List of myalgic encephalomyelitis and chronic fatigue syndrome outbreaks

There have been dozens of documented outbreaks of ME and CFS since the 1930s. Many of these outbreaks occurred at institutions for example, hospitals, schools, army bases or convents. The true number of clusters and outbreaks is likely vastly higher.

History of the name
Before the polio vaccine, outbreaks were often observed in towns experiencing polio epidemics, hence one of ME's earliest names, atypical polio. It is not known whether there is a relationship between polio outbreaks and ME or if outbreaks of ME were more likely to be reported when public health authorities were already mobilized for an earlier crisis.

After the outbreak in Akureyri, Iceland in 1946, the disease came to be called "Akureyri Disease" or Icelandic disease through much of the 1940s and 1950s. It was named Myalgic Encephalomyelitis after London's Royal Free Hospital outbreak in 1955.

After the Incline Village outbreak in Nevada in 1984, the disease came to be called and redefined as Chronic Fatigue Syndrome.

1934 - Los Angeles, USA
Epidemic among personnel at L.A. County Hospital, Ruth Protection Home and throughout California, paralleling poliomyelitis, often diagnosed as atypical poliomyelitis, sometimes including arthropathy.

1936 - Fond-du-Lac, Wisconsin, USA
An outbreak of "encephalitis" in St. Agnes Convent.

1937 - Erstfeld, Switzerland
Outbreak described as "Abortive Poliomyelitis."

1937 - St. Gallen, Switzerland
Outbreak in Frohburg Hospital described as "Abortive Poliomyelitis."

1939 - Middlesex, England
Outbreak at Harefield Sanatorium - "Persistent myalgia following sore throat."

1939 - Degersheim, St. Gallen, Switzerland
Outbreak described as "Abortive Poliomyelitis."

1945 - University Hospital of Pennsylvania, USA
Epidemic described as "pleurodynia with prominent neurological symptoms and no demonstrable cause."

1946-47 - Iceland
"Mixed epidemics of poliomyelitis and a disease resembling poliomyelitis with the character of the Akureyri Disease."

1948-49 - North Coast Towns, Iceland
"A disease epidemic in Iceland simulating Poliomyelitis" in three separate towns during this time.

1949-1953 - Adelaide, Australia
Outbreak of a disease resembling poliomyelitis, during/after a poliomyelitis epidemic.


 * 1951-06-30: "The author describes a disease which has been epidemic in Adelaide since August 1949, and which closely resembles poliomyelitis. Its most characteristic feature is the absence of abnormal findings in the cerebrospinal fluid. Thus, out of 1,350 consecutive cases of " poliomyelitis ", 800 had less than 10 cells per cubic millimetre in the cerebrospinal fluid (the majority had less than 5 cells); and the protein values were normal in all but 2 of these cases.
 * The onset of this illness was either gradual or sudden and, if sudden, headache was a constant feature and often of marked intensity. Muscle weakness - generally slight and diffuse in distribution - occurred more commonly in the legs than in the arms. Where paralysis was severe, rapid recovery generally ensued. Two noteworthy features of the muscle involvement in this disease were as follows: the pain frequently persisted in various muscles for periods up to six months after the acute illness; in some cases the onset of muscle weakness was delayed for several months. The ultimate prognosis was always good, but frequent recurrences were not uncommon. The greatest disabling feature of the disease lay in the psychological sequelae which were fairly constant and comprised one or more of the following - lack of concentration, depression, irritability, emotional instability and hyperacuity of hearing. These manifestations, however, eventually resolved completely".


 * 1952-02-01: "Dr. R.A. Pellew, of Adelaide, who will also address the conference, believes that most of SA's 3,130 polio cases during the past two years and nine months have suffered a mild form of the disease."


 * 1955: The Adelaide outbreak of atypical polio was associated with a reduction in typical polio cases. "There was ... a marked regression of [typical] poliomyelitis in South Australia (413 notifications as compared with 721)." (from page 645 of 1955 WHO report )

1950 - Louisville, Kentucky, USA
Outbreak in the Nurse's Training School of St. Joseph Infirmary, later described as "epidemic neuromyasthenia."

1950 - Upper New York State, USA
Outbreak described as resembling the "Iceland Disease...simulating Acute Anterior Poliomyelitis."

1952 - London, England
Outbreak at Middlesex Hospital Nurses' Home described as "Encephalomyelitis associated with Poliomyelitis Virus."

1952 - Copenhagen, Denmark
Outbreak described as "epidemic myositis."

1952 - Lakeland, Florida, USA
Outbreak described as epidemic neuromyasthenia.

1953 - Coventry and Coventry District, England
"An illness resembling Poliomyelitis observed in nurses."

1953 - Rockville, Maryland, USA
Chestnut Lodge Hospital student nurses described with poliomyelitis-like epidemic neuromyasthenia.

