MEpedia - User contributions [en]

Vaccine

2024-09-14T03:14:50Z

Justin Reilly:/* Risk in developing Gulf War Illness */ formatting

[[File:Vaccine.png|300px|thumb|right|]]
A '''vaccine''' is a biological preparation that provides active acquired immunity to a particular disease. A vaccine typically contains an agent that resembles a disease-causing microorganism and is often made from weakened or killed forms of the microbe, its toxins, or one of its surface proteins. The agent stimulates the body's [[adaptive immune system|immune system]] to recognize the agent as a threat, destroy it, and to further recognize and destroy any of the microorganisms associated with that agent that it may encounter in the future. Vaccines can be prophylactic (example: to prevent or ameliorate the effects of a future infection by a natural or "wild" pathogen), or therapeutic (e.g., vaccines against [[cancer]] are being investigated).<ref name="Melief">{{cite journal |vauthors=Melief C, van Hall T, Arens R, Ossendorp F, van der Burg S | title = Therapeutic cancer vaccines |journal=J Clin Invest |volume=125 |issue=9 |pages=3401–12 | year = 2015 |pmid= |doi=10.1172/JCI80009 |url=https://www.jci.org/articles/view/80009 |archive-url=https://web.archive.org/web/20170629033940/http://jci.org/articles/view/80009 |archive-date=2017-06-29}}</ref><ref name="Bol2016">{{cite journal |vauthors=Bol K, etal | title = Prophylactic vaccines are potent activators of monocyte-derived dendritic cells and drive effective anti-tumor responses in melanoma patients at the cost of toxicity |journal=Cancer Immunology, Immunotherapy |volume=65 |issue=3 |pages=327–39 | year = 2016 |pmid= |doi=10.1007/s00262-016-1796-7 |url=https://link.springer.com/article/10.1007/s00262-016-1796-7}}</ref><ref name="Brotherton2015">{{cite journal |vauthors= | title = HPV prophylactic vaccines: lessons learned from 10 years experience |journal=Future Medicine |volume=10 |issue=8 | pages = 999–1009 | year = |pmid= |doi=10.2217/fvl.15.60 |url=http://www.futuremedicine.com/doi/abs/10.2217/fvl.15.60 | last =Brotherton | first=J. | last2 = | first2 = | date = 2015 | pmc=|quote=|access-date=|via=}}</ref><ref name="Frazier">{{cite journal |vauthors= | title = Development and Implementation of Papillomavirus Prophylactic Vaccines |journal=J. Immunol. |volume=192 |issue=9 |pages=4007–11 | year = |pmid= |doi=10.4049/jimmunol.1490012 |url=http://www.jimmunol.org/content/192/9/4007.short |archive-url=https://web.archive.org/web/20170811190134/http://www.jimmunol.org/content/192/9/4007.short |archive-date=2017-08-11 |df= | last = Frazer | first=I | last2 = | first2 = | date = 2014 | pmc=|quote=|access-date=|via=}}</ref>

==Risk in developing ME/CFS ==
According to the 2018 version of ''The Clinician’s Vaccine Safety Resource Guide Vaccines'': "Vaccines currently routinely recommended to the general population in the U.S. have not been shown to cause [[fibromyalgia]] or [[chronic fatigue syndrome]] (CFS)."<ref name="Dudley2018" />

A 2015 complete population study of data from 2009 to 2012 in [[Norway]], following the country's mass vaccination during the 2009 influenza A (H1N1) pandemic, found that vaccination produced no increased risk of ME/CFS. By contrast, infection with [[influenza|flu]] more than doubled the risk of developing ME/CFS.<ref name=":6">{{Cite journal | last =Magnus | first = Per | last2=Gunnes | first2 = Nina | last3 = Tveito | first3 = Kari | last4 = Bakken | first4=Inger Johanne | last5 = Ghaderi | first5 = Sara | last6 = Stoltenberg | first6 = Camilla | last7 = Hornig | first7 = Mady | last8 = Lipkin | first8 = W. Ian | last9 = Trogstad | first9 = Lill | date = 2015-11-17 | title = Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is associated with pandemic influenza infection, but not with an adjuvanted pandemic influenza vaccine|url=https://www.ncbi.nlm.nih.gov/pubmed/26475444|journal=Vaccine|volume=33|issue=46|pages=6173–6177|doi=10.1016/j.vaccine.2015.10.018|issn=1873-2518|pmid=26475444}}</ref>

A minority of people with [[ME/CFS]] have reported developing it after receiving a vaccination, but a causal relationship has not been shown.<ref name="ICP2011primer" />

In one case, a 43-year-old man with no previous ill health developed CFS after having five vaccinations, all containing aluminium adjuvants, within the same month.<ref name="Exley2009">{{Cite journal | last =Exley | first = Christopher | last2=Swarbrick | first2 = Louise | last3 = Gherardi | first3 = Rhomain K. | last4 = Authier | first4=Francois-Jérôme | date = 2009-02-01 | title = A role for the body burden of aluminium in vaccine-associated macrophagic myofasciitis and chronic fatigue syndrome|url=https://www.sciencedirect.com/science/article/pii/S0306987708004933|journal=Medical Hypotheses|language=en|volume=72|issue=2|pages=135–139|doi=10.1016/j.mehy.2008.09.040|issn=0306-9877}}</ref> Based on this case, Exley et al. (2009) anticipated that the mass human papillomavirus (HPV) vaccination program then recently begun in the UK would carry related risks, as that vaccine also used an aluminium-based adjuvant. That was not borne out: a number of different studies concluded there is no evidence Cervarix,<ref name="Donegan2013">{{Cite journal | first = Katherine | last =Donegan | first2 =Raphaelle | last2 = Beau-Lejdstrom | first3 = Bridget | last3 = King | first4 = Suzie | last4 = Seabroke | first5 = Andrew | last5 = Thomson | first6 = Philip | last6 = Bryan | date = 2013-10-09 | title = Bivalent human papillomavirus vaccine and the risk of fatigue syndromes in girls in the UK|url=https://www.sciencedirect.com/science/article/pii/S0264410X13011158|journal=Vaccine|language=en|volume=31|issue=43|pages=4961–4967|doi=10.1016/j.vaccine.2013.08.024|issn=0264-410X}}</ref> or the later Gardasil<ref name="Liu2016">{{Cite journal | last =Liu | first = Xianfang C. | last2 = Bell | first2 = Christopher A. | last3 = Simmonds | first3=Kimberley A. | last4 = Svenson | first4 = Lawrence W. | last5 = Russell | first5 = Margaret L. | date = 2016-04-04 | title = Adverse events following HPV vaccination, Alberta 2006-2014|url=https://pubmed.ncbi.nlm.nih.gov/26921782/|journal=Vaccine|volume=34|issue=15|pages=1800–1805|doi=10.1016/j.vaccine.2016.02.040|issn=1873-2518|pmid=26921782}}</ref><ref name="PHA-Canada2018">{{Cite web|url=https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2012-38/canada-communicable-disease-report.html | title = NACI Statement: HPV vaccine update | last =Public Health Agency of Canada | first = | authorlink = | date = 2012-01-18 | website = canada.ca|archive-url=|archive-date=|url-status=|access-date=2021-09-30}}</ref><ref name="Feiring2018">{{Cite journal | last = Feiring | first = Berit | last2 = Laake | first2 = Ida | last3 = Bakken | first3=Inger Johanne | last4 = Greve-Isdahl | first4 = Margrethe | last5 = Wyller | first5 = Vegard Bruun | authorlink5 = Vegard Bruun Wyller | last6 = Håberg | first6 = Siri E. | last7 = Magnus | first7 = Per | last8 = Trogstad | first8 = Lill | date = 2017-07-24 | title = HPV vaccination and risk of chronic fatigue syndrome/myalgic encephalomyelitis: A nationwide register-based study from Norway|url=https://www.sciencedirect.com/science/article/pii/S0264410X17308083|journal=Vaccine|language=en|volume=35|issue=33|pages=4203–4212|doi=10.1016/j.vaccine.2017.06.031|issn=0264-410X}}</ref><ref name="Galan2014">{{Cite journal | last =Rodríguez-Galán | first = M. A. | last2 = Pérez-Vilar | first2 = S. | last3 = Díez-Domingo | first3 = J. | last4 = Tuells | first4=J. | last5 = Gomar-Fayos | first5 = J. | last6 = Morales-Olivas | first6 = F. | last7 = Pastor-Villalba | first7 = E. | date = 2014-11-01 | title = Notificación de reacciones adversas a la vacuna frente al virus del papiloma humano en la Comunidad Valenciana (2007-2011)|url=https://www.sciencedirect.com/science/article/pii/S1695403313004980|journal=Anales de Pediatría|language=es|volume=81|issue=5|pages=303–309|doi=10.1016/j.anpedi.2013.11.031|issn=1695-4033}}</ref> and Gardasil 9,<ref name="Liu2016" /> HPV vaccines lead to developing [[chronic fatigue syndrome]].<ref name="NHS-HPV-safety">{{Cite web|url=https://www.nhs.uk/conditions/vaccinations/hpv-vaccine-cervarix-gardasil-safety/ | title = HPV vaccine safety | last = | first = | authorlink = | date = 2019-07-31 | website = National Health Service|language=en|archive-url=|archive-date=|url-status=|access-date=2021-09-30}}</ref><ref name="Arbyn2018">{{Cite journal | last = Arbyn | first = M. | last2 = Xu | first2 = L. | date = 2018-12-02 | title = Efficacy and safety of prophylactic HPV vaccines. A Cochrane review of randomized trials|url=https://doi.org/10.1080/14760584.2018.1548282|journal=Expert Review of Vaccines|volume=17|issue=12|pages=1085–1091|doi=10.1080/14760584.2018.1548282|issn=1476-0584|pmid=30495978}}</ref>

== Risk in developing Gulf War Illness ==
Vaccinations have been proposed as an etiological factor in [[Gulf War Illness]], especially the mass vaccinations given prior to military deployment.<ref name="Peakman, 2006" />

Vaccination in the presence of elevated [[cortisol]] levels can drive [[cytokine]] expression toward [[Th2]] dominance.<ref>{{Cite journal | last =Bernton | first=E. | last2 = Hoover | first2= D. | last3 = Galloway | first3 = R. | last4 = Popp | first4 = K. | date = 1995-12-29 | title = Adaptation to chronic stress in military trainees. Adrenal androgens, testosterone, glucocorticoids, IGF-1, and immune function|url=http://www.ncbi.nlm.nih.gov/pubmed/8597461|journal=Annals of the New York Academy of Sciences|volume=774|pages=217–231|issn=0077-8923|pmid=8597461}}</ref><ref>{{Cite journal | last =Ramírez | first = F. | last2 = Fowell | first2 = D.J. | last3 = Puklavec | first3 = M. | last4 = Simmonds | first4=S. | last5 = Mason | first5 = D. | date = 1996-04-01 | title = Glucocorticoids promote a TH2 cytokine response by CD4+ T cells in vitro|url=http://www.ncbi.nlm.nih.gov/pubmed/8786298|journal=Journal of Immunology (Baltimore, Md.: 1950)|volume=156|issue=7|pages=2406–2412|issn=0022-1767|pmid=8786298}}</ref> Th2 dominance is seen in ME/CFS. <ref>{{Cite journal | last =Skowera | first=A. | author-link = Anna Showera | last2 = Cleare | first2 = A. | authorlink2 = Anthony Cleare | last3 = Blair | first3= D. | authorlink3 = Dorothy Blair | last4 = Bevis | first4 = L. | authorlink4 = L Bevis | last5 = Wessely | first5 = S.C. | authorlink5 = Simon Wessely | last6 = Peakman | first6 = M. | authorlink6 = Mark Peakman | date = Feb 2004 | title = High levels of type 2 cytokine-producing cells in chronic fatigue syndrome|url=https://onlinelibrary.wiley.com/doi/10.1111/j.1365-2249.2004.02354.x|journal=[[Clinical and Experimental Immunology]]|language=en|volume=135|issue=2|pages=294–302|doi=10.1111/j.1365-2249.2004.02354.x|issn=0009-9104|pmc=1808936|pmid=14738459|quote=|via=}}</ref><ref>{{Cite journal | last =Patarca | first = Roberto | author-link =Roberto Patarca-Montero | date = 2001 | title=Cytokines and Chronic Fatigue Syndrome|url=https://nyaspubs.onlinelibrary.wiley.com/doi/abs/10.1111/j.1749-6632.2001.tb05824.x|journal=Annals of the New York Academy of Sciences|language=en|volume=933|issue=1|pages=185–200|doi=10.1111/j.1749-6632.2001.tb05824.x|issn=1749-6632|quote=|via=}}</ref>

== Vaccines in ME/CFS and Fibromyalgia patients==
Risk of contracting an infectious disease such as [[COVID-19]], flu or other [[virus]]es and bacterial diseases depends on exposure to the infection and the strength of the person's immune system. People with a weakened immune system are known as immunocompromised or immunosuppressed, for example people with AIDS, diabetes or malnutrition, or people taking immunosuppressant medications.<ref name="cancer-def">{{Cite web|url=https://www.cancer.gov/publications/dictionaries/cancer-terms/def/immunocompromised | title = Immunocompromised | last = | first = | authorlink = | date = 2011-02-02 | website = cancer.gov|language=en|access-date=2020-12-22}}</ref>

ME/CFS includes [[:Category:Immune signs and symptoms|immune symptoms]] including a [[sore throat]], [[swollen lymph nodes]], and [[flu-like symptoms]], but patients are generally '''''not''''' considered to be severely immunocompromised, and immunosuppressant medications are unlikely to be used by most ME/CFS patients, this means that ME/CFS patients are not significantly more likely to experience life-threatening complications from [[COVID-19]], viral or other infections―however some patients are already very severely ill due to [[severe and very severe ME#verysevere|very severe ME]].<ref name="Klimas20200313">{{Cite web|url=https://www.youtube.com/watch?v=pkGXiJ1jM14 | title = COVID-19 and ME/CFS - Dr Nancy Klimas, Mar 13, 2020 | last = Klimas | first = Nancy | date = 2020-03-13|work=|access-date=Mar 24, 2020|quote= | author-link = Nancy Klimas}}</ref><ref name="canadianconsensus">{{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="ICP2011primer">{{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 | author-link6 = 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> This means most ME/CFS patients would '''''not''''' be considered to be at very high risk of serious COVID-19 complications unless they had other known risk factors such as obesity, older age or other illnesses.<ref name="Klimas20200313" />

===ME/CFS patients, viruses and vaccines ===
Many vaccines exist for common viruses, and [[virus]]es are generally known to increase the severity of ME/CFS in a proportion of patients, either temporarily or permanently; there is a known risk of deterioration after a virus although it is unclear exactly how many ME/CFS patients experience this.<ref name="ICP2011primer" />

