Anonymous
Not logged in
Talk
Contributions
Create account
Log in
Search
Editing
Postviral fatigue syndrome
(section)
From MEpedia, a crowd-sourced encyclopedia of ME and CFS science and history
Namespaces
Page
Discussion
More
More
Page actions
Read
Edit
Edit source
History
Warning:
You are not logged in. Your IP address will be publicly visible if you make any edits. If you
log in
or
create an account
, your edits will be attributed to your username, along with other benefits.
Anti-spam check. Do
not
fill this in!
==Post-EBV ME/CFS == Several studies have performed an extensive follow-up on adolescents with [[Mononucleosis|infectious mononucleosis]] resulting from the [[Epstein-Barr virus]] (EBV). In general these studies have found that approximately 10% of the sample meets the diagnosis of ME/CFS after 6 months, though the percentage decreases as time moves on. Research has not been able to identify significant predictors of ME/CFS diagnosis except for the severity of the acute [[Epstein-Barr virus]] (EBV) infection. === More fatigue after EBV compared to other infections === [[Peter White|White]] et al. showed the percentage of patients developing [[chronic fatigue syndrome]] to be significantly higher after an infection with EBV (9-47%) than after an upper respiratory tract infection (0-6%).<ref name=":0">{{Cite journal | last = White | first = P. D. | last2 = Thomas | first2 = J.M. | last3 = Amess | first3 = J. | last4 = Crawford | first4 = D.H. | last5 = Grover | first5 = S.A. | last6 = Kangro | first6 = H.O. | last7 = Clare | first7 = A.W. | date = Dec 1998 | title = Incidence, risk and prognosis of acute and chronic fatigue syndromes and psychiatric disorders after glandular fever |url =https://www.ncbi.nlm.nih.gov/pubmed/9926075|journal=The British Journal of Psychiatry: The Journal of Mental Science|volume=173 | pages = 475–481|issn=0007-1250|pmid=9926075|issue=|quote= | author-link = Peter White|via=}}</ref> Other research has shown that persistent fatigue is much more common after infectious mononucleosis than after other infectious diseases such as [[influenza]] or [[tonsillitis]].<ref>{{Cite journal | last = Petersen | first = I. | last2 = Thomas | first2 = J.M. | last3 = Hamilton | first3 = W.T. | last4 = White | first4 = P. D. | date = Jan 2006 | title = Risk and predictors of fatigue after infectious mononucleosis in a large primary-care cohort|url=https://www.ncbi.nlm.nih.gov/pubmed/16330509|journal=QJM: monthly journal of the Association of Physicians|volume=99|issue=1 | pages = 49–55|doi=10.1093/qjmed/hci149|issn=1460-2725|pmid=16330509|quote= | authorlink3 = | authorlink4 = Peter White | authorlink5 = |via=}}</ref> === Independent of psychological factors === The study by White et al. demonstrated that EBV does not cause an increase in psychiatric disorder<ref name=":0" /> and that psychosocial factors were not predictors of persistent complaints.<ref>{{Cite journal | last = White | first = P. D. | last2 = Thomas | first2 = J.M. | last3 = Kangro | first3 = H.O. | last4 = Bruce-Jones | first4 = W. D. | last5 = Amess | first5 = J. | last6 = Crawford | first6 = D.H. | last7 = Grover | first7 = S.A. | last8 = Clare | first8 = A.W. | date = 2001-12-08 | title = Predictions and associations of fatigue syndromes and mood disorders that occur after infectious mononucleosis|url=https://www.ncbi.nlm.nih.gov/pubmed/11747919|journal=Lancet (London, England)|volume=358|issue=9297|pages=1946–1954|doi=10.1016/S0140-6736(01)06961-6|issn=0140-6736|pmid=11747919|quote= | author-link = Peter White|via=}}</ref> This indicated that the postviral fatigue syndrome is a distinct disease category.