Enteroviral infection hypothesis

The enteroviral hypothesis is the hypothesis that a significant subset of patients meeting the criteria for myalgic encephalomyelitis, as well as those affected by the historic outbreaks, had their illness triggered by an enterovirus, one that might continue to persist and contribute to symptoms. It is a hypothesis held by John Chia, Byron Hyde, Melvin Ramsay, and others, and recently investigated by Maureen Hanson.

Theory
Enterovirus symptoms could account for many of the symptoms of ME/CFS.

Evidence
Rates of enteroviral infection are higher in ME/CFS than in the general population, and a recent review by O'Neal and Hanson (2021) found that a number of outbreaks of myalgic encephalomyelitis/chronic fatigue syndrome were highly likely to have been caused by an enterovirus.

Persistence
A review by O'Neal and Hanson (2021) found that the presence of chronic enterovirus infection in ME/CFS could not be ruled out.

Notable studies

 * 2022, The Enterovirus Theory of Disease Etiology in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Critical Review - (Full text)