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1984 Incline Village chronic fatigue syndrome outbreak
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In 1984, there was an outbreak of [[myalgic encephalomyelitis]]/[[chronic fatigue syndrome]] ([[ME/CFS]]) (then thought to be [[Chronic Epstein-Barr virus]]) at '''Incline Village''', Nevada, [[United States]].<ref name="cdc">{{Cite web | url = https://www.cdc.gov/mmwr/preview/mmwrhtml/00000740.htm | title = Chronic Fatigue Possibly Related to Epstein-Barr Virus -- Nevada | website = cdc.gov | access-date = 2021-03-24}}</ref> Incline Village is a small town on the north shore of Lake Tahoe. Chronic fatigue syndrome (CFS) was the name coined by the [[Centers for Disease Control]] (CDC) in response to an outbreak of "chronic [[flu-like illness]]" at Incline Village.<ref name="nytimes">{{Cite news |url =https://www.nytimes.com/1987/07/28/science/fatigue-virus-has-experts-more-baffled-and-skeptical-than-ever.html | title = Fatigue 'Virus' Has Experts More Baffled And Skeptical Than Ever | last = Boffey | first = Philip M. | date = 1987-07-28|work=The New York Times | access-date = 2019-02-17|language=en-US|issn=0362-4331}}</ref> ==Outbreak== An estimated 160 residents of Incline Village became ill with [[chronic fatigue syndrome]] ([[chronic fatigue syndrome|CFS]]) the winter of 1985 of which the majority were seen by local doctors, [[Paul Cheney]] and [[Daniel Peterson]].<ref>{{Cite web | url = https://www.latimes.com/archives/la-xpm-1986-06-07-mn-9956-story.html | title = 160 Victims at Lake Tahoe : Chronic Flu-Like Illness a Medical Mystery Story | last = | first = | author-link = | date = 1986-06-07 | website = Los Angeles Times|language=en-US|archive-url=|archive-date=|url-status= | access-date = 2021-03-24}}</ref> Dr. [[Anthony Komaroff]] studied 175 cases around Lake Tahoe and found "quite a number" have been fully or partially disabled while a third said their condition improved.<ref name="nytimes" /> ===Truckee, California High School=== During this same time, about 20 miles away, Truckee, California was involved in a similar outbreak. Nine of 10 teachers using a conference room at the same high school were found to be suffering from [[sick building syndrome]] (SBS) as well as symptoms typical of CFS.<ref name="Chester">{{Cite journal | last = Chester | first = A.C. | author-link = | last2 = Levine | first2 = P.H. | author-link2 = Paul Levine | date = Jan 1994 | title = Concurrent sick building syndrome and chronic fatigue syndrome: epidemic neuromyasthenia revisited | url =https://web.archive.org/web/20180205051123if_/http://www.me-ireland.com:80/Truckee.pdf | journal=Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America | volume = 18 | issue = Supp 1| pages=S43β48|doi=10.1093/clinids/18.supplement_1.s43|issn=1058-4838|pmc=|pmid=8148452|access-date=|quote=|via=}}</ref> ==Local response== ===Paul Cheney and Dan Peterson=== Doctors who practiced at Incline Village and experienced the outbreak first hand include [[Daniel Peterson]] and [[Paul Cheney]].<ref name="Chester" /><ref name="Buchwald1992" /> They have continued to work in the [[ME/CFS]] field. ==CDC investigation== 'The [[CDC]] showed up eventually, but they refused to examine any of the patients. [[Stephen Straus]] called it a disease of βdepressed menopausal women.β [[U.S. Department of Health and Human Services|HHS]] made this characterization known to the press, which then dubbed the disease β[[Yuppie Flu]].β'<ref>{{Cite web | url = https://sarahallegra.wordpress.com/2014/05/13/the-incline-village-outbreak/ | title = The Incline Village Outbreak | date = 2014-05-13 | website = Mythic Pictures|language=en | access-date = 2021-03-24}}</ref> {{See also|Stigma and discrimination||List of abnormal findings in chronic fatigue syndrome and myalgic encephalomyelitis|||}} The local doctors seemed to be defending their scorned and disabled patients from the CDC and medical establishment.