==Vaccine effectiveness in ME/CFS patients ==
A study in 2012 assessed immune system responses to the flu [[vaccine]] in people with ME/CFS, and took biological samples that showed the immune systems of ME/CFS patients responded similarly to those of healthy people. The study indicated a similar antibody response in ME/CFS patients after the vaccine, and it was likely to be as effective in protecting ME/CFS patients against flu.<ref name="Prinsen2012" /> The study did not include a long-term follow-up to assess duration of vaccine effectiveness or overall effect on ME/CFS symptoms.<ref name="Prinsen2012">{{Cite journal | last =Prinsen | first=Hetty | authorlink = | last2 = de Vries | first2=I. Jolanda M.|author-link2 = | last3 = Torensma | first3 = Ruurd | author-link3 = | last4 = Pots | first4=Jeanette M. | authorlink4 = | last5 = Mulder | first5 = Sasja F. | authorlink5 = | last6 = van Herpen | first6 = Carla M. L. | authorlink6 = | last7 = Elving | first7 = Lammy D. | last8 = Bleijenberg | first8 = Gijs | authorlink8 = Gijs Bleijenberg | last9 = Stelma | first9 = Foekje F. | date = 2012-12-17 | title = Humoral and cellular immune responses after influenza vaccination in patients with chronic fatigue syndrome|url=https://doi.org/10.1186/1471-2172-13-71|journal=BMC Immunology|volume=13|issue=1 | pages = 71|doi=10.1186/1471-2172-13-71|issn=1471-2172|pmc=3534525|pmid=23244635|access-date=|quote=|via=}}</ref>

==Immunocompromised people and vaccines ==
People who are severely immunocompromised either by a particular disease or treatment are advised to get additional vaccines due to their suppressed immune system being unlikely to fight off infections.<ref name="Avaz2014">{{Cite journal | last = Arvas | first = Ahmet | date = 2014-09-01 | title = Vaccination in patients with immunosuppression|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4462293/|journal=Turkish Archives of Pediatrics/Türk Pediatri Arşivi|volume=49|issue=3|pages=181–185|doi=10.5152/tpa.2014.2206|issn=1306-0015|pmc=4462293|pmid=26078660}}</ref> The CDC states that only live and bacterial vaccines should be avoided by immunocompromised people (vaccines containing a reduced amount of a live virus or other infection).<ref name="CDC-weakenedimmune" /><ref name="Avaz2014" /> While having ME/CFS does '''''not''''' make a person severely immunocompromised, some people with ME/CFS may have other known risk factors.<ref name="Klimas20200313" /> Immunocompromised people who receive a vaccine that is not live and not a bacterial vaccine will not be able to produce as many antibodies as a healthy person so the vaccine will not work as well, but the reduced protection should reduce the severity of the virus and improve survival rates.<ref name="CDC-weakenedimmune">{{Cite web|url=https://www.cdc.gov/vaccines/adults/rec-vac/health-conditions/weakened-immune.html | title = Vaccination of Adults with Weakened Immune System | last = | first = | authorlink = | date = 2020-11-12 | website = [[Centers for Disease Control and Prevention]]|language=en-us|access-date=2020-12-22}}</ref><ref name="Avaz2014" /> Immunocompromised people who choose to have a vaccine may be given a specific type of vaccine more suited to their needs, for example a flu vaccine injection instead of the flu nasal spray vaccine (because the flu nasal spray is a live vaccine).<ref name="CDC-disabilities">{{Cite web|url=https://www.cdc.gov/flu/highrisk/people-with-disabilities.htm | title = Children and Flu Antiviral Drugs | last =CDC | first = | authorlink = | date = 2020-11-17 | website = [[Centers for Disease Control and Prevention]]|language=en-us|access-date=2020-12-22}}</ref>

==Autoimmunity and ME/CFS ==
The unproven [[autoimmune hypothesis]] states that a subtype of ME involves autoimmunity, which is an overactive immune system rather than a weakened immune response.<ref name="OMF2018research">{{Cite web|url=https://www.omf.ngo/2018/02/28/omf-funded-research-t-cells-molecular-immunology/ | title = OMF-funded research: T cells and molecular immunology | last =Open Medicine Foundation | first= | authorlink = Open Medicine Foundation | date = Feb 28, 2018 | website = Open Medicine Foundation|language=en-US|access-date=2019-07-11}}</ref> Evidence for this theory is limited.
{{See also|Autoimmune hypothesis}}
{{See also|Influenza vaccine}}

==Types==

===Live vaccines ===
Live vaccines contain either weakened or killed pathogens which cannot cause disease. Different types include:
* Whole-pathogen vaccines, for example the Harvix Hepatitis A vaccine, these provide very good immunity for either a lifetime. or a very long period of time
* Subunit vaccines that just contain the antigens needed.<ref name="niaid-types" />
Live vaccines may not be suitable for some people, for example those who have received an organ transparent, or those with a weakened immune system, or people with long-term conditions.<ref name="hhs-types">{{Cite web|url=https://www.vaccines.gov/types | title = Vaccine Types | last =Health and Human Services | first = | authorlink = | date = |website=vaccines.gov|access-date=2020-11-01}}</ref>

===Inactivated vaccines===
These may contain all the pathogen, which has been killed or inactivated in a lab, for example by heat or another method, or just the antigens needed, for example the newer whooping cough (pertussis) which has a lower risk of fever or swelling at the injection site.<ref name="niaid-types" />
Protection is not as strong as with live vaccines, so several booster shots are usually needed.<ref name="hhs-types" />

===Toxoid vaccines ===
These contain chemically inactivated toxins, for example the diphtheria and tetanus vaccines that protect against those bacteria.<ref name="niaid-types" />

===Subunit, recombinant, polysaccharide and conjugate vaccines===
These vaccines do not contain the whole virus or pathogen, they may contain just particular pieces, e.g. a protein, sugar or part of the shell of the pathogen. This creates a very strong targetted immune response.<ref name="hhs-types" />

Recombinant vaccines have been around since the 1970s and use DNA technology to combine two or more sources, e.g., antigen in the hepatitis B vaccine is a hepatitis B virus protein produced by yeast cells into which the genetic code for the viral protein has been inserted into.
These may use virus-like particles (VLP) from the shell of a virus to cause immunity without the risk of infection.<ref name="niaid-types" />

Subunit, recombinant, polysaccharide and conjugate viruses are suitable for people with '''weakened immune systems''', chronic illness or other long-term health conditions as well as the general population. Examples include the current Hib (haemophilus influenzae type b) vaccines, [[HPV]] vaccines, and [[hepatitis B vaccine]].<ref name="hhs-types" />

Several booster shots may be needed.<ref name="hhs-types" />

===New types of vaccines===
The first COVID-19 vaccines to be approved in the [[United States]], [[UK]] and European Union are the Pfizer-BioNTech and Moderna messenger RNA (mRNA) COVID-19 vaccines, mRNA vaccines do not contain live or weakened [[COVID-19]], so these vaccines are suitable for severely immunocompromised people as well as people in the general population and cannot cause COVID-19.<ref name="CDC-">{{Cite web|url=https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/mrna.html | title = mRNA vaccines {{!}} COVID-19 and Your Health | last = | first = | authorlink = | date = 2020-02-11 | website = [[Centers for Disease Control and Prevention]]|language=en-us|access-date=2020-12-22}}</ref>

A number of other new types of vaccines are being developed. A vaccine to protect against multiple diseases caused by mosquitos is being developed to cause an immune response to mosquitos saliva rather than a particular virus or bacterium.<ref name="niaid-types" />

==Publications==
* 2018, Do Vaccines Cause Fibromyalgia or Chronic Fatigue Syndrome (CFS)? in ''The Clinician’s Vaccine Safety Resource Guide''<ref name="Dudley2018">{{Cite book | last =Dudley | first = Matthew Z. | last2 = Salmon | first2=Daniel A. | last3 = Halsey | first3 = Neal A. | last4 = Orenstein | first4=Walter A. | last5 = Limaye | first5 = Rupali J. | last6 = O'Leary | first6 = Sean T. | last7 = Omer | first7 = Saad B. | date = 2018 | title = Do Vaccines Cause Fibromyalgia or Chronic Fatigue Syndrome (CFS)?|url=https://link.springer.com/chapter/10.1007%2F978-3-319-94694-8_35|language=en|location=Cham|publisher=Springer International Publishing|pages=241–244|doi=10.1007/978-3-319-94694-8_35|isbn=9783319946931}}</ref>

== See also ==
* [[Influenza]]
* [[Influenza vaccine]]
* [[Coronavirus disease 19]]
* [[COVID-19 vaccines]]
* [[Staphylococcus vaccine]]

== Learn more ==
*[https://www.vaccines.gov/basics Vaccine Basics]<ref name="hhs-basics">{{Cite web|url=https://www.vaccines.gov/basics | title = Vaccine Basics | last =Health and Human Services | first = | authorlink = | date = |website=vaccines.gov|archive-url=|archive-date=|access-date=2020-11-01}}</ref> - Health and Human Services
* [https://www.niaid.nih.gov/research/vaccine-types Vaccine Types]<ref name="niaid-types">{{Cite web|url=http://www.niaid.nih.gov/research/vaccine-types | title = Vaccine Types | last =National Institute of Allergy and Infectious Diseases | first = | authorlink = National Institute of Allergy and Infectious Diseases | date = |website=niaid.nih.gov|language=en|access-date=2020-11-01}}</ref> - NIAID
*[https://www.who.int/news-room/q-a-detail/coronavirus-disease-(covid-19)-vaccines Coronavirus (COVID-19) vaccines]<ref name="COVID-vaccines-WHO">{{Cite web|url=https://www.who.int/news-room/q-a-detail/coronavirus-disease-(covid-19)-vaccines | title = Coronavirus disease (COVID-19): Vaccines | last =World Health Organization | first= | authorlink = World Health Organization | date = |website=[[World Health Organization]]|language=en|access-date=2020-11-01}}</ref> - World Health Organization - with a details of vaccines in development
*[https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/mrna.html mRNA vaccines] - CDC
* [https://www.cdc.gov/vaccines/adults/rec-vac/health-conditions/weakened-immune.html Vaccination of Adults with weakened immune systems] - CDC
* [https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/vac-storage.pdf Vaccine Storage and Handling]<ref>{{Cite web|url=https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/vac-storage.pdf | title = Vaccine Storage and Handling | last =Centers for Disease Control | first = | date = |website=cdc.gov|publisher=[[Centers for Disease Control and Prevention]]|access-date= | authorlink = Centers for Disease Control and Prevention}}</ref> - CDC
*[https://www.cdc.gov/coronavirus/2019-ncov/hcp/vaccination.html 10 Things to Know about US COVID-19 Vaccine Plans]<ref name="CDC-covid-vaccineplans">{{Cite web|url=https://www.cdc.gov/coronavirus/2019-ncov/hcp/vaccination.html | title = Coronavirus Disease 2019 (COVID-19) | last =CDC | first = | authorlink = Centers for Disease Control and Prevention | date = 2020-02-11 | website = [[Centers for Disease Control and Prevention]]|language=en-us|access-date=2020-11-01}}</ref>
* [https://blausen.com/en/video/vaccines/ Vaccines]<ref>{{Cite web|url=https://blausen.com/en/video/vaccines/ | title = Vaccines|website=blausen.com|access-date=2018-08-25}}</ref> Video short - Blausen.com

==References==
<references>
<ref name="Peakman, 2006">{{Citation | last1 = Peakman | first1 = Mark | authorlink1 = | last2 = Skowera | first2 = Ania | authorlink2 = | last3 = Hotopf | first3 = Matthew | authorlink3 = | title = Immunological dysfunction, vaccination and Gulf War illness | journal = Immunological dysfunction, vaccination and Gulf War illness. Philosophical Transactions of the Royal Society B: Biological Sciences | volume = 361 | issue = 1468 | page = 681–687 | date = 2006
| doi = 10.1098/rstb.2006.1826 }}</ref>
</references>
[[Category:Immunology]]
[[Category:Immunostimulants]]
[[Category:Triggers and risk factors]]

Vaccine

2024-09-14T03:11:01Z

Justin Reilly:/* Risk in developing Gulf War Illness */ clarify that Th2 dominance seen in ME

[[File:Vaccine.png|300px|thumb|right|]]
A '''vaccine''' is a biological preparation that provides active acquired immunity to a particular disease. A vaccine typically contains an agent that resembles a disease-causing microorganism and is often made from weakened or killed forms of the microbe, its toxins, or one of its surface proteins. The agent stimulates the body's [[adaptive immune system|immune system]] to recognize the agent as a threat, destroy it, and to further recognize and destroy any of the microorganisms associated with that agent that it may encounter in the future. Vaccines can be prophylactic (example: to prevent or ameliorate the effects of a future infection by a natural or "wild" pathogen), or therapeutic (e.g., vaccines against [[cancer]] are being investigated).<ref name="Melief">{{cite journal |vauthors=Melief C, van Hall T, Arens R, Ossendorp F, van der Burg S | title = Therapeutic cancer vaccines |journal=J Clin Invest |volume=125 |issue=9 |pages=3401–12 | year = 2015 |pmid= |doi=10.1172/JCI80009 |url=https://www.jci.org/articles/view/80009 |archive-url=https://web.archive.org/web/20170629033940/http://jci.org/articles/view/80009 |archive-date=2017-06-29}}</ref><ref name="Bol2016">{{cite journal |vauthors=Bol K, etal | title = Prophylactic vaccines are potent activators of monocyte-derived dendritic cells and drive effective anti-tumor responses in melanoma patients at the cost of toxicity |journal=Cancer Immunology, Immunotherapy |volume=65 |issue=3 |pages=327–39 | year = 2016 |pmid= |doi=10.1007/s00262-016-1796-7 |url=https://link.springer.com/article/10.1007/s00262-016-1796-7}}</ref><ref name="Brotherton2015">{{cite journal |vauthors= | title = HPV prophylactic vaccines: lessons learned from 10 years experience |journal=Future Medicine |volume=10 |issue=8 | pages = 999–1009 | year = |pmid= |doi=10.2217/fvl.15.60 |url=http://www.futuremedicine.com/doi/abs/10.2217/fvl.15.60 | last =Brotherton | first=J. | last2 = | first2 = | date = 2015 | pmc=|quote=|access-date=|via=}}</ref><ref name="Frazier">{{cite journal |vauthors= | title = Development and Implementation of Papillomavirus Prophylactic Vaccines |journal=J. Immunol. |volume=192 |issue=9 |pages=4007–11 | year = |pmid= |doi=10.4049/jimmunol.1490012 |url=http://www.jimmunol.org/content/192/9/4007.short |archive-url=https://web.archive.org/web/20170811190134/http://www.jimmunol.org/content/192/9/4007.short |archive-date=2017-08-11 |df= | last = Frazer | first=I | last2 = | first2 = | date = 2014 | pmc=|quote=|access-date=|via=}}</ref>