1953 - Jutland, Denmark
Outbreak of "Epidemic encephalitis with vertigo."

1954 - Tallahassee, Florida, USA
Bond JO. A new clinical entity? Lancet 1956; 2:256.

1954 - Seward, Alaska
Outbreak described as "Benign Myalgic Encephalomyelitis (Iceland Disease)."

1954 - Berlin, Germany
Among the British Army, a "further outbreak of a disease resembling poliomyelitis."

1954 - Liverpool, England
Outbreak among medical and nursing staff in a Liverpool Hospital.

1954 - Dalston, Cumbria, England
"...an unusual disease seen in epidemic and sporadic form in general practice in 1955 and subsequent years."

1955 - London, England
Famous outbreak of benign myalgic encephalomyelitis among Royal Free Hospital staff.

1955 - Perth, Australia
"Virus epidemic in recurrent waves."

1955 - Gilfach Goch, Wales
Outbreak of Benign encephalomyelitis.

1955 - Durban and Durban City, South Africa
Outbreak among nurses at Addington Hospital called "The Durban Mystery Disease" describing neuromuscular dysfunction, and epidemic myalgic encephalomyelopathy, including sporadic cases in Johannesburg of a outbreak resembling poliomyelitis.

1955-56 - Segbwema, Sierra Leone
An outbreak of encephalomyelitis.

1955-56 - Patreksfordur and Thorshofn, Iceland
Unusual response to poliomyelitis vaccination.

1955-56 - North West London, England
Outbreak of acute infective encephalomyelitis simulating poliomyelitis among a residential home for nurses.

1956 - Ridgefield, Connecticut, USA
An epidemic of neuromyasthenia.

1956 - Punta Gorda, Florida, USA
An outbreak of epidemic neuromyasthenia.

1956 - Newton-le-Willows, Lancashire, England
Outbreak described as "lymphocytic meningo-encephalitis with myalgia and rash," "An outbreak of a disease believed to have been cause by Echo 9 virus," with other varying descriptions.

1956 - Pittsfield, Williamstown, Massachusetts, USA
Outbreak of "epidemic neuromyasthenia" later described as benign myalgic encephalomyelitis. (Included in this summary are sporadic cases in Hygiea, Sweden, with descriptions of encephalitis, meningitis or poliomyelitis; Coxsackie B and Echo Virus infections; benign myalgic encephalomyelitis.)

1956-57 - Coventry, England
Outbreak described as epidemic malaise and benign myalgic encephalomyelitis.

1957 - Brighton, South Australia
Outbreak described as "Coxsackie, Echo Virus meningitis and myalgic encephalomyelitis", "Epidemic myalgic encephalomyelitis," and "Benign myalgic encephalomyelitis."

1958 - Athens, Greece
An outbreak of benign myalgic encephalomyelitis in a nurse's school, "periostitis and arthropathy noted." (Included in this summary is an outbreak of benign myalgic encephalomyelitis in Switzerland.)

1958-59 - S.W. London, England
Reports of sporadic cases of myalgic encephalomyelitis.

1959 - Newcastle upon Tyne, England
Outbreak of benign myalgic encephalomylitis.

1959 - N.W. London, England
Reports of sporadic cases of influenza-like illness.

1959 - England
Article describing sporadic cases and "The psychiatric sequelae of Benign Myalgic Encephalomyelitis."

1961 - Basel, Switzerland
Sporadic case of benign myalgic encephalomyelitis described.

1961-62 - New York State, USA
Outbreak described as epidemic neuromyasthenia in a convent in New York State.

1964-66 - N.W. London, England
Outbreak described as epidemic malaise and epidemic neuromyasthenia.

1964-66 - Franklin, Kentucky, USA
Outbreak of "neurmyasthenia" in a Kentucky factory, possibly due to mercury exposure.

1965-66 - Galveston County, Texas, USA
Outbreak described as "Epidemic Neuromyasthenia Variant?" and "Epidemic Diencephalomyelitis," the latter describing neuropsychiatric, cardiovascular and endocrine disorders.

1967-70 - Edinburgh, Scotland
Sporadic cases resembling benign myalgic encephalomyelitis.

1968 - Fraidek, Lebanon
Report on an epidemic of benign myalgic encephalomyelitis.

1969 - State University of New York, USA
Medical Centre - report of epidemic Neuromyasthenia and "unidentified symptom complex."

1970 - Lackland Air Force Base, Texas, USA
Epidemic Neuromyasthenia reported. "A syndrome or disease?"

1970-71 - London, England
An outbreak of "epidemic neuromyasthenia" among nurses a the Hospital for Sick Children, Great Oromond Street.

1975 - Sacramento, California, USA
"200 hospital staff in the [Mercy San Juan Hospital] fell ill in August September 1975. The epidemic appears to have spread to the children of the hospital staff and from there to the children's teachers.  43 have been seriously disabled with chronic illness from 1975-1992" [at publication of this text].

