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Epidemiology of myalgic encephalomyelitis and chronic fatigue syndrome
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== Severity == [[File:HRQoL-journal.pone.0132421.g003.PNG|200px|thumb|right|Comparison of disability for ME/CFS and other conditions. Source: Hvidberg et al 2015. PLoSOne 10(7):e0132421.<ref name="Hvidberg2015" />]] People with ME/CFS are more disabled and socially marginalized than for most other chronic illnesses.<ref name="Hvidberg2015">{{citation | last = Hvidberg | first1 = Michael Falk | author-link1 = Michael Falk Hvidberg | last2 = Brinth | first2 = Louise Schouborg | authorlink2 = Louise Schouborg Brinth | last3 = Olesen | first3 = Anne V | authorlink3 = Anne V Oleson | last4 = Petersen | first4 = Karin D | authorlink4 = Karin Peterson | last5 = Ehlers | first5 = Lars | authorlink5 = Lars Ehlers | title = The Health-Related Quality of Life for Patients with Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME/CFS) | journal =PLoS One|volume =10 |issue =7 | page=e0132421 | date = Jul 6, 2015 | doi = 10.1371/journal.pone.0132421 | url = http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0132421 }}</ref> Around 25 percent of people with ME/CFS will have a mild form and are able to go to school or work either part-time or full-time, while reducing other activities. About 50 percent will have a moderate to severe form of ME/CFS and are unlikely to able to study or work. Another 25 percent will experience [[Severe and very severe ME|severe ME/CFS]] and have to stay at home or in bed.<ref name="SEID-IOM2015" /> According to the CDC, up to the 75% of [[US|United States]] patients with [[ME/CFS]] are too ill to work,<ref name="CDC2016">{{Citation | last = Lapp | first = C | authorlink = Charles Lapp | last2 = Unger | first2 = ER | authorlink2 = Elizabeth Unger | last3 = Komaroff | first3 = AL | authorlink3 = Anthony Komaroff | last4 = Nath | first4 = A . | authorlink4 = Avindra Nath | title = CDC public health grand rounds. Chronic fatigue syndrome: advancing research and clinical education|website=[[Centers for Disease Control and Prevention]] | date = Feb 2016|access-date=2020-04-03 | url = https://www.cdc.gov/grand-rounds/pp/2016/20160216-presentation-chronic-fatigue-H.pdf}}</ref> with rates of between 50 and 75% [[disability|too ill to work worldwide]].<ref name="Vink2019">{{Cite journal | last = Vink | last2 = Vink-Niese | date = 2019-09-20 | title = Work Rehabilitation and Medical Retirement for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Patients. A Review and Appraisal of Diagnostic Strategies |url =https://www.mdpi.com/2075-4418/9/4/124/htm|journal=Diagnostics|language=en|volume=9|issue=4 | pages = 124|doi=10.3390/diagnostics9040124|issn=2075-4418 | first = Mark | first2 = Alexandra|pmc=|pmid=|quote= | author-link = Mark Vink | authorlink2 = Alexandra Vink-Niese|access-date=|via=}}</ref> A study in France by Ghali et al 2020 looked at factors associated with increased severity of [[post-exertional malaise]] (PEM), the hallmark symptom, and found that onset at age 32 or later, a gastrointestinal illness triggering ME/CFS and recurrent infections during the illness all increased risk of having more severe PEM.<ref name="Ghali2020">{{Cite journal | last = Ghali | first = Alaa | author-link = Alaa Ghali | last2 = Richa | first2 = Paul | authorlink2 = | last3 = Lacout | first3 = Carole | authorlink3 = | last4 = Gury | first4 = Aline | authorlink4 = | last5 = Beucher | first5 = Anne-Berengere | authorlink5 = | last6 = Homedan | first6 = Chadi | author-link6 = | last7 = Lavigne | first7 = Christian | last8 = Urbanski | first8 = Geoffrey | date = 2020-06-22 | title = Epidemiological and clinical factors associated with post-exertional malaise severity in patients with myalgic encephalomyelitis/chronic fatigue syndrome | url =https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7309998/|journal=Journal of Translational Medicine|volume=18|issue= | pages = |doi=10.1186/s12967-020-02419-4|issn=1479-5876|pmc=7309998|pmid=32571354|access-date=|quote=|via= | author-link8 = Geoffrey Urbanski}}</ref>
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