==Risk in developing ME/CFS ==
According to the 2018 version of ''The Clinician’s Vaccine Safety Resource Guide Vaccines'': "Vaccines currently routinely recommended to the general population in the U.S. have not been shown to cause [[fibromyalgia]] or [[chronic fatigue syndrome]] (CFS)."<ref name="Dudley2018" />

A 2015 complete population study of data from 2009 to 2012 in [[Norway]], following the country's mass vaccination during the 2009 influenza A (H1N1) pandemic, found that vaccination produced no increased risk of ME/CFS. By contrast, infection with [[influenza|flu]] more than doubled the risk of developing ME/CFS.<ref name=":6">{{Cite journal | last =Magnus | first = Per | last2=Gunnes | first2 = Nina | last3 = Tveito | first3 = Kari | last4 = Bakken | first4=Inger Johanne | last5 = Ghaderi | first5 = Sara | last6 = Stoltenberg | first6 = Camilla | last7 = Hornig | first7 = Mady | last8 = Lipkin | first8 = W. Ian | last9 = Trogstad | first9 = Lill | date = 2015-11-17 | title = Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is associated with pandemic influenza infection, but not with an adjuvanted pandemic influenza vaccine|url=https://www.ncbi.nlm.nih.gov/pubmed/26475444|journal=Vaccine|volume=33|issue=46|pages=6173–6177|doi=10.1016/j.vaccine.2015.10.018|issn=1873-2518|pmid=26475444}}</ref>

A minority of people with [[ME/CFS]] have reported developing it after receiving a vaccination, but a causal relationship has not been shown.<ref name="ICP2011primer" />

In one case, a 43-year-old man with no previous ill health developed CFS after having five vaccinations, all containing aluminium adjuvants, within the same month.<ref name="Exley2009">{{Cite journal | last =Exley | first = Christopher | last2=Swarbrick | first2 = Louise | last3 = Gherardi | first3 = Rhomain K. | last4 = Authier | first4=Francois-Jérôme | date = 2009-02-01 | title = A role for the body burden of aluminium in vaccine-associated macrophagic myofasciitis and chronic fatigue syndrome|url=https://www.sciencedirect.com/science/article/pii/S0306987708004933|journal=Medical Hypotheses|language=en|volume=72|issue=2|pages=135–139|doi=10.1016/j.mehy.2008.09.040|issn=0306-9877}}</ref> Based on this case, Exley et al. (2009) anticipated that the mass human papillomavirus (HPV) vaccination program then recently begun in the UK would carry related risks, as that vaccine also used an aluminium-based adjuvant. That was not borne out: a number of different studies concluded there is no evidence Cervarix,<ref name="Donegan2013">{{Cite journal | first = Katherine | last =Donegan | first2 =Raphaelle | last2 = Beau-Lejdstrom | first3 = Bridget | last3 = King | first4 = Suzie | last4 = Seabroke | first5 = Andrew | last5 = Thomson | first6 = Philip | last6 = Bryan | date = 2013-10-09 | title = Bivalent human papillomavirus vaccine and the risk of fatigue syndromes in girls in the UK|url=https://www.sciencedirect.com/science/article/pii/S0264410X13011158|journal=Vaccine|language=en|volume=31|issue=43|pages=4961–4967|doi=10.1016/j.vaccine.2013.08.024|issn=0264-410X}}</ref> or the later Gardasil<ref name="Liu2016">{{Cite journal | last =Liu | first = Xianfang C. | last2 = Bell | first2 = Christopher A. | last3 = Simmonds | first3=Kimberley A. | last4 = Svenson | first4 = Lawrence W. | last5 = Russell | first5 = Margaret L. | date = 2016-04-04 | title = Adverse events following HPV vaccination, Alberta 2006-2014|url=https://pubmed.ncbi.nlm.nih.gov/26921782/|journal=Vaccine|volume=34|issue=15|pages=1800–1805|doi=10.1016/j.vaccine.2016.02.040|issn=1873-2518|pmid=26921782}}</ref><ref name="PHA-Canada2018">{{Cite web|url=https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2012-38/canada-communicable-disease-report.html | title = NACI Statement: HPV vaccine update | last =Public Health Agency of Canada | first = | authorlink = | date = 2012-01-18 | website = canada.ca|archive-url=|archive-date=|url-status=|access-date=2021-09-30}}</ref><ref name="Feiring2018">{{Cite journal | last = Feiring | first = Berit | last2 = Laake | first2 = Ida | last3 = Bakken | first3=Inger Johanne | last4 = Greve-Isdahl | first4 = Margrethe | last5 = Wyller | first5 = Vegard Bruun | authorlink5 = Vegard Bruun Wyller | last6 = Håberg | first6 = Siri E. | last7 = Magnus | first7 = Per | last8 = Trogstad | first8 = Lill | date = 2017-07-24 | title = HPV vaccination and risk of chronic fatigue syndrome/myalgic encephalomyelitis: A nationwide register-based study from Norway|url=https://www.sciencedirect.com/science/article/pii/S0264410X17308083|journal=Vaccine|language=en|volume=35|issue=33|pages=4203–4212|doi=10.1016/j.vaccine.2017.06.031|issn=0264-410X}}</ref><ref name="Galan2014">{{Cite journal | last =Rodríguez-Galán | first = M. A. | last2 = Pérez-Vilar | first2 = S. | last3 = Díez-Domingo | first3 = J. | last4 = Tuells | first4=J. | last5 = Gomar-Fayos | first5 = J. | last6 = Morales-Olivas | first6 = F. | last7 = Pastor-Villalba | first7 = E. | date = 2014-11-01 | title = Notificación de reacciones adversas a la vacuna frente al virus del papiloma humano en la Comunidad Valenciana (2007-2011)|url=https://www.sciencedirect.com/science/article/pii/S1695403313004980|journal=Anales de Pediatría|language=es|volume=81|issue=5|pages=303–309|doi=10.1016/j.anpedi.2013.11.031|issn=1695-4033}}</ref> and Gardasil 9,<ref name="Liu2016" /> HPV vaccines lead to developing [[chronic fatigue syndrome]].<ref name="NHS-HPV-safety">{{Cite web|url=https://www.nhs.uk/conditions/vaccinations/hpv-vaccine-cervarix-gardasil-safety/ | title = HPV vaccine safety | last = | first = | authorlink = | date = 2019-07-31 | website = National Health Service|language=en|archive-url=|archive-date=|url-status=|access-date=2021-09-30}}</ref><ref name="Arbyn2018">{{Cite journal | last = Arbyn | first = M. | last2 = Xu | first2 = L. | date = 2018-12-02 | title = Efficacy and safety of prophylactic HPV vaccines. A Cochrane review of randomized trials|url=https://doi.org/10.1080/14760584.2018.1548282|journal=Expert Review of Vaccines|volume=17|issue=12|pages=1085–1091|doi=10.1080/14760584.2018.1548282|issn=1476-0584|pmid=30495978}}</ref>

== Risk in developing Gulf War Illness ==
Vaccinations have been proposed as an etiological factor in [[Gulf War Illness]], especially the mass vaccinations given prior to military deployment.<ref name="Peakman, 2006" />

Vaccination in the presence of elevated [[cortisol]] levels can drive [[cytokine]] expression toward [[Th2]] dominance.<ref>{{Cite journal | last =Bernton | first=E. | last2 = Hoover | first2= D. | last3 = Galloway | first3 = R. | last4 = Popp | first4 = K. | date = 1995-12-29 | title = Adaptation to chronic stress in military trainees. Adrenal androgens, testosterone, glucocorticoids, IGF-1, and immune function|url=http://www.ncbi.nlm.nih.gov/pubmed/8597461|journal=Annals of the New York Academy of Sciences|volume=774|pages=217–231|issn=0077-8923|pmid=8597461}}</ref><ref>{{Cite journal | last =Ramírez | first = F. | last2 = Fowell | first2 = D.J. | last3 = Puklavec | first3 = M. | last4 = Simmonds | first4=S. | last5 = Mason | first5 = D. | date = 1996-04-01 | title = Glucocorticoids promote a TH2 cytokine response by CD4+ T cells in vitro|url=http://www.ncbi.nlm.nih.gov/pubmed/8786298|journal=Journal of Immunology (Baltimore, Md.: 1950)|volume=156|issue=7|pages=2406–2412|issn=0022-1767|pmid=8786298}}</ref> Th2 dominance is seen in ME/CFS. {{Cite journal | last =Skowera | first=A. | author-link = Anna Showera | last2 = Cleare | first2 = A. | authorlink2 = Anthony Cleare | last3 = Blair | first3= D. | authorlink3 = Dorothy Blair | last4 = Bevis | first4 = L. | authorlink4 = L Bevis | last5 = Wessely | first5 = S.C. | authorlink5 = Simon Wessely | last6 = Peakman | first6 = M. | authorlink6 = Mark Peakman | date = Feb 2004 | title = High levels of type 2 cytokine-producing cells in chronic fatigue syndrome|url=https://onlinelibrary.wiley.com/doi/10.1111/j.1365-2249.2004.02354.x|journal=[[Clinical and Experimental Immunology]]|language=en|volume=135|issue=2|pages=294–302|doi=10.1111/j.1365-2249.2004.02354.x|issn=0009-9104|pmc=1808936|pmid=14738459|quote=|via=}}</ref><ref>{{Cite journal | last =Patarca | first = Roberto | author-link =Roberto Patarca-Montero | date = 2001 | title=Cytokines and Chronic Fatigue Syndrome|url=https://nyaspubs.onlinelibrary.wiley.com/doi/abs/10.1111/j.1749-6632.2001.tb05824.x|journal=Annals of the New York Academy of Sciences|language=en|volume=933|issue=1|pages=185–200|doi=10.1111/j.1749-6632.2001.tb05824.x|issn=1749-6632|quote=|via=}}</ref>

== Vaccines in ME/CFS and Fibromyalgia patients==
Risk of contracting an infectious disease such as [[COVID-19]], flu or other [[virus]]es and bacterial diseases depends on exposure to the infection and the strength of the person's immune system. People with a weakened immune system are known as immunocompromised or immunosuppressed, for example people with AIDS, diabetes or malnutrition, or people taking immunosuppressant medications.<ref name="cancer-def">{{Cite web|url=https://www.cancer.gov/publications/dictionaries/cancer-terms/def/immunocompromised | title = Immunocompromised | last = | first = | authorlink = | date = 2011-02-02 | website = cancer.gov|language=en|access-date=2020-12-22}}</ref>

ME/CFS includes [[:Category:Immune signs and symptoms|immune symptoms]] including a [[sore throat]], [[swollen lymph nodes]], and [[flu-like symptoms]], but patients are generally '''''not''''' considered to be severely immunocompromised, and immunosuppressant medications are unlikely to be used by most ME/CFS patients, this means that ME/CFS patients are not significantly more likely to experience life-threatening complications from [[COVID-19]], viral or other infections―however some patients are already very severely ill due to [[severe and very severe ME#verysevere|very severe ME]].<ref name="Klimas20200313">{{Cite web|url=https://www.youtube.com/watch?v=pkGXiJ1jM14 | title = COVID-19 and ME/CFS - Dr Nancy Klimas, Mar 13, 2020 | last = Klimas | first = Nancy | date = 2020-03-13|work=|access-date=Mar 24, 2020|quote= | author-link = Nancy Klimas}}</ref><ref name="canadianconsensus">{{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="ICP2011primer">{{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 | author-link6 = 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> This means most ME/CFS patients would '''''not''''' be considered to be at very high risk of serious COVID-19 complications unless they had other known risk factors such as obesity, older age or other illnesses.<ref name="Klimas20200313" />

===ME/CFS patients, viruses and vaccines ===
Many vaccines exist for common viruses, and [[virus]]es are generally known to increase the severity of ME/CFS in a proportion of patients, either temporarily or permanently; there is a known risk of deterioration after a virus although it is unclear exactly how many ME/CFS patients experience this.<ref name="ICP2011primer" />

==Vaccine effectiveness in ME/CFS patients ==
A study in 2012 assessed immune system responses to the flu [[vaccine]] in people with ME/CFS, and took biological samples that showed the immune systems of ME/CFS patients responded similarly to those of healthy people. The study indicated a similar antibody response in ME/CFS patients after the vaccine, and it was likely to be as effective in protecting ME/CFS patients against flu.<ref name="Prinsen2012" /> The study did not include a long-term follow-up to assess duration of vaccine effectiveness or overall effect on ME/CFS symptoms.<ref name="Prinsen2012">{{Cite journal | last =Prinsen | first=Hetty | authorlink = | last2 = de Vries | first2=I. Jolanda M.|author-link2 = | last3 = Torensma | first3 = Ruurd | author-link3 = | last4 = Pots | first4=Jeanette M. | authorlink4 = | last5 = Mulder | first5 = Sasja F. | authorlink5 = | last6 = van Herpen | first6 = Carla M. L. | authorlink6 = | last7 = Elving | first7 = Lammy D. | last8 = Bleijenberg | first8 = Gijs | authorlink8 = Gijs Bleijenberg | last9 = Stelma | first9 = Foekje F. | date = 2012-12-17 | title = Humoral and cellular immune responses after influenza vaccination in patients with chronic fatigue syndrome|url=https://doi.org/10.1186/1471-2172-13-71|journal=BMC Immunology|volume=13|issue=1 | pages = 71|doi=10.1186/1471-2172-13-71|issn=1471-2172|pmc=3534525|pmid=23244635|access-date=|quote=|via=}}</ref>