1976 - Southwest Ireland
Reports on Mylagic Encephalomyelits and epidemic neuromyasthenia in this region.

1977 - Dallas-Fort Worth, Texas, USA
"Epidemic Neuromyasthenia" reported.

1978 - Symposium
[Ed. note: Dr. Hyde's text notes that the first major ME symposium was held at the Royal Society of Medicine in London in this year. ME aka epidemic neuromyasthenia, viral relationships to this disease, biochemical abnormalities in patients and other subjects were discussed by experts such as Shelokov, Ramsay, Richardson, Behan, Parish and others.

1979 - Southampton, England
Outbreak of M.E. in a girls' school.

1980-81 - West Kilbridge, Ayrshire, Scotland
M.E. epidemic reported in a rural medical practice.

1980-83 - Helensburgh, Scotland
Coxsackie B outbreak reported in a general practice.

1981-82 - Stirlingshire, Scotland
Sporadic cases of M.E. reported.

1981 - Gunnedah, NSW, Australia
The Gunnedah outbreak was linked with pesticides, which were conjectured to be interacting with viruses and other environmental chemicals in a post-viral syndrome. Those affected included one local GP, with that GP forming the view this was clearly a physical illness. The outbreak was featured in a film More than Just Poison made in 1986 by the Toxic and Hazardous Chemicals Committee.

1984 - Tapanui & West Otago, New Zealand
Outbreak first described and an "unexplained illness," later as M.E. Included here are outbreaks in Dunedin and Hamilton New Zealand.

1984 - North America (Endemic)
"From 1984 until 1992 [at publication of this text] an endemic period occurred in which an usually large number of cluster and epidemics of M.E./CFS have been recognized in North America. After an apparent initial increase in the morbidity in 1983 there seemed to have appeared in late summer of 1984 an unprecedented increase of sporadic and epidemic cases across North America.  Although certain geographical hot spots seen to have taken up much of the medical interest, this endemic situation probably represents an unusual and unremitting morbidity in all areas of the United States and Canada." -Dr. Byron Hyde-

1984 - Incline village, Lake Tahoe, Nevada, USA
A chronic illness characterized by fatigue, neurologic and immunologic disorders and active human herpesvirus type 6 infection. This community epidemic, apparently started in a girls' basketball team, then involved primarily teacher in at least three high schools, and then large numbers of the community.

1984 - Chapel Hill, North Carolina, USA
"Epidemic amongst members of The North Carolina Symphony Orchestra. Low NKC [Natural Killer Cells] associated with high yield of lymphoma, astrocytoma, glioma."

All the members of the N.C. Symphony Orchestra, Chapel Hill, NC got sick. Seven remained ill with chronic fatigue as late as 2009. A series of studies done in 1988 and 1989 by the University of Pittsburgh Cancer Center showed that four the inflicted NC orchestra members who developed cancer had lower levels of activity of natural killer cells, a type of immune cell that can directly kill cancer.

1984 - Montreal, Quebec-Ontario, Canada
Over 500 cases of M.E./CFS documented during August-November 1984 period. This endemic was active in all parts of Canada during this period and appears [to] have maintained its activity until the time of writing in 1991.

1984-85 - Truckee, California, USA
M.E. epidemic involving teachers and students.

1985 - Lyndonville, New York, USA
M.E. epidemic in a rural community involving children and adults.

1985 Yerington, Nevada, USA
In the same area [not far from Truckee, California] an M.E./CFS-like epidemic reputedly occurred in a reservation of American Native people.

1986 - Placerville, California, USA
Outbreak of chronic fatigue syndrome 'coincident with a heavy contamination of the local unfiltered water supply'.

1988 - Sonora, California, USA
"More than 35 children and adults were diagnosed with M.E. in the mountain country 100 miles from Lake Tahoe. Many of these patients were associated in some way with Columbia Community College."

1989 - Roseville, California, USA
Rosedale Hospital reported 11 cases of M.E./CFS among staff.

1990 - Elk Grove, California, USA
M.E. epidemic among teachers and students.

Australia and New Zealand

 * 1949-54 - Adelaide, South Australia
 * 1955 - Perth, Western Australia
 * 1957 - Brighton, South Australia
 * 1984 - West Otago, New Zealand
 * 1988 - Narrabeen, NSW, Australia

Related Lists

 * Myalgic Encephalomyelitis and Post Viral Fatigue States: the Saga of the Royal Free Disease by Dr Melvin Ramsay, 1955.
 * Reference index of papers published on epidemics of ME 1934-80 (collected by Dr J. Gordon Parish), ME Research UK, 1980.
 * The Clinical and Scientific Basis of Myalgic Encephalomyelitis and Chronic Fatigue Syndrome (edited by Dr. Byron Hyde), Nightingale Foundation, 1992.