Chronic fatigue syndrome

Chronic fatigue syndrome (CFS) was a name coined by the Centers for Disease Control (CDC) in response to an outbreak of "chronic flu-like illness" in Incline Village, Lake Tahoe in 1984-1985 and several outbreaks and sporadic cases in the United States during the 1980s.

Prior to Incline Village, chronic fatigue syndrome was known as myalgic encephalomyelitis (ME). The "chronic fatigue syndrome" outbreaks of the 1980s and 1990s were likely ME outbreaks, although they differed in some respects from the 1930s-1960s outbreaks. With the development of the 1991 Oxford criteria and the 1994 Fukuda criteria for CFS, which differed in significant respects from historic descriptions of ME, CFS became a wastebasket diagnosis that included patients with ME along with those suffering from a wide range of undefined or misdiagnosed fatiguing illnesses.

Although a diagnosis of CFS is valid and in the US was historically made with the flawed Fukuda criteria, diagnostic criterion such as SEID (ME/CFS), the Canadian Consensus Criteria (ME/CFS), and International Consensus Criteria (ME) offer a more accurate diagnosis for ME/CFS and ME.

Name controversy
The name Chronic Fatigue Syndrome is controversial, as many consider it stigmatizing and focusing on a symptom, chronic fatigue. For decades, patient advocates have been lobbying the Centers for Disease Control and Prevention (CDC) to instead use the name myalgic encephalomyelitis (ME). Most patients and patient organizations prefer the name ME, or the hybrid ME/CFS.


 * Jun 2014, Dr. Nancy Klimas discusses the name controversy in the video ME/CFS Diagnosis and Name.


 * Feb 2016, Dr Anthony Komaroff, who was part of the CDC group of clinicians who coined the name Chronic Fatigue Syndrome, said of it: "I think that was a big mistake because the name, in my opinion, and the opinion of a lot of people, it both trivializes and stigmatizes the illness. It makes it seem unimportant, maybe not even real".

The Oxford and Fukuda criteria are used in Australia, South Africa, Canada, and parts of Europe so they use the name CFS; the UK will sometimes use the name CFS although they also use the name ME. The United States CDC has begun using the acronym ME/CFS.
 * Jul 2017, the CDC changed its website for Chronic Fatigue Syndrome to Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).

Generally accepted criteria for diagnosing ME/CFS and ME

 * Canadian Consensus Criteria (CCC) A diagnosis of moderate and severe forms of ME/CFS are accurately made using this criterion. Adults can be diagnosed at six months while pediatric cases are diagnosed at three months.
 * International Consensus Criteria (ICC) - This criterion will accurately diagnose myalgic encephalomyelitis (ME) which is a chronic, inflammatory, physically and neurologically disabling disease. For pediatric and adult cases a diagnosis should be made immediately. CCC and SEID criteria cannot diagnose immediately nor speak to the array and severity of central nervous system (CNS), autonomic (ANS), and immune system symptoms patients experience.
 * Systemic Exertion Intolerance Disease (SEID) - A mild form of ME/CFS (SEID) is accurately diagnosed when the most basic of its criteria is met but is useful for a more severe presentation of the disease as symptom severity and other symptoms are outlined in the Institute of Medicine report. Adults can be diagnosed at six months while pediatric cases are diagnosed at three months.

Learn more

 * Chronic Fatigue Syndrome