==Immunocompromised people and vaccines ==
People who are severely immunocompromised either by a particular disease or treatment are advised to get additional vaccines due to their suppressed immune system being unlikely to fight off infections.<ref name="Avaz2014">{{Cite journal | last = Arvas | first = Ahmet | date = 2014-09-01 | title = Vaccination in patients with immunosuppression|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4462293/|journal=Turkish Archives of Pediatrics/Türk Pediatri Arşivi|volume=49|issue=3|pages=181–185|doi=10.5152/tpa.2014.2206|issn=1306-0015|pmc=4462293|pmid=26078660}}</ref> The CDC states that only live and bacterial vaccines should be avoided by immunocompromised people (vaccines containing a reduced amount of a live virus or other infection).<ref name="CDC-weakenedimmune" /><ref name="Avaz2014" /> While having ME/CFS does '''''not''''' make a person severely immunocompromised, some people with ME/CFS may have other known risk factors.<ref name="Klimas20200313" /> Immunocompromised people who receive a vaccine that is not live and not a bacterial vaccine will not be able to produce as many antibodies as a healthy person so the vaccine will not work as well, but the reduced protection should reduce the severity of the virus and improve survival rates.<ref name="CDC-weakenedimmune">{{Cite web|url=https://www.cdc.gov/vaccines/adults/rec-vac/health-conditions/weakened-immune.html | title = Vaccination of Adults with Weakened Immune System | last = | first = | authorlink = | date = 2020-11-12 | website = [[Centers for Disease Control and Prevention]]|language=en-us|access-date=2020-12-22}}</ref><ref name="Avaz2014" /> Immunocompromised people who choose to have a vaccine may be given a specific type of vaccine more suited to their needs, for example a flu vaccine injection instead of the flu nasal spray vaccine (because the flu nasal spray is a live vaccine).<ref name="CDC-disabilities">{{Cite web|url=https://www.cdc.gov/flu/highrisk/people-with-disabilities.htm | title = Children and Flu Antiviral Drugs | last =CDC | first = | authorlink = | date = 2020-11-17 | website = [[Centers for Disease Control and Prevention]]|language=en-us|access-date=2020-12-22}}</ref>

==Autoimmunity and ME/CFS ==
The unproven [[autoimmune hypothesis]] states that a subtype of ME involves autoimmunity, which is an overactive immune system rather than a weakened immune response.<ref name="OMF2018research">{{Cite web|url=https://www.omf.ngo/2018/02/28/omf-funded-research-t-cells-molecular-immunology/ | title = OMF-funded research: T cells and molecular immunology | last =Open Medicine Foundation | first= | authorlink = Open Medicine Foundation | date = Feb 28, 2018 | website = Open Medicine Foundation|language=en-US|access-date=2019-07-11}}</ref> Evidence for this theory is limited.
{{See also|Autoimmune hypothesis}}
{{See also|Influenza vaccine}}

==Types==

===Live vaccines ===
Live vaccines contain either weakened or killed pathogens which cannot cause disease. Different types include:
* Whole-pathogen vaccines, for example the Harvix Hepatitis A vaccine, these provide very good immunity for either a lifetime. or a very long period of time
* Subunit vaccines that just contain the antigens needed.<ref name="niaid-types" />
Live vaccines may not be suitable for some people, for example those who have received an organ transparent, or those with a weakened immune system, or people with long-term conditions.<ref name="hhs-types">{{Cite web|url=https://www.vaccines.gov/types | title = Vaccine Types | last =Health and Human Services | first = | authorlink = | date = |website=vaccines.gov|access-date=2020-11-01}}</ref>

===Inactivated vaccines===
These may contain all the pathogen, which has been killed or inactivated in a lab, for example by heat or another method, or just the antigens needed, for example the newer whooping cough (pertussis) which has a lower risk of fever or swelling at the injection site.<ref name="niaid-types" />
Protection is not as strong as with live vaccines, so several booster shots are usually needed.<ref name="hhs-types" />

===Toxoid vaccines ===
These contain chemically inactivated toxins, for example the diphtheria and tetanus vaccines that protect against those bacteria.<ref name="niaid-types" />

===Subunit, recombinant, polysaccharide and conjugate vaccines===
These vaccines do not contain the whole virus or pathogen, they may contain just particular pieces, e.g. a protein, sugar or part of the shell of the pathogen. This creates a very strong targetted immune response.<ref name="hhs-types" />

Recombinant vaccines have been around since the 1970s and use DNA technology to combine two or more sources, e.g., antigen in the hepatitis B vaccine is a hepatitis B virus protein produced by yeast cells into which the genetic code for the viral protein has been inserted into.
These may use virus-like particles (VLP) from the shell of a virus to cause immunity without the risk of infection.<ref name="niaid-types" />

Subunit, recombinant, polysaccharide and conjugate viruses are suitable for people with '''weakened immune systems''', chronic illness or other long-term health conditions as well as the general population. Examples include the current Hib (haemophilus influenzae type b) vaccines, [[HPV]] vaccines, and [[hepatitis B vaccine]].<ref name="hhs-types" />

Several booster shots may be needed.<ref name="hhs-types" />

===New types of vaccines===
The first COVID-19 vaccines to be approved in the [[United States]], [[UK]] and European Union are the Pfizer-BioNTech and Moderna messenger RNA (mRNA) COVID-19 vaccines, mRNA vaccines do not contain live or weakened [[COVID-19]], so these vaccines are suitable for severely immunocompromised people as well as people in the general population and cannot cause COVID-19.<ref name="CDC-">{{Cite web|url=https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/mrna.html | title = mRNA vaccines {{!}} COVID-19 and Your Health | last = | first = | authorlink = | date = 2020-02-11 | website = [[Centers for Disease Control and Prevention]]|language=en-us|access-date=2020-12-22}}</ref>

A number of other new types of vaccines are being developed. A vaccine to protect against multiple diseases caused by mosquitos is being developed to cause an immune response to mosquitos saliva rather than a particular virus or bacterium.<ref name="niaid-types" />

==Publications==
* 2018, Do Vaccines Cause Fibromyalgia or Chronic Fatigue Syndrome (CFS)? in ''The Clinician’s Vaccine Safety Resource Guide''<ref name="Dudley2018">{{Cite book | last =Dudley | first = Matthew Z. | last2 = Salmon | first2=Daniel A. | last3 = Halsey | first3 = Neal A. | last4 = Orenstein | first4=Walter A. | last5 = Limaye | first5 = Rupali J. | last6 = O'Leary | first6 = Sean T. | last7 = Omer | first7 = Saad B. | date = 2018 | title = Do Vaccines Cause Fibromyalgia or Chronic Fatigue Syndrome (CFS)?|url=https://link.springer.com/chapter/10.1007%2F978-3-319-94694-8_35|language=en|location=Cham|publisher=Springer International Publishing|pages=241–244|doi=10.1007/978-3-319-94694-8_35|isbn=9783319946931}}</ref>

== See also ==
* [[Influenza]]
* [[Influenza vaccine]]
* [[Coronavirus disease 19]]
* [[COVID-19 vaccines]]
* [[Staphylococcus vaccine]]

== Learn more ==
*[https://www.vaccines.gov/basics Vaccine Basics]<ref name="hhs-basics">{{Cite web|url=https://www.vaccines.gov/basics | title = Vaccine Basics | last =Health and Human Services | first = | authorlink = | date = |website=vaccines.gov|archive-url=|archive-date=|access-date=2020-11-01}}</ref> - Health and Human Services
* [https://www.niaid.nih.gov/research/vaccine-types Vaccine Types]<ref name="niaid-types">{{Cite web|url=http://www.niaid.nih.gov/research/vaccine-types | title = Vaccine Types | last =National Institute of Allergy and Infectious Diseases | first = | authorlink = National Institute of Allergy and Infectious Diseases | date = |website=niaid.nih.gov|language=en|access-date=2020-11-01}}</ref> - NIAID
*[https://www.who.int/news-room/q-a-detail/coronavirus-disease-(covid-19)-vaccines Coronavirus (COVID-19) vaccines]<ref name="COVID-vaccines-WHO">{{Cite web|url=https://www.who.int/news-room/q-a-detail/coronavirus-disease-(covid-19)-vaccines | title = Coronavirus disease (COVID-19): Vaccines | last =World Health Organization | first= | authorlink = World Health Organization | date = |website=[[World Health Organization]]|language=en|access-date=2020-11-01}}</ref> - World Health Organization - with a details of vaccines in development
*[https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/mrna.html mRNA vaccines] - CDC
* [https://www.cdc.gov/vaccines/adults/rec-vac/health-conditions/weakened-immune.html Vaccination of Adults with weakened immune systems] - CDC
* [https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/vac-storage.pdf Vaccine Storage and Handling]<ref>{{Cite web|url=https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/vac-storage.pdf | title = Vaccine Storage and Handling | last =Centers for Disease Control | first = | date = |website=cdc.gov|publisher=[[Centers for Disease Control and Prevention]]|access-date= | authorlink = Centers for Disease Control and Prevention}}</ref> - CDC
*[https://www.cdc.gov/coronavirus/2019-ncov/hcp/vaccination.html 10 Things to Know about US COVID-19 Vaccine Plans]<ref name="CDC-covid-vaccineplans">{{Cite web|url=https://www.cdc.gov/coronavirus/2019-ncov/hcp/vaccination.html | title = Coronavirus Disease 2019 (COVID-19) | last =CDC | first = | authorlink = Centers for Disease Control and Prevention | date = 2020-02-11 | website = [[Centers for Disease Control and Prevention]]|language=en-us|access-date=2020-11-01}}</ref>
* [https://blausen.com/en/video/vaccines/ Vaccines]<ref>{{Cite web|url=https://blausen.com/en/video/vaccines/ | title = Vaccines|website=blausen.com|access-date=2018-08-25}}</ref> Video short - Blausen.com

==References==
<references>
<ref name="Peakman, 2006">{{Citation | last1 = Peakman | first1 = Mark | authorlink1 = | last2 = Skowera | first2 = Ania | authorlink2 = | last3 = Hotopf | first3 = Matthew | authorlink3 = | title = Immunological dysfunction, vaccination and Gulf War illness | journal = Immunological dysfunction, vaccination and Gulf War illness. Philosophical Transactions of the Royal Society B: Biological Sciences | volume = 361 | issue = 1468 | page = 681–687 | date = 2006
| doi = 10.1098/rstb.2006.1826 }}</ref>
</references>
[[Category:Immunology]]
[[Category:Immunostimulants]]
[[Category:Triggers and risk factors]]

Vaccine

2024-09-14T02:30:48Z

Justin Reilly:/* Risk in developing ME/CFS */

[[File:Vaccine.png|300px|thumb|right|]]
A '''vaccine''' is a biological preparation that provides active acquired immunity to a particular disease. A vaccine typically contains an agent that resembles a disease-causing microorganism and is often made from weakened or killed forms of the microbe, its toxins, or one of its surface proteins. The agent stimulates the body's [[adaptive immune system|immune system]] to recognize the agent as a threat, destroy it, and to further recognize and destroy any of the microorganisms associated with that agent that it may encounter in the future. Vaccines can be prophylactic (example: to prevent or ameliorate the effects of a future infection by a natural or "wild" pathogen), or therapeutic (e.g., vaccines against [[cancer]] are being investigated).<ref name="Melief">{{cite journal |vauthors=Melief C, van Hall T, Arens R, Ossendorp F, van der Burg S | title = Therapeutic cancer vaccines |journal=J Clin Invest |volume=125 |issue=9 |pages=3401–12 | year = 2015 |pmid= |doi=10.1172/JCI80009 |url=https://www.jci.org/articles/view/80009 |archive-url=https://web.archive.org/web/20170629033940/http://jci.org/articles/view/80009 |archive-date=2017-06-29}}</ref><ref name="Bol2016">{{cite journal |vauthors=Bol K, etal | title = Prophylactic vaccines are potent activators of monocyte-derived dendritic cells and drive effective anti-tumor responses in melanoma patients at the cost of toxicity |journal=Cancer Immunology, Immunotherapy |volume=65 |issue=3 |pages=327–39 | year = 2016 |pmid= |doi=10.1007/s00262-016-1796-7 |url=https://link.springer.com/article/10.1007/s00262-016-1796-7}}</ref><ref name="Brotherton2015">{{cite journal |vauthors= | title = HPV prophylactic vaccines: lessons learned from 10 years experience |journal=Future Medicine |volume=10 |issue=8 | pages = 999–1009 | year = |pmid= |doi=10.2217/fvl.15.60 |url=http://www.futuremedicine.com/doi/abs/10.2217/fvl.15.60 | last =Brotherton | first=J. | last2 = | first2 = | date = 2015 | pmc=|quote=|access-date=|via=}}</ref><ref name="Frazier">{{cite journal |vauthors= | title = Development and Implementation of Papillomavirus Prophylactic Vaccines |journal=J. Immunol. |volume=192 |issue=9 |pages=4007–11 | year = |pmid= |doi=10.4049/jimmunol.1490012 |url=http://www.jimmunol.org/content/192/9/4007.short |archive-url=https://web.archive.org/web/20170811190134/http://www.jimmunol.org/content/192/9/4007.short |archive-date=2017-08-11 |df= | last = Frazer | first=I | last2 = | first2 = | date = 2014 | pmc=|quote=|access-date=|via=}}</ref>

==Risk in developing ME/CFS ==
According to the 2018 version of ''The Clinician’s Vaccine Safety Resource Guide Vaccines'': "Vaccines currently routinely recommended to the general population in the U.S. have not been shown to cause [[fibromyalgia]] or [[chronic fatigue syndrome]] (CFS)."<ref name="Dudley2018" />

A 2015 complete population study of data from 2009 to 2012 in [[Norway]], following the country's mass vaccination during the 2009 influenza A (H1N1) pandemic, found that vaccination produced no increased risk of ME/CFS. By contrast, infection with [[influenza|flu]] more than doubled the risk of developing ME/CFS.<ref name=":6">{{Cite journal | last =Magnus | first = Per | last2=Gunnes | first2 = Nina | last3 = Tveito | first3 = Kari | last4 = Bakken | first4=Inger Johanne | last5 = Ghaderi | first5 = Sara | last6 = Stoltenberg | first6 = Camilla | last7 = Hornig | first7 = Mady | last8 = Lipkin | first8 = W. Ian | last9 = Trogstad | first9 = Lill | date = 2015-11-17 | title = Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is associated with pandemic influenza infection, but not with an adjuvanted pandemic influenza vaccine|url=https://www.ncbi.nlm.nih.gov/pubmed/26475444|journal=Vaccine|volume=33|issue=46|pages=6173–6177|doi=10.1016/j.vaccine.2015.10.018|issn=1873-2518|pmid=26475444}}</ref>

A minority of people with [[ME/CFS]] have reported developing it after receiving a vaccination, but a causal relationship has not been shown.<ref name="ICP2011primer" />

