. Patients may look well and recovery is thought to have taken place, but they still have to adapt their lifestyle to avoid relapses and symptom exacerbation.
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