William Reeves

William C. Reeves, MD, MS (27 March 1943 - 3 Aug 2012) was an epidemiologist and former CFS Research Chief of the Centers for Disease Control & Prevention from 1992 to 2010. He was criticized for promoting psychological causal factors for ME/CFS, as well as for his department misspending funds appropriated for ME/CFS.

In 2010, he was removed from the CFS program and reassigned as Senior Advisor for Mental Health Surveillance in the Public Health Surveillance Program Office within the CDC. He died at his home in Atlanta on Aug. 3, 2012. He was 69.

Wichita Clinical Study

From December 2002 to July 2003 in Wichita, Kansas, USA, a 2-day in-hospital clinical assessment study was conducted by Reeves and his CDC department. It was named the Wichita Clinical Study. The complete data set is available on the CDC Wichita Clinical Study Data Access website. The study enrolled 227 people and classified them into five study groups, one with CFS patients as defined by the 1994 CDC Fukuda criteria case definition, one non-fatigued control group and three other groups reporting ongoing fatigue. The main objective of the study was to characterize the physiologic status of subjects with CFS, and to apply the 1994 CFS criteria to standardized reproducible criteria.

The conclusion of the Wichita Clinical Study published in 2005 stated: "The empirical definition includes all aspects of CFS specified in the 1994 case definition and identifies persons with CFS in a precise manner that can be readily reproduced by both investigators and clinicians."

In 2006, Reeves spoke at The National Press Club as part of a Chronic Fatigue Syndrome Awareness Campaign. Using results from the Wichita Clinical Study, he stated: "When we completed the medical workups of people in Wichita to confirm that they had CFS, we found that only half of those with the illness had consulted a physician for the illness. We found that only 16 percent had been diagnosed and treated for CFS...We found that a quarter of the people with CFS are either unemployed or receiving disability...We’ve documented, as have others, that the level of functional impairment in people who suffer from CFS is comparable to multiple sclerosis, AIDS, end-stage renal failure, [or] chronic obstructive pulmonary disease. The disability is equivalent to that of some well-known, very severe medical conditions.”

Case Definition

In 2005, the CDC published a paper outlining the Wichita Clinical Study which stated that the 1994 CDC case definition of CFS (called the empirical definition or the Fukuda criteria) was an accurate case definition. The study has garnered much criticism for not being specific enough to exclude patients which other illnesses. In particular, there is no mention of post-exertional malaise, instead they use the symptom "post-exertional fatigue."Since the study was led by Reeves, the case definition is sometimes referred to as the Reeves criteria although it has no distinction from the 1994 CDC case definition of CFS.

Notable Studies

• 2009, An evaluation of exclusionary medical/psychiatric conditions in the definition of chronic fatigue syndrome.
• 2007, Perception versus polysomnographic assessment of sleep in CFS and non-fatigued control subjects: results from a population-based study.
• 2006, Post-infective and chronic fatigue syndromes precipitated by viral and non-viral pathogens: Prospective cohort study

  "Abstract -To delineate the risk factors, symptom patterns, and longitudinal course of prolonged illnesses after a variety of acute infections. Prospective cohort study following patients from the time of acute infection with Epstein-Barr virus (glandular fever), Coxiella burnetii (Q fever), or Ross River virus (epidemic polyarthritis). The region surrounding the township of Dubbo in rural Australia, encompassing a 200 km geographical radius and 104,400 residents. 253 patients enrolled and followed at regular intervals over 12 months by self report, structured interview, and clinical assessment. Detailed medical, psychiatric, and laboratory evaluations at six months to apply diagnostic criteria for chronic fatigue syndrome. Premorbid and intercurrent illness characteristics recorded to define risk factors for chronic fatigue syndrome. Self reported illness phenotypes compared between infective groups. Prolonged illness characterised by disabling fatigue, musculoskeletal pain, neurocognitive difficulties, and mood disturbance was evident in 29 (12%) of 253 participants at six months, of whom 28 (11%) met the diagnostic criteria for chronic fatigue syndrome. This post-infective fatigue syndrome phenotype was stereotyped and occurred at a similar incidence after each infection. The syndrome was predicted largely by the severity of the acute illness rather than by demographic, psychological, or microbiological factors. A relatively uniform post-infective fatigue syndrome persists in a significant minority of patients for six months or more after clinical infection with several different viral and non-viral micro-organisms. Post-infective fatigue syndrome is a valid illness model for investigating one pathophysiological pathway to chronic fatigue syndrome."

• 2006, Sleep characteristics of persons with chronic fatigue syndrome and non-fatigued controls: results from a population-based study.
• 2006, Cognitive dysfunction relates to subjective report of mental fatigue in patients with chronic fatigue syndrome

  "CFS patients with significant complaints of mental fatigue (score of mental fatigue 2 standard deviations above the mean of nonfatigued subjects) exhibited significant impairment in the spatial working memory and sustained attention (rapid visual information processing) tasks when compared to CFS patients with low complaints of mental fatigue and nonfatigued subjects. In CFS patients with significant mental fatigue, sustained attention performance was impaired only in the final stages of the test, indicating greater cognitive fatigability in these patients."

• 2006, Preliminary evidence of mitochondrial dysfunction associated with post-infective fatigue after acute infection with Epstein Barr Virus FULL TEXT
• 2005, Chronic Fatigue Syndrome – A clinically empirical approach to its definition and study.
• 2005, Psychometric properties of the CDC Symptom Inventory for assessment of Chronic Fatigue Syndrome.
• 2003, Identification of ambiguities in the 1994 chronic fatigue syndrome research case definition and recommendations for resolution
• 1997, The Prevalence of Chronic Fatiguing Illnesses Among Adolescents in the United States

News Articles

• 1999 Washington Post article about Dr. Reeves being retaliated against following the CFS budget misspending
• Obituary

Talks and Interviews

• 2000 Documentary, I Remember Me, directed by Kim A. Snyder

Also See

• Centers for Disease Control & Prevention
• Wichita Clinical Study
• Reeves criteria

Centers for Disease Control and Prevention (CDC) - The Centers for Disease Control and Prevention is a U.S. government agency dedicated to epidemiology and public health. It operates under the auspices of the Department of Health and Human Services.

renal involving, related to or in the area of the kidneys

cognition Thought processes, including attention, reasoning, and memory.

cognition Thought processes, including attention, reasoning, and memory.

mitochondria Important parts of the biological cell, with each mitochondrion encased within a mitochondrial membrane. Mitochondria are best known for their role in energy production, earning them the nickname "the powerhouse of the cell". Mitochondria also participate in the detection of threats and the response to these threats. One of the responses to threats orchestrated by mitochondria is apoptosis, a cell suicide program used by cells when the threat can not be eliminated.

BMJ The BMJ (previously the British Medical Journal) is a weekly peer-reviewed medical journal.

chronic fatigue (CF) - Persistent and abnormal fatigue is a symptom, not an illness. It may be caused by depression, multiple sclerosis, fibromyalgia, chronic fatigue syndrome or many other illnesses. The term "chronic fatigue" should never be confused with the disease chronic fatigue syndrome.