In one case, a 43-year-old man with no previous ill health developed CFS after having five vaccinations, all containing aluminium adjuvants, within the same month.<ref name="Exley2009">{{Cite journal | last =Exley | first = Christopher | last2=Swarbrick | first2 = Louise | last3 = Gherardi | first3 = Rhomain K. | last4 = Authier | first4=Francois-Jérôme | date = 2009-02-01 | title = A role for the body burden of aluminium in vaccine-associated macrophagic myofasciitis and chronic fatigue syndrome|url=https://www.sciencedirect.com/science/article/pii/S0306987708004933|journal=Medical Hypotheses|language=en|volume=72|issue=2|pages=135–139|doi=10.1016/j.mehy.2008.09.040|issn=0306-9877}}</ref> Based on this case, Exley et al. (2009) anticipated that the mass human papillomavirus (HPV) vaccination program then recently begun in the UK would carry related risks, as that vaccine also used an aluminium-based adjuvant. That was not borne out: a number of different studies concluded there is no evidence Cervarix,<ref name="Donegan2013">{{Cite journal | first = Katherine | last =Donegan | first2 =Raphaelle | last2 = Beau-Lejdstrom | first3 = Bridget | last3 = King | first4 = Suzie | last4 = Seabroke | first5 = Andrew | last5 = Thomson | first6 = Philip | last6 = Bryan | date = 2013-10-09 | title = Bivalent human papillomavirus vaccine and the risk of fatigue syndromes in girls in the UK|url=https://www.sciencedirect.com/science/article/pii/S0264410X13011158|journal=Vaccine|language=en|volume=31|issue=43|pages=4961–4967|doi=10.1016/j.vaccine.2013.08.024|issn=0264-410X}}</ref> or the later Gardasil<ref name="Liu2016">{{Cite journal | last =Liu | first = Xianfang C. | last2 = Bell | first2 = Christopher A. | last3 = Simmonds | first3=Kimberley A. | last4 = Svenson | first4 = Lawrence W. | last5 = Russell | first5 = Margaret L. | date = 2016-04-04 | title = Adverse events following HPV vaccination, Alberta 2006-2014|url=https://pubmed.ncbi.nlm.nih.gov/26921782/|journal=Vaccine|volume=34|issue=15|pages=1800–1805|doi=10.1016/j.vaccine.2016.02.040|issn=1873-2518|pmid=26921782}}</ref><ref name="PHA-Canada2018">{{Cite web|url=https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2012-38/canada-communicable-disease-report.html | title = NACI Statement: HPV vaccine update | last =Public Health Agency of Canada | first = | authorlink = | date = 2012-01-18 | website = canada.ca|archive-url=|archive-date=|url-status=|access-date=2021-09-30}}</ref><ref name="Feiring2018">{{Cite journal | last = Feiring | first = Berit | last2 = Laake | first2 = Ida | last3 = Bakken | first3=Inger Johanne | last4 = Greve-Isdahl | first4 = Margrethe | last5 = Wyller | first5 = Vegard Bruun | authorlink5 = Vegard Bruun Wyller | last6 = Håberg | first6 = Siri E. | last7 = Magnus | first7 = Per | last8 = Trogstad | first8 = Lill | date = 2017-07-24 | title = HPV vaccination and risk of chronic fatigue syndrome/myalgic encephalomyelitis: A nationwide register-based study from Norway|url=https://www.sciencedirect.com/science/article/pii/S0264410X17308083|journal=Vaccine|language=en|volume=35|issue=33|pages=4203–4212|doi=10.1016/j.vaccine.2017.06.031|issn=0264-410X}}</ref><ref name="Galan2014">{{Cite journal | last =Rodríguez-Galán | first = M. A. | last2 = Pérez-Vilar | first2 = S. | last3 = Díez-Domingo | first3 = J. | last4 = Tuells | first4=J. | last5 = Gomar-Fayos | first5 = J. | last6 = Morales-Olivas | first6 = F. | last7 = Pastor-Villalba | first7 = E. | date = 2014-11-01 | title = Notificación de reacciones adversas a la vacuna frente al virus del papiloma humano en la Comunidad Valenciana (2007-2011)|url=https://www.sciencedirect.com/science/article/pii/S1695403313004980|journal=Anales de Pediatría|language=es|volume=81|issue=5|pages=303–309|doi=10.1016/j.anpedi.2013.11.031|issn=1695-4033}}</ref> and Gardasil 9,<ref name="Liu2016" /> HPV vaccines lead to developing [[chronic fatigue syndrome]].<ref name="NHS-HPV-safety">{{Cite web|url=https://www.nhs.uk/conditions/vaccinations/hpv-vaccine-cervarix-gardasil-safety/ | title = HPV vaccine safety | last = | first = | authorlink = | date = 2019-07-31 | website = National Health Service|language=en|archive-url=|archive-date=|url-status=|access-date=2021-09-30}}</ref><ref name="Arbyn2018">{{Cite journal | last = Arbyn | first = M. | last2 = Xu | first2 = L. | date = 2018-12-02 | title = Efficacy and safety of prophylactic HPV vaccines. A Cochrane review of randomized trials|url=https://doi.org/10.1080/14760584.2018.1548282|journal=Expert Review of Vaccines|volume=17|issue=12|pages=1085–1091|doi=10.1080/14760584.2018.1548282|issn=1476-0584|pmid=30495978}}</ref>

== Risk in developing Gulf War Illness ==
Vaccinations have been proposed as an etiological factor in [[Gulf War Illness]], especially the mass vaccinations given prior to military deployment.<ref name="Peakman, 2006" />

Vaccination in the presence of elevated [[cortisol]] levels can drive [[cytokine]] expression toward [[Th2]] dominance.<ref>{{Cite journal | last =Bernton | first=E. | last2 = Hoover | first2= D. | last3 = Galloway | first3 = R. | last4 = Popp | first4 = K. | date = 1995-12-29 | title = Adaptation to chronic stress in military trainees. Adrenal androgens, testosterone, glucocorticoids, IGF-1, and immune function|url=http://www.ncbi.nlm.nih.gov/pubmed/8597461|journal=Annals of the New York Academy of Sciences|volume=774|pages=217–231|issn=0077-8923|pmid=8597461}}</ref><ref>{{Cite journal | last =Ramírez | first = F. | last2 = Fowell | first2 = D.J. | last3 = Puklavec | first3 = M. | last4 = Simmonds | first4=S. | last5 = Mason | first5 = D. | date = 1996-04-01 | title = Glucocorticoids promote a TH2 cytokine response by CD4+ T cells in vitro|url=http://www.ncbi.nlm.nih.gov/pubmed/8786298|journal=Journal of Immunology (Baltimore, Md.: 1950)|volume=156|issue=7|pages=2406–2412|issn=0022-1767|pmid=8786298}}</ref>

== Vaccines in ME/CFS and Fibromyalgia patients==
Risk of contracting an infectious disease such as [[COVID-19]], flu or other [[virus]]es and bacterial diseases depends on exposure to the infection and the strength of the person's immune system. People with a weakened immune system are known as immunocompromised or immunosuppressed, for example people with AIDS, diabetes or malnutrition, or people taking immunosuppressant medications.<ref name="cancer-def">{{Cite web|url=https://www.cancer.gov/publications/dictionaries/cancer-terms/def/immunocompromised | title = Immunocompromised | last = | first = | authorlink = | date = 2011-02-02 | website = cancer.gov|language=en|access-date=2020-12-22}}</ref>

ME/CFS includes [[:Category:Immune signs and symptoms|immune symptoms]] including a [[sore throat]], [[swollen lymph nodes]], and [[flu-like symptoms]], but patients are generally '''''not''''' considered to be severely immunocompromised, and immunosuppressant medications are unlikely to be used by most ME/CFS patients, this means that ME/CFS patients are not significantly more likely to experience life-threatening complications from [[COVID-19]], viral or other infections―however some patients are already very severely ill due to [[severe and very severe ME#verysevere|very severe ME]].<ref name="Klimas20200313">{{Cite web|url=https://www.youtube.com/watch?v=pkGXiJ1jM14 | title = COVID-19 and ME/CFS - Dr Nancy Klimas, Mar 13, 2020 | last = Klimas | first = Nancy | date = 2020-03-13|work=|access-date=Mar 24, 2020|quote= | author-link = Nancy Klimas}}</ref><ref name="canadianconsensus">{{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="ICP2011primer">{{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 | author-link6 = 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> This means most ME/CFS patients would '''''not''''' be considered to be at very high risk of serious COVID-19 complications unless they had other known risk factors such as obesity, older age or other illnesses.<ref name="Klimas20200313" />

===ME/CFS patients, viruses and vaccines ===
Many vaccines exist for common viruses, and [[virus]]es are generally known to increase the severity of ME/CFS in a proportion of patients, either temporarily or permanently; there is a known risk of deterioration after a virus although it is unclear exactly how many ME/CFS patients experience this.<ref name="ICP2011primer" />

==Vaccine effectiveness in ME/CFS patients ==
A study in 2012 assessed immune system responses to the flu [[vaccine]] in people with ME/CFS, and took biological samples that showed the immune systems of ME/CFS patients responded similarly to those of healthy people. The study indicated a similar antibody response in ME/CFS patients after the vaccine, and it was likely to be as effective in protecting ME/CFS patients against flu.<ref name="Prinsen2012" /> The study did not include a long-term follow-up to assess duration of vaccine effectiveness or overall effect on ME/CFS symptoms.<ref name="Prinsen2012">{{Cite journal | last =Prinsen | first=Hetty | authorlink = | last2 = de Vries | first2=I. Jolanda M.|author-link2 = | last3 = Torensma | first3 = Ruurd | author-link3 = | last4 = Pots | first4=Jeanette M. | authorlink4 = | last5 = Mulder | first5 = Sasja F. | authorlink5 = | last6 = van Herpen | first6 = Carla M. L. | authorlink6 = | last7 = Elving | first7 = Lammy D. | last8 = Bleijenberg | first8 = Gijs | authorlink8 = Gijs Bleijenberg | last9 = Stelma | first9 = Foekje F. | date = 2012-12-17 | title = Humoral and cellular immune responses after influenza vaccination in patients with chronic fatigue syndrome|url=https://doi.org/10.1186/1471-2172-13-71|journal=BMC Immunology|volume=13|issue=1 | pages = 71|doi=10.1186/1471-2172-13-71|issn=1471-2172|pmc=3534525|pmid=23244635|access-date=|quote=|via=}}</ref>

==Immunocompromised people and vaccines ==
People who are severely immunocompromised either by a particular disease or treatment are advised to get additional vaccines due to their suppressed immune system being unlikely to fight off infections.<ref name="Avaz2014">{{Cite journal | last = Arvas | first = Ahmet | date = 2014-09-01 | title = Vaccination in patients with immunosuppression|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4462293/|journal=Turkish Archives of Pediatrics/Türk Pediatri Arşivi|volume=49|issue=3|pages=181–185|doi=10.5152/tpa.2014.2206|issn=1306-0015|pmc=4462293|pmid=26078660}}</ref> The CDC states that only live and bacterial vaccines should be avoided by immunocompromised people (vaccines containing a reduced amount of a live virus or other infection).<ref name="CDC-weakenedimmune" /><ref name="Avaz2014" /> While having ME/CFS does '''''not''''' make a person severely immunocompromised, some people with ME/CFS may have other known risk factors.<ref name="Klimas20200313" /> Immunocompromised people who receive a vaccine that is not live and not a bacterial vaccine will not be able to produce as many antibodies as a healthy person so the vaccine will not work as well, but the reduced protection should reduce the severity of the virus and improve survival rates.<ref name="CDC-weakenedimmune">{{Cite web|url=https://www.cdc.gov/vaccines/adults/rec-vac/health-conditions/weakened-immune.html | title = Vaccination of Adults with Weakened Immune System | last = | first = | authorlink = | date = 2020-11-12 | website = [[Centers for Disease Control and Prevention]]|language=en-us|access-date=2020-12-22}}</ref><ref name="Avaz2014" /> Immunocompromised people who choose to have a vaccine may be given a specific type of vaccine more suited to their needs, for example a flu vaccine injection instead of the flu nasal spray vaccine (because the flu nasal spray is a live vaccine).<ref name="CDC-disabilities">{{Cite web|url=https://www.cdc.gov/flu/highrisk/people-with-disabilities.htm | title = Children and Flu Antiviral Drugs | last =CDC | first = | authorlink = | date = 2020-11-17 | website = [[Centers for Disease Control and Prevention]]|language=en-us|access-date=2020-12-22}}</ref>

==Autoimmunity and ME/CFS ==
The unproven [[autoimmune hypothesis]] states that a subtype of ME involves autoimmunity, which is an overactive immune system rather than a weakened immune response.<ref name="OMF2018research">{{Cite web|url=https://www.omf.ngo/2018/02/28/omf-funded-research-t-cells-molecular-immunology/ | title = OMF-funded research: T cells and molecular immunology | last =Open Medicine Foundation | first= | authorlink = Open Medicine Foundation | date = Feb 28, 2018 | website = Open Medicine Foundation|language=en-US|access-date=2019-07-11}}</ref> Evidence for this theory is limited.
{{See also|Autoimmune hypothesis}}
{{See also|Influenza vaccine}}

==Types==

===Live vaccines ===
Live vaccines contain either weakened or killed pathogens which cannot cause disease. Different types include:
* Whole-pathogen vaccines, for example the Harvix Hepatitis A vaccine, these provide very good immunity for either a lifetime. or a very long period of time
* Subunit vaccines that just contain the antigens needed.<ref name="niaid-types" />
Live vaccines may not be suitable for some people, for example those who have received an organ transparent, or those with a weakened immune system, or people with long-term conditions.<ref name="hhs-types">{{Cite web|url=https://www.vaccines.gov/types | title = Vaccine Types | last =Health and Human Services | first = | authorlink = | date = |website=vaccines.gov|access-date=2020-11-01}}</ref>

===Inactivated vaccines===
These may contain all the pathogen, which has been killed or inactivated in a lab, for example by heat or another method, or just the antigens needed, for example the newer whooping cough (pertussis) which has a lower risk of fever or swelling at the injection site.<ref name="niaid-types" />
Protection is not as strong as with live vaccines, so several booster shots are usually needed.<ref name="hhs-types" />

===Toxoid vaccines ===
These contain chemically inactivated toxins, for example the diphtheria and tetanus vaccines that protect against those bacteria.<ref name="niaid-types" />

===Subunit, recombinant, polysaccharide and conjugate vaccines===
These vaccines do not contain the whole virus or pathogen, they may contain just particular pieces, e.g. a protein, sugar or part of the shell of the pathogen. This creates a very strong targetted immune response.<ref name="hhs-types" />

Recombinant vaccines have been around since the 1970s and use DNA technology to combine two or more sources, e.g., antigen in the hepatitis B vaccine is a hepatitis B virus protein produced by yeast cells into which the genetic code for the viral protein has been inserted into.
These may use virus-like particles (VLP) from the shell of a virus to cause immunity without the risk of infection.<ref name="niaid-types" />

Subunit, recombinant, polysaccharide and conjugate viruses are suitable for people with '''weakened immune systems''', chronic illness or other long-term health conditions as well as the general population. Examples include the current Hib (haemophilus influenzae type b) vaccines, [[HPV]] vaccines, and [[hepatitis B vaccine]].<ref name="hhs-types" />