<ref>{{Cite web | url = https://phoenixrising.me/folder/ed/original-sin-incline-village-chronic-fatigue-syndrome-and-myalgic-encephalomyelitis-by-cort-johnson | title = ORIGINAL SIN: Incline Village, Chronic Fatigue Syndrome and Myalgic Encephalomyelitis | last = Johnson | first = Cort | author-link = Cort Johnson | date = | website = Phoenix Rising: Supporting People With Chronic Fatigue Syndrome (ME/CFS)|language=en-US|archive-url=|archive-date=|url-status= | access-date = 2021-03-24}}</ref> In an interview with [[Hillary Johnson]], she spoke about Incline Village and the CDC response. "In 1984-85, a large number of people living in Incline Village, Nevada, were devastated by a mysterious, debilitating disease, now known to be Chronic Fatigue Syndrome. After a cursory investigation of the outbreak, the Centers for Disease Control (CDC) and the [[National Institutes of Health]] (NIH) have made little effort to aggressively research the disease. It was not until 1995--ten years later--that scientists at the CDC gave CFS a "Priority 1" listing among their "New and Reemerging Infectious Diseases" category, thus officially recognizing it as a bona fide disease. Despite including CFS in this category, these agencies continue to insist there is no evidence that CFS is infectious."<ref name="OslerInterview">{{Cite web | url = https://www.ncf-net.org/library/hillary.htm | title = Oslers Web Author, Hillary Johnson, Talks about CFS and her Book | website = ncf-net.org | access-date = 2021-03-24}}</ref> Although the CDC did not examine patients when they were sent to investigate the mysterious illness they were called in for, they somehow were able to, at a later date, produce a report based on whether or not the patients were experiencing [[Chronic Epstein-Barr virus]]. The non-conclusion was: "Currently available data neither prove nor disprove the hypothesis that EBV activity is responsible for chronic illness, but it is clear that the diagnosis of CEBV using current clinical and laboratory criteria in an individual patient is unreliable."<ref name="cdc" /> ==Media coverage== *1996 PrimeTime TV segment [[Sick and Tired - Incline Village Outbreak]] *[[I Remember Me]] *[https://twitter.com/erikmoldwarrior/status/798024814329929728 Doctors say strange form of mono under control in Incline Village] via Twitter [[Erik Johnson]]. Dated Oct, 16, 1985, Media outlet unknown. ==Possible causes== === Herpes viruses === [[Gary Holmes]] found that patients in Nevada near the outbreak with what his team hypothesized was [[chronic Epstein-Barr virus]] had elevated antibody titers to several [[herpesviruses]] including [[Epstein-Barr virus]], [[cytomegalovirus]], and [[herpes simplex]], as well as [[measles]] viruses than age-matched controls.<ref>{{Cite journal | last = Holmes | first = Gary P | author-link = Gary Holmes | date = May 1, 1987 | title = A Cluster of Patients With a Chronic Mononucleosis-like Syndrome Is Epstein-Barr Virus the Cause? | url = https://jamanetwork.com/journals/jama/article-abstract/365861 | journal = Journal of the American Medical Association | volume = 257 | pages = 2297-2302|via=}}</ref> However, the study cohort was defined as patients who had experienced excessive fatigue between January 1 and September 15. In 1992, Buchwald, Cheney, Peterson and others published a study of 259 patients who fell ill during the outbreak, with 29% of these [[Severe and very severe ME|severely ill]]. They concluded: {{Quote|text=Patients had a higher mean (+/- SD) [[CD4+ T cell|CD4]]/[[CD8+ T cell|CD8-cell]] ratio than matched healthy controls (3.16 +/- 1.5 compared with 2.3 +/- 1.0, respectively; P < 0.003). [[Magnetic resonance imaging|Magnetic resonance scans]] of the brain showed punctate, subcortical areas of high signal intensity consistent with edema or demyelination in 78% of patients (95% Cl, 72% to 86%) and in 21% of controls (Cl, 11% to 36%) (P < 10-9). Primary cell culture of [[lymphocyte]]s showed active replication of HHV-6 in 79 of 113 patients (70%; CI, 61% to 78%) and in 8 of 40 controls (20%; Cl, 9% to 36%) (P < 10-8), a finding confirmed by assays using monoclonal antibodies specific for HHV-6 proteins and by polymerase chain reaction assays specific for HHV-6 DNA.