<ref>{{Cite journal | last = White | first = P. D. | last2 = Grover | first2 = S.A. | last3 = Kangro | first3 = H.O. | last4 = Thomas | first4 = J.M. | last5 = Amess | first5 = J. | last6 = Clare | first6 = A.W. | date = Sep 1995 | title = The validity and reliability of the fatigue syndrome that follows glandular fever |url =https://www.ncbi.nlm.nih.gov/pubmed/8588010|journal=Psychological Medicine|volume=25|issue=5 | pages = 917–924|issn=0033-2917|pmid=8588010|quote= | author-link = Peter White|via=}}</ref> According to the authors, patients with the postviral fatigue syndrome reported more severe physical fatigue, especially after exertion, than patients with psychiatric disorders. A similiar conclusion was drawn by [[Dedra Buchwald|Buchwald]] et al., who followed up on 150 patients with infectious mononucleosis in the Seattle area. After six months, 12% of the patient sample said they still were not recovered. In agreement with White, the authors stated that they “do not believe that the postinfectious fatigue syndrome after infectious mononucleosis can be explained primarily by psychologic factors.”<ref>{{Cite journal | last = Buchwald | first= D. S. | last2 = Rea | first2 = T. D. | last3 = Katon | first3 = W.J. | last4 = Russo | first4 = J.E. | last5 = Ashley | first5 = R.L. | date=Nov 2000 | title = Acute infectious mononucleosis: characteristics of patients who report failure to recover |url =https://www.ncbi.nlm.nih.gov/pubmed/11063953|journal=The American Journal of Medicine|volume=109|issue=7 | pages = 531–537|issn=0002-9343|pmid=11063953|quote= | author-link = Dedra Buchwald|via=}}</ref> ===Only severity of the acute illness predicts ME/CFS === The most comprehensive study of postviral fatigue syndrome was organized and funded by the [[Centers for Disease Control and Prevention|CDC]] in the 2000s. The study focused on Dubbo a remote township in [[Australia]] where it is easier to follow up on medical records; 253 patients with either an acute infection with [[Epstein-Barr virus]] (EBV), [[coxiella burnetti]] (the bacteria that causes [[Q fever|Q-fever]]) or [[Ross River virus]] were studied.<ref name="Hickie2006">{{Cite journal | last = Hickie | first = Ian | authorlink = Ian Hickie | last2 = Davenport | first2 = Tracey | authorlink2 = Tracey Davenport | last3 = Wakefield | first3 = Denis | authorlink3 = Denis Wakefield | last4 = Vollmer-Conna | first4 = Ute | authorlink4 = Uté Vollmer-Conna | last5 = Cameron | first5 = Barbara | authorlink5 = Suzanne Vernon | last6 = Vernon | first6 = Suzanne D | authorlink6 = | last7 = Reeves | first7 = William C | authorlink7 = William Reeves | last8 = Lloyd | first8 = Andrew | authorlink8 = Andrew Lloyd| date = 2006-09-16 | title = Post-infective and chronic fatigue syndromes precipitated by viral and non-viral pathogens: prospective cohort study|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1569956/|journal=BMJ : British Medical Journal|volume=333|issue=7568 | pages = 575|doi=10.1136/bmj.38933.585764.AE|issn=0959-8138|pmc=1569956|pmid=16950834|access-date=|quote=|via=}}</ref> After six months, 11% of the patient sample met diagnostic criteria for chronic fatigue syndrome, with no significant differences in prevalence between the different infections. ME/CFS was predicted mostly by the severity of the acute infection, rather than by demographic, psychological or microbiological factors. There was no significant difference in [[cytokine]] expression<ref>{{Cite journal | last = Vollmer-Conna | first=Uté | last2 = Cameron | first2 = Barbara | last3 = Hadzi-Pavlovic | first3 = Dusan | last4 = Singletary | first4 = Kristi | last5 = Davenport | first5 = Tracey | last6 = Vernon | first6 = Suzanne | last7 = Reeves | first7 = William C. | last8 = Hickie | first8 = Ian | last9 = Wakefield | first9 = Denis| date = 2007-09-15 | title = Postinfective fatigue syndrome is not associated with altered cytokine production|url=https://www.ncbi.nlm.nih.gov/pubmed/17712757|journal=Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America|volume=45|issue=6 | pages = 732–735|doi=10.1086/520990|issn=1537-6591|pmid=17712757|quote= | author-link = Uté Vollmer-Conna | authorlink2 = Barbara Cameron | author-link3 = | authorlink4 = | authorlink5 = Tracey Davenport|via= | authorlink6 = Suzanne Vernon | authorlink7 = William Reeves | authorlink8 = Ian Hickie | authorlink9 = Denis Wakefield}}</ref> or reactivation of [[herpesviruses]] ([[Epstein-Barr virus|EBV]], [[Human herpesvirus 6|HHV-6]], [[Cytomegalovirus|CMV]])<ref>{{Cite journal | last = Cameron | first = Barbara | last2 = Flamand | first2 = Louis | last3 = Juwana | first3 = Hedy | last4 = Middeldorp | first4 = Jaap | last5 = Naing | first5 = Zin | last6 = Rawlinson | first6 = William | last7 = Ablashi | first7 = Dharam | last8 = Lloyd | first8 = Andrew| date = Oct 2010 | title = Serological and virological investigation of the role of the herpesviruses EBV, CMV and HHV-6 in post-infective fatigue syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/20827765|journal=Journal of Medical Virology|volume=82|issue=10|pages=1684–1688|doi=10.1002/jmv.21873|issn=1096-9071|pmid=20827765|quote=|via= | authorlink7 = Dharam Ablashi | authorlink8 = Andrew Lloyd}}</ref> between the group that did or did not recover. ===ME/CFS cases decrease over time=== A study in the Chicago area showed that the percentage of patients meeting ME/CFS criteria after infectious mononucleosis decreases as time moves on. While 13% met ME/CFS criteria at the six-month time interval, this decreased to 7% at 12 months and only 4% at 24 months.<ref>{{Cite journal | last = Katz | first = Ben Z. | last2 = Jason | first2 = Leonard A. | date = Feb 2013 | title = Chronic fatigue syndrome following infections in adolescents|url=https://www.ncbi.nlm.nih.gov/pubmed/23263024|journal=Current Opinion in Pediatrics|volume=25|issue=1 | pages = 95–102|doi=10.1097/MOP.0b013e32835c1108|issn=1531-698X|pmid=23263024|quote= | author-link = Ben Katz | authorlink2 = Leonard Jason|via=}}</ref> The most important predictors of ME/CFS caseness were [[Autonomic nervous system|autonomic]] symptoms and days spent in bed since mono.<ref>{{Cite journal | last= Jason | first = Leonard A. | last2 = Katz | first2 = Ben Z. | last3 = Shiraishi | first3 = Yukiko | last4 = Mears | first4 = Cynthia J. | last5 = Im | first5 = Young | last6 = Taylor | first6 = Renee R. | date = 2014-01-01 | title = Predictors of post-infectious chronic fatigue syndrome in adolescents|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3956649/|journal=Health Psychology and Behavioral Medicine|volume=2|issue=1 | pages = 41–51|doi=10.1080/21642850.2013.869176|issn=2164-2850|pmc=3956649|pmid=24660116|quote= | author-link = Leonard Jason | authorlink2 = Ben Katz|via= | authorlink6 = Renee Taylor}}</ref> This confirmed the main conclusion of the Dubbo studies, namely that the severity of the acute infection is the main predictor of ME/CFS. In the Chicago study however, cytokine expression indicated differences in [[Th17]] function in patients with post-infectious ME/CFS.