Several booster shots may be needed.<ref name="hhs-types" />

===New types of vaccines===
The first COVID-19 vaccines to be approved in the [[United States]], [[UK]] and European Union are the Pfizer-BioNTech and Moderna messenger RNA (mRNA) COVID-19 vaccines, mRNA vaccines do not contain live or weakened [[COVID-19]], so these vaccines are suitable for severely immunocompromised people as well as people in the general population and cannot cause COVID-19.<ref name="CDC-">{{Cite web|url=https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/mrna.html | title = mRNA vaccines {{!}} COVID-19 and Your Health | last = | first = | authorlink = | date = 2020-02-11 | website = [[Centers for Disease Control and Prevention]]|language=en-us|access-date=2020-12-22}}</ref>

A number of other new types of vaccines are being developed. A vaccine to protect against multiple diseases caused by mosquitos is being developed to cause an immune response to mosquitos saliva rather than a particular virus or bacterium.<ref name="niaid-types" />

==Publications==
* 2018, Do Vaccines Cause Fibromyalgia or Chronic Fatigue Syndrome (CFS)? in ''The Clinician’s Vaccine Safety Resource Guide''<ref name="Dudley2018">{{Cite book | last =Dudley | first = Matthew Z. | last2 = Salmon | first2=Daniel A. | last3 = Halsey | first3 = Neal A. | last4 = Orenstein | first4=Walter A. | last5 = Limaye | first5 = Rupali J. | last6 = O'Leary | first6 = Sean T. | last7 = Omer | first7 = Saad B. | date = 2018 | title = Do Vaccines Cause Fibromyalgia or Chronic Fatigue Syndrome (CFS)?|url=https://link.springer.com/chapter/10.1007%2F978-3-319-94694-8_35|language=en|location=Cham|publisher=Springer International Publishing|pages=241–244|doi=10.1007/978-3-319-94694-8_35|isbn=9783319946931}}</ref>

== See also ==
* [[Influenza]]
* [[Influenza vaccine]]
* [[Coronavirus disease 19]]
* [[COVID-19 vaccines]]
* [[Staphylococcus vaccine]]

== Learn more ==
*[https://www.vaccines.gov/basics Vaccine Basics]<ref name="hhs-basics">{{Cite web|url=https://www.vaccines.gov/basics | title = Vaccine Basics | last =Health and Human Services | first = | authorlink = | date = |website=vaccines.gov|archive-url=|archive-date=|access-date=2020-11-01}}</ref> - Health and Human Services
* [https://www.niaid.nih.gov/research/vaccine-types Vaccine Types]<ref name="niaid-types">{{Cite web|url=http://www.niaid.nih.gov/research/vaccine-types | title = Vaccine Types | last =National Institute of Allergy and Infectious Diseases | first = | authorlink = National Institute of Allergy and Infectious Diseases | date = |website=niaid.nih.gov|language=en|access-date=2020-11-01}}</ref> - NIAID
*[https://www.who.int/news-room/q-a-detail/coronavirus-disease-(covid-19)-vaccines Coronavirus (COVID-19) vaccines]<ref name="COVID-vaccines-WHO">{{Cite web|url=https://www.who.int/news-room/q-a-detail/coronavirus-disease-(covid-19)-vaccines | title = Coronavirus disease (COVID-19): Vaccines | last =World Health Organization | first= | authorlink = World Health Organization | date = |website=[[World Health Organization]]|language=en|access-date=2020-11-01}}</ref> - World Health Organization - with a details of vaccines in development
*[https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/mrna.html mRNA vaccines] - CDC
* [https://www.cdc.gov/vaccines/adults/rec-vac/health-conditions/weakened-immune.html Vaccination of Adults with weakened immune systems] - CDC
* [https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/vac-storage.pdf Vaccine Storage and Handling]<ref>{{Cite web|url=https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/vac-storage.pdf | title = Vaccine Storage and Handling | last =Centers for Disease Control | first = | date = |website=cdc.gov|publisher=[[Centers for Disease Control and Prevention]]|access-date= | authorlink = Centers for Disease Control and Prevention}}</ref> - CDC
*[https://www.cdc.gov/coronavirus/2019-ncov/hcp/vaccination.html 10 Things to Know about US COVID-19 Vaccine Plans]<ref name="CDC-covid-vaccineplans">{{Cite web|url=https://www.cdc.gov/coronavirus/2019-ncov/hcp/vaccination.html | title = Coronavirus Disease 2019 (COVID-19) | last =CDC | first = | authorlink = Centers for Disease Control and Prevention | date = 2020-02-11 | website = [[Centers for Disease Control and Prevention]]|language=en-us|access-date=2020-11-01}}</ref>
* [https://blausen.com/en/video/vaccines/ Vaccines]<ref>{{Cite web|url=https://blausen.com/en/video/vaccines/ | title = Vaccines|website=blausen.com|access-date=2018-08-25}}</ref> Video short - Blausen.com

==References==
<references>
<ref name="Peakman, 2006">{{Citation | last1 = Peakman | first1 = Mark | authorlink1 = | last2 = Skowera | first2 = Ania | authorlink2 = | last3 = Hotopf | first3 = Matthew | authorlink3 = | title = Immunological dysfunction, vaccination and Gulf War illness | journal = Immunological dysfunction, vaccination and Gulf War illness. Philosophical Transactions of the Royal Society B: Biological Sciences | volume = 361 | issue = 1468 | page = 681–687 | date = 2006
| doi = 10.1098/rstb.2006.1826 }}</ref>
</references>
[[Category:Immunology]]
[[Category:Immunostimulants]]
[[Category:Triggers and risk factors]]

Names of myalgic encephalomyelitis and chronic fatigue syndrome

2023-05-02T08:50:00Z

Justin Reilly:add jump cite

The name [[myalgic encephalomyelitis]] (ME) was coined by Dr. [[Melvin Ramsay]] following the [[1955 Royal Free Hospital outbreak]]<ref>{{Cite journal | last = | first = | date = 1957-10-19 | title = An Outbreak of Encephalomyelitis in the Royal Free Hospital Group, London, in 1955|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1962472/|journal=British Medical Journal|volume=2|issue=5050 | pages = 895–904|issn=0007-1447|pmc=|pmid=13472002|via=}}</ref> and is a portmanteau of several of the key signs and symptoms of the disease: myalgic ([[muscle pain]]), encephalo ([[brain]]), myel ([[spinal cord]]), itis ([[inflammation]]).<ref>{{Cite web|url=http://www.investinme.org/Article%20010-Encephalopathy%20Hooper.shtml | title = Invest in ME Research - The Terminology of ME & CFS | last = Hooper | first = Malcolm | date = Feb 2005 | website = [[Invest in ME Research]]|archive-url=|archive-date=|url-status=|access-date=2018-08-13}}</ref>

Several other names have been used or proposed throughout the history of the disease, including [[atypical polio]], [[1948-49 Akureyri outbreak|Icelandic disease]], benign myalgic encephalomyelitis, [[epidemic neuromyasthenia]], [[chronic fatigue syndrome]] (CFS), and [[systemic exertion intolerance disease]] (SEID). This has lead to much confusion as a variety of names have been used at different times to describe discrete [[List of outbreaks|outbreaks]], a wider and potentially more heterogenous population of sporadic cases, and with a wide variety of [[Definitions of myalgic encephalomyelitis and chronic fatigue syndrome|case definitions]].

A survey by [[The MEAction Network]] in 2016 found that the majority of patients prefer the name myalgic encephalomyelitis (69% said “ME” was an acceptable name) to other names including ME/CFS (28% said acceptable) and chronic fatigue syndrome (only 6% found acceptable).<ref>{{Cite web|url=http://www.meaction.net/2016/08/07/meaction-rfi-poll-report-1-of-3/ | title = #MEAction RFI Poll Report (Part 1 of 3) {{!}} #MEAction | last = | first = | date = Aug 7, 2016|website = [[The MEAction Network]]|language=en-US|archive-url=|archive-date=|url-status=|access-date=2018-08-13}}</ref> <ref>{{Cite web|url=https://www.nih.gov/sites/default/files/research-training/initiatives/mecfs/rfi-patient-organizations.pdf|title=ME Action Survey; see p.27|last=|first=|authorlink=|last2=|first2=|authorlink2=|date=|website=|archive-url=|archive-date=|url-status=|access-date=}}</ref> Most government agencies and researchers around the world now use the term [[ME/CFS]].{{Citation needed}}

== Criteria defining ME, CFS, and ME/CFS ==
{{Main article |page_name = Definitions of myalgic encephalomyelitis and chronic fatigue syndrome}}

Patients that meet the [[International Consensus Criteria]] (ICC) defining ME are usually more severely impaired than patients that meet the [[Canadian Consensus Criteria]] (CCC) defining ME/CFS, or the minimum symptoms defined in the criteria for patients with SEID which also defines ME/CFS. Researchers believe all patients meeting these criteria, including [[Fukuda criteria]] (with [[post-exertional malaise]]) defining CFS, are experiencing brain inflammation.{{Citation needed}}

== References ==
{{Reflist}}

Talk:Chronic Lyme disease

2023-04-24T22:27:09Z

Justin Reilly:

please can we discuss
*Lyme disease can be caused by *many* bacterial species within Borrelia family (see wikipedia)
*It can be transmitted by *many* different vectors - multiple ticks species, other insects, sexually, congenitally, etc
*the bullseye rash / erythema migrans is the same thing - and is an early symptom
*expand 'neurological symptoms' to mention autonomic probs, paralysis, seizures, temporary blindness, tourette's, etc
*the CDC testing has been criticised for inaccuracy - many false negatives on the first tier test, borrelia often suppress the immune system, tests for limited number of species (there are hundreds), and deliberately ignores one of the most significant markers (for historical / technical reasons).
*ILADS (intnl lyme & associated diseases society) have very different guidelines, which may be more reliable
*very different guidelines & treatment in europe, brasil, etc - especially where it's endemic
--[[User:Suelala|Suelala]] ([[User talk:Suelala|talk]]) 09:52, 30 March 2016 (PDT)

::Agree with these points.
--[[User:Justin Reilly|Justin Reilly]] ([[User talk:Justin Reilly|talk]]) 18 March 2023

Talk:Chronic Lyme disease

2023-04-24T22:25:30Z

Justin Reilly:

please can we discuss
*Lyme disease can be caused by *many* bacterial species within Borrelia family (see wikipedia)
*It can be transmitted by *many* different vectors - multiple ticks species, other insects, sexually, congenitally, etc
*the bullseye rash / erythema migrans is the same thing - and is an early symptom
*expand 'neurological symptoms' to mention autonomic probs, paralysis, seizures, temporary blindness, tourette's, etc
*the CDC testing has been criticised for inaccuracy - many false negatives on the first tier test, borrelia often suppress the immune system, tests for limited number of species (there are hundreds), and deliberately ignores one of the most significant markers (for historical / technical reasons).
*ILADS (intnl lyme & associated diseases society) have very different guidelines, which may be more reliable
*very different guidelines & treatment in europe, brasil, etc - especially where it's endemic
::Agree with these points.
--[[User:Justin Reilly|Justin Reilly]] ([[User talk:Justin Reilly|talk]]) 18 March 2023

Talk:Chronic fatigue syndrome

2023-04-24T15:10:17Z

Justin Reilly:/* Re: Change of main photo -- Justin Reilly (talk) 15:06, April 24, 2023 (UTC) */

==Change of main photo ==

[[File:Malaise_Cropped.JPG|thumb|120px|Current: Malaise_Cropped.KPG]]
The main photo is not a photo of someone who actually has CFS, and looks to me more like someone tired/sleepy rather than ill. The other photos of those with CFS on the page are from when they were well. I would like to get some different and realistic photos for the page.

Separately, it might be better to have a symptom-type diagram as the first / main picture, with photos under it.
[[File:Chronic Fatigue Syndrome-symptoms-diagram.jpg|thumb|left|120px|Chronic Fatigue Syndrome-symptoms-diagram.jpg<ref name="Bjorklund2019">{{Cite journal| title =Chronic fatigue syndrome (CFS): Suggestions for a nutritional treatment in the therapeutic approach| date = 2019-01-01|url=https://www.sciencedirect.com/science/article/pii/S0753332218342987|journal=Biomedicine & Pharmacotherapy|volume=109|pages=1000–1007 | last =Bjørklund | first=Geir | last2=Dadar | first2 = Maryam | last3 = Pen | first3 = Joeri J. | last4 = Chirumbolo | first4 = Salvatore | last5 = Aaseth | first5 = Jan|language=en|doi=10.1016/j.biopha.2018.10.076|issn=0753-3322}}</ref>]]

Any thoughts or suggestions? ~[[User:Notjusttired|Njt]] ([[User talk:Notjusttired|talk]]) 23:29, February 4, 2022 (UTC)

{{clear|both}}

===Re: Change of main photo -- [[User:Justin Reilly|Justin Reilly]] ([[User talk:Justin Reilly|talk]]) 15:06, April 24, 2023 (UTC)===

: Agree. Can someone delete this? I don’t have enough edits to edit a semi-protected page. Thanks! 🙏🏻

==Prevalence ==
As of February 2013, the CDC recognized that more than one million Americans have CFS.<ref>[http://www.cdc.gov/cfs/causes/risk-groups.html Chronic Fatigue Syndrome - CDC]</ref> The February 2015 [[Institute of Medicine report]] stated that there are 836,000 to 2.5 million [[ME/CFS]] patients.<ref name="IOM2015MECFS"/> The [[Prognosis]] for ME/CFS is generally poor.