<br /> <br /> Conclusions: [[:Category:Neurological signs and symptoms|Neurologic symptoms]], MRI findings, and lymphocyte phenotyping studies suggest that the patients may have been experiencing a chronic, immunologically mediated inflammatory process of the central nervous system. The active replication of [[Human herpesvirus 6|HHV-6]] most likely represents reactivation of latent infection, perhaps due to immunologic dysfunction.<ref name="Buchwald1992" />|sign=Buchwald et al. (1992)|source=Annals of Internal Medicine 116(2) pp. 103β113}} Dr. [[Paul Cheney]] theorizes that a particularly virulent strain of [[Human herpesvirus 6]] swept the population.<ref>Unreleased Canary in a Coal Mine interview, 2015.</ref> He found that the sufferers were "mass-producing antibodies to [[Epstein-Barr virus]], the herpes virus that causes infectious [[mononucleosis]]."<ref name="newsweek" /><ref name="Buchwald1992">{{Cite journal | last = Buchwald | first = Dedra | author-link = Dedra Buchwald | last2 = Cheney | first2 = Paul R. | author-link2 = Paul Cheney | last3 = Peterson | first3 = Daniel L. | author-link3 = Daniel Peterson | last4 = Henry | first4 = Berch | author-link4 = | last5 = Wormsley | first5 = Susan B. | author-link5 = | last6 = Geiger | first6 = Ann | author-link6 = | last7 = Ablashi | first7 = Dharam V. | last8 = Salahuddin | first8 = S. Zaki | last9 = Saxinger | first9 = Carl | date = 1992-01-15 | title = A Chronic Illness Characterized by Fatigue, Neurologic and Immunologic Disorders, and Active Human Herpesvirus Type 6 Infection | url =https://www.acpjournals.org/doi/abs/10.7326/0003-4819-116-2-103 | journal = Annals of Internal Medicine | volume = 116 | issue = 2 | pages = 103β113|doi=10.7326/0003-4819-116-2-103|issn=0003-4819|pmc=|pmid=|access-date=|quote=|via=}}</ref> Dr. Cheney contacted the [[Centers for Disease Control and Prevention|CDC]] to report the outbreak.<ref name="newsweek">{{Cite web | url = https://www.newsweek.com/chronic-fatigue-syndrome-205712 | title = Chronic Fatigue Syndrome | last = | first = | author-link = | date = 1990-11-11 | website = Newsweek|language=en|archive-url=|archive-date=|url-status= | access-date = 2021-03-24}}</ref> ===Biotoxin exposure=== [[Erik Johnson]], a patient who pioneered [[mold avoidance]] for [[chronic fatigue syndrome]], theorizes that an outbreak of toxic [[cyanobacteria]] (blue green algae) on Lake Tahoe located near Incline Village, combined with other biotoxins such as toxic mold, may have created susceptibility to a viral infection and caused the outbreak.<ref>[http://paradigmchange.me/avoidance/ Paradigm Change - Avoidance]</ref> It has been observed that the outbreak in Tahoe shared some but not all features with Sick Building Syndrome, and that the cluster of teachers who became sick at Truckee high school involved teachers who all used the same lounge, which may have had a chemical or biotoxin. <ref name="Chester" /> ==Learn more== *Nov 12, 1990, [[Chronic Fatigue Syndrome - Newsweek (1990)|Chronic Fatigue Syndrome - Newsweek]] * January 15, 1992, [https://web.archive.org/web/20180205051123if_/http://www.me-ireland.com:80/Truckee.pdf A Chronic Illness Characterised by Fatigue, Neurological and Immunological Disorders, and Active Human Herpesvirus Type 6 Infection] ==See also== *[[Daniel Peterson]] *[[Paul Cheney]] *[[List of myalgic encephalomyelitis and chronic fatigue syndrome outbreaks|List of outbreaks]] *[[Osler's Web]] ==References== [[Category:History]] [[Category:Outbreaks]] [[Category:Outbreaks in the 1980s]] [[Category:Outbreaks in the United States of America]] <references />
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