<ref>{{Cite journal | last = Broderick | first = Gordon | last2 = Katz | first2 = Ben Z. | last3 = Fernandes | first3 = Henrique | last4 = Fletcher | first4 = Mary Ann | last5 = Klimas | first5 = Nancy | last6 = Smith | first6 = Frederick A. | last7 = O'Gorman | first7 = Maurice R.G. | last8 = Vernon | first8 = Suzanne D. | last9 = Taylor | first9 = Renee | date = 2012-09-13 | title = Cytokine expression profiles of immune imbalance in post-mononucleosis chronic fatigue|url=https://www.ncbi.nlm.nih.gov/pubmed/22973830|journal=Journal of Translational Medicine|volume=10|pages=191|doi=10.1186/1479-5876-10-191|issn=1479-5876|pmc=3480896|pmid=22973830|issue=|quote= | author-link = Gordon Broderick | authorlink2 = Ben Katz | authorlink3 = | authorlink4 = Mary Ann Fletcher | authorlink5 = Nancy Klimas|via= | authorlink8 = Suzanne Vernon | authorlink9 = Renee Taylor}}</ref> ===Psychosocial factors determine persistent fatigue but not ME/CFS === Studies that looked at a broader definition of fatigue after an [[Epstein-Barr virus|EBV]] infection have reached different conclusions. Candy et al. (2003) for example found that persistent fatigue six months after infectious mononucleosis was predicted by certain illness perceptions such as the belief that the illness would take more than one month to recover from and would have serious consequences.<ref>{{Cite journal | last = Candy | first = B. | last2 = Chalder | first2 = T. | last3 = Cleare | first3 = A.J. | last4 = Peakman | first4 = A. | last5 = Skowera | first5 = A. | last6 = Wessely | first6 = S. | last7 = Weinman | first7 = J. | last8 = Zuckerman | first8 = M. | last9 = Hotopf | first9 = M. | date = Jul 2003 | title = Predictors of fatigue following the onset of infectious mononucleosis|url=https://www.ncbi.nlm.nih.gov/pubmed/12877399|journal=Psychological Medicine|volume=33|issue=5 | pages = 847–855|issn=0033-2917|pmid=12877399 | author-link = | author-link2 = Trudie Chalder|via= | authorlink6 = Simon Wessely}}</ref> [[Rona Moss-Morris|Moss-Morris]] et al. followed-up on 246 patients with [[Mononucleosis|glandular fever]] from [[New Zealand]]. After six months, 7.8% still reported severe fatigue. [[Depression]], [[anxiety]] and [[perfectionism]] were associated with persistent complaints though perceived stress and limiting activity were not.<ref>{{Cite journal | last = Moss-Morris | first = R. | last2 = Spence | first2 = M.J. | last3 = Hou | first3 = R. | date = May 2011 | title = The pathway from glandular fever to chronic fatigue syndrome: can the cognitive behavioural model provide the map?|url=https://www.ncbi.nlm.nih.gov/pubmed/20663256|journal=Psychological Medicine|volume=41|issue=5|pages=1099–1107|doi=10.1017/S003329171000139X|issn=1469-8978|pmid=20663256|quote= | author-link = Rona Moss-Morris|via=}}</ref> A [[Norway|Norwegian]] study found that [[fatigue]] after acute EBV was predicted by variables related to symptoms and negative emotions instead of immune processes.<ref>{{Cite journal | last = Pedersen | first = Maria | authorlink = Maria Pedersen | last2 = Asprusten | first2 = Tarjei Tørre | last3 = Godang | first3 = Kristin | last4 = Leegaard | first4 = Truls Michael | last5 = Osnes | first5 = Liv Toril | last6 = Skovlund | first6 = Eva | last7 = Tjade | first7 = Trygve | last8 = Øie | first8 = Merete Glenne | last9 = Wyller | first9 = Vegard Bruun Bratholm| date = 2018-09-25 | title = Predictors of chronic fatigue in adolescents six months after acute Epstein-Barr virus infection: A prospective cohort study|url=https://www.ncbi.nlm.nih.gov/pubmed/30261303|journal=Brain, Behavior, and Immunity|doi=10.1016/j.bbi.2018.09.023|issn=1090-2139|pmid=30261303}}</ref> These findings would later be disrupted, and [[Personality traits and patient attitudes in ME/CFS|patient attitudes beliefs]] are no longer considered influence outcomes.