Chronic Fatigue Syndrome should be distinguished from [[Chronic fatigue (symptom)|chronic fatigue]] (CF), which is a symptom of many different conditions, though not a condition in its own right. These terms are often confused by the media, healthcare practitioners, and the general public. CFS is a grossly misnamed disease whereas CF is a symptom of many diseases, illnesses and drug therapies.<ref>[http://chronicfatigue.about.com/od/whatischronicfatigue/a/cf_vs_cfs.htm?utm_content=bufferda812 Chronic Fatigue vs. Chronic Fatigue Syndrome - One's a Symptom, One's a Disease - About.com Health FMS/ME/CFS By: Adrienne Dellwo]</ref><ref>[http://arthritis.about.com/od/fatigue/f/chronicfatigue.htm Chronic Fatigue Versus Chronic Fatigue Syndrome What's the Difference? - About.com Health FMS/ME/CFS - By Carol Eustice]</ref> Dr. [[Jarred Younger]] explains chronic fatigue and begins by stating "Fatigue is not a disease and it is not even a symptom. So fatigue is a alarm system and the most general alarm system the body has." [https://www.youtube.com/watch?v=wJB95m4FLa0 Webinar with Jarred Younger, Ph.D. (@6:04-7:54)]

== Symptoms ==

=== Hallmark symptom ===
*[[Post-exertional malaise]] (PEM) is the hallmark symptom of ME/CFS. After physical or mental exertion (which for some patients can be a shower or making out a to-do list, others grocery shopping, socializing or reading a news article, while some just walking to the mailbox, getting to the doctor or mentally following a T.V. program) there is a payback which can be delayed 24-48 hours and can last 24 hours or more. The patient will experience even greater fatigue as well as exacerbate the flu-like symptoms and body pain. Every patient experiences different symptoms and symptom severity from different activities and exertion output according to how sick he or she is with the disease.<ref>[http://solvecfs.org/unraveling-post-exertional-malaise/ Unraveling Post-Exertional Malaise - Solve ME/CFS Initiative By: Jennifer M. Spotila, J.D. - Plus a link to all 4 parts]</ref><ref>[http://www.webmd.com/chronic-fatigue-syndrome/chronic-fatigue-syndrome-symptoms Chronic Fatigue Syndrome - Symptoms - Web MD]</ref><ref>[http://chronicfatigue.about.com/od/cfsglossary/g/malaise.htm Post-Exertional Malaise - About.com Health - FMS/ME/CFS]</ref>

:Regarding PEM the [[CFIDS Association of America]] states: "This is a term which describes a symptom in which exercise or exertion can bring on malaise (illness). In the case of people with ME/CFS, malaise often occurs during a period some 24-72 hours after exertion. For example, in some cases, a short walk can worsen ME/CFS symptoms two days later. This lack of understanding about the delayed onset of symptoms has, in the past, made it harder to test for ME/CFS. Follow-up tests, taken less than 24 hours after an initial exercise test, may show that the patient can still perform activities at the same level (before post-exertional malaise has a chance to take hold)."<ref>[http://www.whathealth.com/awareness/event/internationalcfsmeawarenessday.html - What Health - International CFS/ME Awareness Day 2017 - CFIDS Association of America]</ref>

=== Core and additional symptoms (see IOM Clinicians Guide below) ===
<div style="column-count:2;">
*[[Orthostatic intolerance]]
*[[Postural orthostatic tachycardia syndrome|POTS]]
*[[Cognitive dysfunction]]
*[[Unrefreshing sleep]]
*[[Chronic fatigue (symptom)|chronic fatigue]]
*[[Chronic pain]]
*Immune Impairment
*Infection
</div>

=== Other symptoms, comorbids ===
*Neurologic impairments - ME: [[ICC]]<ref>[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3427890/ Myalgic encephalomyelitis: International Consensus Criteria - Wiley - Journal of International Medicine]</ref>
*[[Fibromyalgia]], [[Irritable bowel syndrome]], [[Temporomandibular joint disorder]] (TMJ) and [[Multiple chemical sensitivity]]<ref>[http://solvecfs.org/what-is-mecfs/ What is ME/CFS? - Solve ME/CFS Initiative]</ref>

==== Expanded lists of symptoms ====

*[http://chronicfatigue.about.com/od/whatischronicfatigue/a/cfs_symptoms.htm Chronic Fatigue Syndrome Symptoms - The Monster List!]

*[http://solvecfs.org/what-is-mecfs/ What are the symptoms of ME/CFS?]

== Clinicians guides ==

====US Government guides on symptoms====
*The [[Institute of Medicine report]] - IOM [http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2015/MECFS/MECFScliniciansguide.pdf Clinicians Guide]
*[http://www.cdc.gov/cfs/symptoms/index.html CDC - CFS Symptoms]

==== Canada guides on symptoms ====
*[http://linkis.com/org/tUheh Alberta Clinicians Guide]

== Disease onset and course of illness==
The disease [[ME/CFS]] is diagnosed when a person does not recover from a flu-like illness, [[Epstein-Barr virus|EBV]], [[Mononucleosis]], [[HHV]], [[Q fever]], [[Virus]] or other infections and meets one or more diagnostic criteria for either ME, CFS or ME/CFS.<ref>[https://www.nap.edu/read/19012/chapter/7#157 IOM Report - INFECTION]</ref><ref>[http://www.cortjohnson.org/blog/2014/01/09/lipkin-study-vagus-nerve-hhv-6-loomis-hhv-6-foundation/ The Lipkin Study, The Vagus Nerve Infection Hypothesis and HHV-6: Kristin Loomis of the HHV-6 Foundation Talks – Pt. I - Health Rising - By: Cort Johnson - June 2014]</ref>{{citation needed| date = 2021}} "Occasionally, ME/CFS has been triggered by environmental toxins, the receipt of an immunizing injection, or surviving a major trauma."<ref>[https://www.masscfids.org/images/pdf/Primer_2014.pdf Chronic Fatigue Syndrome Myalgic Encephalomyelitis - Primer for Clinical Practitioners - 2014 Edition - Massachusettes CFIDS/FM Assoc]</ref> Patient health is never the same and they experience numerous symptoms and disease severity which fluctuate day to day, week to week, month to month, year to year and decade to decade as well as varying symptoms and disease severity among patients.<ref>[http://www.meassociation.org.uk/about/the-symptoms-and-diagnosis-of-mecfs/ Symptoms and diagnosis of ME/CFS - ME Association]</ref><ref>[http://www.webmd.com/chronic-fatigue-syndrome/chronic-fatigue-syndrome-symptoms Chronic Fatigue Syndrome - Symptoms - Web MD]</ref><ref>[http://phoenixrising.me/mecfs-basics/chronic-fatigue-syndrome-mecfs-facts-chronic-fatigue-syndrome-is-2 Facts (ME/CFS) Severity]</ref>

=== Female to male ratio ===
Like many auto-immune and neuro-immune diseases where mostly women are afflicted,<ref>[http://www.rightdiagnosis.com/artic/fact_sheet_autoimmune_disease_in_women_nwhic.htm Fact Sheet Autoimmune Disease in Women: NWHIC - Right Diagnosis - Aug 2015]</ref> the ME/CFS female/male patient ratio is 6:1.<ref>[https://www.ncbi.nlm.nih.gov/pubmed/21244747 Chronic fatigue syndrome/myalgic encephalomyelitis: an update. - PUBMed Dec. 2010]</ref> [[Fibromyalgia]] has a F/M 7:1 ratio and some ME/CFS patients have this additional diagnosis.<ref>[http://www.cdc.gov/arthritis/basics/fibromyalgia.htm Fibromyalgia - CDC]</ref><ref>[http://solvecfs.org/what-is-mecfs/ What Is ME/CFS (Fibromyalgia) Solve ME/CFS Initiative]</ref>

[[Jennifer Brea]] gives a WMC Live radio interview addressing F/M auto-immune ratio and the disease [https://secure-hwcdn.libsyn.com/p/1/c/3/1c390d4707a99658/WMCLive_Episode159.mp3?c_id=11198959&expiration=1458320878&hwt=eb06639b1ec5ae7b7fd4e0fd83cc70f9 at 5:00].

==Clinical course==
From the [[Centers for Disease Control]] (CDC): ''What's the Clinical Course of CFS?''

::The severity of CFS varies from patient to patient. Some people can maintain fairly active lives. For most patients, however, CFS significantly limits their work, school, and family activities for periods of time.

::While symptoms vary from person to person in number, type, and severity, all CFS patients are limited in what they can do to some degree. CDC studies show that CFS can be as disabling as multiple sclerosis, lupus, rheumatoid arthritis, heart disease, end-stage renal disease, chronic obstructive pulmonary disease (COPD), and similar chronic conditions.

::CFS often affects patients in cycles: Patients will have periods of illness followed by periods of relative well-being. For some patients, symptoms may diminish or even go into complete remission; however, they often recur at a later point in time. This pattern of remission and relapse makes CFS especially hard for patients to manage. Patients who are in remission may be tempted to overdo activities when they're feeling better, but this overexertion may actually contribute to a relapse.

::The percentage of CFS patients who recover is unknown, but there is some evidence to indicate that patients benefit when accompanying conditions are identified and treated and when symptoms are managed. High-quality health care is important.<ref>[http://www.cdc.gov/cfs/symptoms/index.html What's the Clinical Course of CFS? - CDC]</ref>

==Name controversy==
The name Chronic Fatigue Syndrome is controversial, as many consider it stigmatizing. For decades, patient advocates have been lobbying the CDC to instead use the name [[Myalgic Encephalomyelitis]] ([[myalgic encephalomyelitis|ME]]), though the CDC has refused.<ref>[http://www.chronicfatiguesupport.com/library/showarticle.cfm/id/7603 A Disease in Search of a Name: The History of CFS and the Efforts to Change Its Name - Chronic Fatigue Support]</ref> Most patients and patient organizations prefer the name [[myalgic encephalomyelitis|ME]], or the hybrid [[ME/CFS]].

In February 2016, Dr [[Anthony Komaroff]], who was part of the [[Centers for Disease Control and Prevention|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".<ref name="Komaroff20160217video"/>

Dr. [[Nancy Klimas]] discusses the name controversy in the video [https://www.youtube.com/watch?v=c2vIQ92wU9Y ME/CFS Diagnosis and Name].

== Notable studies ==
*2016, [[Metabolic features of chronic fatigue syndrome]]

*2016, A six-year longitudinal MRI study found that [[Chronic Fatigue Syndrome]] (per Fukuda & Canadian Consensus Criteria) is associated with decreases in [[white matter]], [[gray matter]] and blood volume deficits in the brain as compared to healthy controls.<ref name="Shan2016"/><ref name="JaimeS20160505"/>

*2016, Dr. [[Jose Montoya]] and Dr. [[Michael Zeineh]]'s brain imaging studies show CFS patients suffer 3 brain abnormalities: an overall reduction in white matter; consistent abnormality in the [[right arcuate fasciculus]]; thickened gray matter at two areas of the brain connected by the right [[arcuate fasciculus]].<ref>[http://privatehealthcarereports.com/chronic-fatigue-patients-suffer-3-major-brain-abnormalities-findings-may-lead-to-clearer-diagnosis/ Chronic Fatigue Patients Suffer 3 Major Brain Abnormalities; Findings May Lead To Clearer Diagnosis. - Patient Health Care]</ref>

*2014, [[Brains of People With Chronic Fatigue Syndrome Offer Clues About Disorder - New York Times: Well (2014)]] With brain images.

== History ==
*[[Osler's Web]] is a book on the early history of CFS.
*[[Thirty Years of Disdain]] picks up on the ME/CFS history where Osler's Web leaves off.
*[[Forgotten Plague]] 2015 documentary on the CDC and US patient history of CFS.
*[[List of news articles on ME and CFS]]
*[[Sophia Mirza]]'s life ended due to CFS.
*[[Disabled_in_Tory_Britain#PACE_trial|UK agencies involved in implementation of the PACE trial.]] Disabled in Tory Britain - PACE trial]

==Learn more==
*[[Definitions of ME and CFS]]
*[[Neuroimaging]]
*[[Pediatric]]

==See also==
*[[Systemic Exertion Intolerance Disease]] ([[SEID]]) is the [[Institute of Medicine report]]'s name and diagnostic criteria.
*[[Primer for the public]] An extensive overview of the disease(s) ME, CFS, ME/CFS and SEID, their criteria, history, research and more.
*[[PACE trial]] The highly controversial UK trial that led to the implementation of [[Graded exercise therapy]] (GET) and [[Cognitive behavioral therapy]] (CBT) as treatment paths for CFS.
*[[XMRV]]

== References ==
<references>

<ref name="IOM2015MECFS">{{citation | last1 = Institute of Medicine (USA) | last2 = Committee on the Diagnostic Criteria for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | title = Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness | date = Feb 10, 2015
| url = http://iom.nationalacademies.org/Reports/2015/ME-CFS.aspx }}</ref>

<ref name="Komaroff20160217video">{{citation | last1 = Komaroff | first1 = Anthony | authorlink1 = Anthony Komaroff | last2 = Iskander | first2 = John | authorlink2 = John Iskander
| displayauthors = | title = Interview with Dr Anthony Komaroff | journal = CDC Public Health Ground Rounds - Beyond the Data - Chronic Fatigue Syndrome: Advancing Research and Clinical Education | date = Feb 17, 2016
| url = http://youtu.be/hRdn4A2SGic }}</ref>

<ref name="JaimeS20160505">{{citation | author = Jaime S | authorlink1 = Jaime S | title = Progressive Brain Changes in Patients with Chronic Fatigue Syndrome: Are our Brains Starved of Oxygen?
| website = #MEAction | date = 2016-05-05
| url = http://www.meaction.net/2016/05/05/progressive-brain-changes-in-patients-with-chronic-fatigue-syndrome-are-our-brains-starved-of-oxygen/ }}</ref>

<ref name="Shan2016">{{citation | last1 = Shan | first1 = ZY | authorlink1 = Zack Shan | last2 = Kwiatek | first2 = R | authorlink2 = Richard Kwiatek | last3 = Burnet | first3 = R | authorlink3 = Richard Burnet | last4 = Del Fante | first4 = P | authorlink4 = Peter Del Fante | last5 = Staines | first5 = DR | authorlink5 = Donald Staines | last6 = Marshall-Gradisnik | first6 = SM | authorlink6 = Sonya Marshall-Gradisnik | last7 = Barnden | first7 = LR | authorlink7 = Leighton Barnden | title = Progressive brain changes in patients with chronic fatigue syndrome: A longitudinal MRI study | journal = Journal of magnetic resonance imaging: JMRI | date = 2016-04-28 | pmid = 27123773 | doi = 10.1002/jmri.25283
| url = http://onlinelibrary.wiley.com/doi/10.1002/jmri.25283/abstract;jsessionid=070BE1111DE3D52AC62FD00B68E96028.f03t01 }}</ref>


</references>

Talk:Chronic fatigue syndrome

2023-04-24T15:06:24Z

Justin Reilly:/* Change of main photo */

==Change of main photo ==

[[File:Malaise_Cropped.JPG|thumb|120px|Current: Malaise_Cropped.KPG]]
The main photo is not a photo of someone who actually has CFS, and looks to me more like someone tired/sleepy rather than ill. The other photos of those with CFS on the page are from when they were well. I would like to get some different and realistic photos for the page.