<ref name="canadianconsensus-CCC">{{Citation | last1 = Carruthers | first1 = Bruce M. | authorlink1 = Bruce Carruthers | last2 = Jain | first2 = Anil Kumar | authorlink2 = Anil Kumar Jain | last3 = De Meirleir | first3 = Kenny L. | authorlink3 = Kenny De Meirleir | last4 = Peterson | first4 = Daniel L. | authorlink4 = Daniel Peterson | last5 = Klimas | first5 = Nancy G. | authorlink5 = Nancy Klimas | last6 = Lerner | first6 = A. Martin | authorlink6 = Martin Lerner | last7 = Bested | first7 = Alison C. | authorlink7 = Alison Bested | last8 = Flor-Henry | first8 = Pierre | authorlink8 = Pierre Flor-Henry | last9 = Joshi | first9 = Pradip | authorlink9 = Pradip Joshi | last10 = Powles | first10 = AC Peter | authorlink10 = A C Peter Powles | last11 = Sherkey | first11 = Jeffrey A. | authorlink11 = Jeffrey Sherkey | last12 = van de Sande | first12 = Marjorie I. | authorlink12 = Marjorie van de Sande | title = Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols | journal = Journal of Chronic Fatigue Syndrome | volume = 11 | issue = 2 | pages = 7-115 | date = 2003 | pmid = | doi = 10.1300/J092v11n01_02 | url = http://www.investinme.org/Documents/PDFdocuments/CanadianDefinitionME-CFS.pdf }}</ref><ref name="ICC2011primer">{{citation | last1 = Carruthers | first1 = BM | authorlink1 = Bruce Carruthers | last2 = van de Sande | first2 = MI | authorlink2 = Marjorie van de Sande | last3 = De Meirleir | first3 = KL | authorlink3 = Kenny de Meirleir | last4 = Klimas | first4 = NG | authorlink4 = Nancy Klimas | last5 = Broderick | first5 = G | authorlink5 = Gordon Broderick | last6 = Mitchell | first6 = T | authorlink6 = Terry Mitchell | last7 = Staines | first7 = D | authorlink7 = Donald Staines | last8 = Powles | first8 = ACP | authorlink8 = A C Peter Powles | last9 = Speight | first9 = N | authorlink9 = Nigel Speight | last10 = Vallings | first10 = R | authorlink10 = Rosamund Vallings | last11 = Bateman | first11 = L | authorlink11 = Lucinda Bateman | last12 = Bell | first12 = DS | authorlink12 = David Bell | last13 = Carlo-Stella | first13 = N | authorlink13 = Nicoletta Carlo-Stella | last14 = Chia | first14 = J | authorlink14 = John Chia | last15 = Darragh | first15 = A | authorlink15 = Austin Darragh | last16 = Gerken | first16 = A | authorlink16 = Anne Gerken | last17 = Jo | first17 = D | authorlink17 = Daehyun Jo | last18 = Lewis | first18 = DP | authorlink18 = Donald Lewis | last19 = Light | first19 = AR | authorlink19 = Alan Light | last20 = Light | first20 = KC | authorlink20 = Kathleen Light | last21 = Marshall-Gradisnik | first21 = S | authorlink21 = Sonya Marshall-Gradisnik | last22 = McLaren-Howard | first22 = J | authorlink22 = John McLaren-Howard | last23 = Mena | first23 = I | authorlink23 = Ismael Mena | last24 = Miwa | first24 = K | authorlink24 = Kunihisa Miwa | last25 = Murovska | first25 = M | authorlink25= Modra Murovska | last26 = Stevens | first26 = SR | authorlink26 = Staci Stevens | title = Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners | date = 2012 | isbn = 978-0-9739335-3-6 | url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf }}</ref> {{See also|Biopsychosocial model}}
Summary:
Please make sure your edits are consistent with
MEpedia's guidelines
.
By saving changes, you agree to the
Terms of use
, and you irrevocably agree to release your contribution under the
CC BY-SA 3.0 License
and the
GFDL
. You agree that a hyperlink or URL is sufficient attribution under the Creative Commons license.
Cancel
Editing help
(opens in new window)
Navigation
Navigation
Skip to content
Main page
Browse
Become an editor
Random page
Popular pages
Abbreviations
Glossary
About MEpedia
Links for editors
Contents
Guidelines
Recent changes
Pages in need
Search
Help
Wiki tools
Wiki tools
Special pages
Page tools
Page tools
User page tools
More
What links here
Related changes
Page information
Page logs