Separately, it might be better to have a symptom-type diagram as the first / main picture, with photos under it.
[[File:Chronic Fatigue Syndrome-symptoms-diagram.jpg|thumb|left|120px|Chronic Fatigue Syndrome-symptoms-diagram.jpg<ref name="Bjorklund2019">{{Cite journal| title =Chronic fatigue syndrome (CFS): Suggestions for a nutritional treatment in the therapeutic approach| date = 2019-01-01|url=https://www.sciencedirect.com/science/article/pii/S0753332218342987|journal=Biomedicine & Pharmacotherapy|volume=109|pages=1000–1007 | last =Bjørklund | first=Geir | last2=Dadar | first2 = Maryam | last3 = Pen | first3 = Joeri J. | last4 = Chirumbolo | first4 = Salvatore | last5 = Aaseth | first5 = Jan|language=en|doi=10.1016/j.biopha.2018.10.076|issn=0753-3322}}</ref>]]

Any thoughts or suggestions? ~[[User:Notjusttired|Njt]] ([[User talk:Notjusttired|talk]]) 23:29, February 4, 2022 (UTC)

{{clear|both}}

===Re: Change of main photo -- [[User:Justin Reilly|Justin Reilly]] ([[User talk:Justin Reilly|talk]]) 15:06, April 24, 2023 (UTC)===

: Agree. Deleting it.

==Prevalence ==
As of February 2013, the CDC recognized that more than one million Americans have CFS.<ref>[http://www.cdc.gov/cfs/causes/risk-groups.html Chronic Fatigue Syndrome - CDC]</ref> The February 2015 [[Institute of Medicine report]] stated that there are 836,000 to 2.5 million [[ME/CFS]] patients.<ref name="IOM2015MECFS"/> The [[Prognosis]] for ME/CFS is generally poor.

Chronic Fatigue Syndrome should be distinguished from [[Chronic fatigue (symptom)|chronic fatigue]] (CF), which is a symptom of many different conditions, though not a condition in its own right. These terms are often confused by the media, healthcare practitioners, and the general public. CFS is a grossly misnamed disease whereas CF is a symptom of many diseases, illnesses and drug therapies.<ref>[http://chronicfatigue.about.com/od/whatischronicfatigue/a/cf_vs_cfs.htm?utm_content=bufferda812 Chronic Fatigue vs. Chronic Fatigue Syndrome - One's a Symptom, One's a Disease - About.com Health FMS/ME/CFS By: Adrienne Dellwo]</ref><ref>[http://arthritis.about.com/od/fatigue/f/chronicfatigue.htm Chronic Fatigue Versus Chronic Fatigue Syndrome What's the Difference? - About.com Health FMS/ME/CFS - By Carol Eustice]</ref> Dr. [[Jarred Younger]] explains chronic fatigue and begins by stating "Fatigue is not a disease and it is not even a symptom. So fatigue is a alarm system and the most general alarm system the body has." [https://www.youtube.com/watch?v=wJB95m4FLa0 Webinar with Jarred Younger, Ph.D. (@6:04-7:54)]

== Symptoms ==

=== Hallmark symptom ===
*[[Post-exertional malaise]] (PEM) is the hallmark symptom of ME/CFS. After physical or mental exertion (which for some patients can be a shower or making out a to-do list, others grocery shopping, socializing or reading a news article, while some just walking to the mailbox, getting to the doctor or mentally following a T.V. program) there is a payback which can be delayed 24-48 hours and can last 24 hours or more. The patient will experience even greater fatigue as well as exacerbate the flu-like symptoms and body pain. Every patient experiences different symptoms and symptom severity from different activities and exertion output according to how sick he or she is with the disease.<ref>[http://solvecfs.org/unraveling-post-exertional-malaise/ Unraveling Post-Exertional Malaise - Solve ME/CFS Initiative By: Jennifer M. Spotila, J.D. - Plus a link to all 4 parts]</ref><ref>[http://www.webmd.com/chronic-fatigue-syndrome/chronic-fatigue-syndrome-symptoms Chronic Fatigue Syndrome - Symptoms - Web MD]</ref><ref>[http://chronicfatigue.about.com/od/cfsglossary/g/malaise.htm Post-Exertional Malaise - About.com Health - FMS/ME/CFS]</ref>

:Regarding PEM the [[CFIDS Association of America]] states: "This is a term which describes a symptom in which exercise or exertion can bring on malaise (illness). In the case of people with ME/CFS, malaise often occurs during a period some 24-72 hours after exertion. For example, in some cases, a short walk can worsen ME/CFS symptoms two days later. This lack of understanding about the delayed onset of symptoms has, in the past, made it harder to test for ME/CFS. Follow-up tests, taken less than 24 hours after an initial exercise test, may show that the patient can still perform activities at the same level (before post-exertional malaise has a chance to take hold)."<ref>[http://www.whathealth.com/awareness/event/internationalcfsmeawarenessday.html - What Health - International CFS/ME Awareness Day 2017 - CFIDS Association of America]</ref>

=== Core and additional symptoms (see IOM Clinicians Guide below) ===
<div style="column-count:2;">
*[[Orthostatic intolerance]]
*[[Postural orthostatic tachycardia syndrome|POTS]]
*[[Cognitive dysfunction]]
*[[Unrefreshing sleep]]
*[[Chronic fatigue (symptom)|chronic fatigue]]
*[[Chronic pain]]
*Immune Impairment
*Infection
</div>

=== Other symptoms, comorbids ===
*Neurologic impairments - ME: [[ICC]]<ref>[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3427890/ Myalgic encephalomyelitis: International Consensus Criteria - Wiley - Journal of International Medicine]</ref>
*[[Fibromyalgia]], [[Irritable bowel syndrome]], [[Temporomandibular joint disorder]] (TMJ) and [[Multiple chemical sensitivity]]<ref>[http://solvecfs.org/what-is-mecfs/ What is ME/CFS? - Solve ME/CFS Initiative]</ref>

==== Expanded lists of symptoms ====

*[http://chronicfatigue.about.com/od/whatischronicfatigue/a/cfs_symptoms.htm Chronic Fatigue Syndrome Symptoms - The Monster List!]

*[http://solvecfs.org/what-is-mecfs/ What are the symptoms of ME/CFS?]

== Clinicians guides ==

====US Government guides on symptoms====
*The [[Institute of Medicine report]] - IOM [http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2015/MECFS/MECFScliniciansguide.pdf Clinicians Guide]
*[http://www.cdc.gov/cfs/symptoms/index.html CDC - CFS Symptoms]

==== Canada guides on symptoms ====
*[http://linkis.com/org/tUheh Alberta Clinicians Guide]

== Disease onset and course of illness==
The disease [[ME/CFS]] is diagnosed when a person does not recover from a flu-like illness, [[Epstein-Barr virus|EBV]], [[Mononucleosis]], [[HHV]], [[Q fever]], [[Virus]] or other infections and meets one or more diagnostic criteria for either ME, CFS or ME/CFS.<ref>[https://www.nap.edu/read/19012/chapter/7#157 IOM Report - INFECTION]</ref><ref>[http://www.cortjohnson.org/blog/2014/01/09/lipkin-study-vagus-nerve-hhv-6-loomis-hhv-6-foundation/ The Lipkin Study, The Vagus Nerve Infection Hypothesis and HHV-6: Kristin Loomis of the HHV-6 Foundation Talks – Pt. I - Health Rising - By: Cort Johnson - June 2014]</ref>{{citation needed| date = 2021}} "Occasionally, ME/CFS has been triggered by environmental toxins, the receipt of an immunizing injection, or surviving a major trauma."<ref>[https://www.masscfids.org/images/pdf/Primer_2014.pdf Chronic Fatigue Syndrome Myalgic Encephalomyelitis - Primer for Clinical Practitioners - 2014 Edition - Massachusettes CFIDS/FM Assoc]</ref> Patient health is never the same and they experience numerous symptoms and disease severity which fluctuate day to day, week to week, month to month, year to year and decade to decade as well as varying symptoms and disease severity among patients.<ref>[http://www.meassociation.org.uk/about/the-symptoms-and-diagnosis-of-mecfs/ Symptoms and diagnosis of ME/CFS - ME Association]</ref><ref>[http://www.webmd.com/chronic-fatigue-syndrome/chronic-fatigue-syndrome-symptoms Chronic Fatigue Syndrome - Symptoms - Web MD]</ref><ref>[http://phoenixrising.me/mecfs-basics/chronic-fatigue-syndrome-mecfs-facts-chronic-fatigue-syndrome-is-2 Facts (ME/CFS) Severity]</ref>

=== Female to male ratio ===
Like many auto-immune and neuro-immune diseases where mostly women are afflicted,<ref>[http://www.rightdiagnosis.com/artic/fact_sheet_autoimmune_disease_in_women_nwhic.htm Fact Sheet Autoimmune Disease in Women: NWHIC - Right Diagnosis - Aug 2015]</ref> the ME/CFS female/male patient ratio is 6:1.<ref>[https://www.ncbi.nlm.nih.gov/pubmed/21244747 Chronic fatigue syndrome/myalgic encephalomyelitis: an update. - PUBMed Dec. 2010]</ref> [[Fibromyalgia]] has a F/M 7:1 ratio and some ME/CFS patients have this additional diagnosis.<ref>[http://www.cdc.gov/arthritis/basics/fibromyalgia.htm Fibromyalgia - CDC]</ref><ref>[http://solvecfs.org/what-is-mecfs/ What Is ME/CFS (Fibromyalgia) Solve ME/CFS Initiative]</ref>

[[Jennifer Brea]] gives a WMC Live radio interview addressing F/M auto-immune ratio and the disease [https://secure-hwcdn.libsyn.com/p/1/c/3/1c390d4707a99658/WMCLive_Episode159.mp3?c_id=11198959&expiration=1458320878&hwt=eb06639b1ec5ae7b7fd4e0fd83cc70f9 at 5:00].

==Clinical course==
From the [[Centers for Disease Control]] (CDC): ''What's the Clinical Course of CFS?''

::The severity of CFS varies from patient to patient. Some people can maintain fairly active lives. For most patients, however, CFS significantly limits their work, school, and family activities for periods of time.

::While symptoms vary from person to person in number, type, and severity, all CFS patients are limited in what they can do to some degree. CDC studies show that CFS can be as disabling as multiple sclerosis, lupus, rheumatoid arthritis, heart disease, end-stage renal disease, chronic obstructive pulmonary disease (COPD), and similar chronic conditions.

::CFS often affects patients in cycles: Patients will have periods of illness followed by periods of relative well-being. For some patients, symptoms may diminish or even go into complete remission; however, they often recur at a later point in time. This pattern of remission and relapse makes CFS especially hard for patients to manage. Patients who are in remission may be tempted to overdo activities when they're feeling better, but this overexertion may actually contribute to a relapse.

::The percentage of CFS patients who recover is unknown, but there is some evidence to indicate that patients benefit when accompanying conditions are identified and treated and when symptoms are managed. High-quality health care is important.<ref>[http://www.cdc.gov/cfs/symptoms/index.html What's the Clinical Course of CFS? - CDC]</ref>

==Name controversy==
The name Chronic Fatigue Syndrome is controversial, as many consider it stigmatizing. For decades, patient advocates have been lobbying the CDC to instead use the name [[Myalgic Encephalomyelitis]] ([[myalgic encephalomyelitis|ME]]), though the CDC has refused.<ref>[http://www.chronicfatiguesupport.com/library/showarticle.cfm/id/7603 A Disease in Search of a Name: The History of CFS and the Efforts to Change Its Name - Chronic Fatigue Support]</ref> Most patients and patient organizations prefer the name [[myalgic encephalomyelitis|ME]], or the hybrid [[ME/CFS]].

In February 2016, Dr [[Anthony Komaroff]], who was part of the [[Centers for Disease Control and Prevention|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".<ref name="Komaroff20160217video"/>

Dr. [[Nancy Klimas]] discusses the name controversy in the video [https://www.youtube.com/watch?v=c2vIQ92wU9Y ME/CFS Diagnosis and Name].

== Notable studies ==
*2016, [[Metabolic features of chronic fatigue syndrome]]

*2016, A six-year longitudinal MRI study found that [[Chronic Fatigue Syndrome]] (per Fukuda & Canadian Consensus Criteria) is associated with decreases in [[white matter]], [[gray matter]] and blood volume deficits in the brain as compared to healthy controls.<ref name="Shan2016"/><ref name="JaimeS20160505"/>

*2016, Dr. [[Jose Montoya]] and Dr. [[Michael Zeineh]]'s brain imaging studies show CFS patients suffer 3 brain abnormalities: an overall reduction in white matter; consistent abnormality in the [[right arcuate fasciculus]]; thickened gray matter at two areas of the brain connected by the right [[arcuate fasciculus]].<ref>[http://privatehealthcarereports.com/chronic-fatigue-patients-suffer-3-major-brain-abnormalities-findings-may-lead-to-clearer-diagnosis/ Chronic Fatigue Patients Suffer 3 Major Brain Abnormalities; Findings May Lead To Clearer Diagnosis. - Patient Health Care]</ref>

*2014, [[Brains of People With Chronic Fatigue Syndrome Offer Clues About Disorder - New York Times: Well (2014)]] With brain images.

== History ==
*[[Osler's Web]] is a book on the early history of CFS.
*[[Thirty Years of Disdain]] picks up on the ME/CFS history where Osler's Web leaves off.
*[[Forgotten Plague]] 2015 documentary on the CDC and US patient history of CFS.
*[[List of news articles on ME and CFS]]
*[[Sophia Mirza]]'s life ended due to CFS.
*[[Disabled_in_Tory_Britain#PACE_trial|UK agencies involved in implementation of the PACE trial.]] Disabled in Tory Britain - PACE trial]

==Learn more==
*[[Definitions of ME and CFS]]
*[[Neuroimaging]]
*[[Pediatric]]

==See also==
*[[Systemic Exertion Intolerance Disease]] ([[SEID]]) is the [[Institute of Medicine report]]'s name and diagnostic criteria.
*[[Primer for the public]] An extensive overview of the disease(s) ME, CFS, ME/CFS and SEID, their criteria, history, research and more.
*[[PACE trial]] The highly controversial UK trial that led to the implementation of [[Graded exercise therapy]] (GET) and [[Cognitive behavioral therapy]] (CBT) as treatment paths for CFS.
*[[XMRV]]

== References ==
<references>

<ref name="IOM2015MECFS">{{citation | last1 = Institute of Medicine (USA) | last2 = Committee on the Diagnostic Criteria for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | title = Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness | date = Feb 10, 2015
| url = http://iom.nationalacademies.org/Reports/2015/ME-CFS.aspx }}</ref>

<ref name="Komaroff20160217video">{{citation | last1 = Komaroff | first1 = Anthony | authorlink1 = Anthony Komaroff | last2 = Iskander | first2 = John | authorlink2 = John Iskander
| displayauthors = | title = Interview with Dr Anthony Komaroff | journal = CDC Public Health Ground Rounds - Beyond the Data - Chronic Fatigue Syndrome: Advancing Research and Clinical Education | date = Feb 17, 2016
| url = http://youtu.be/hRdn4A2SGic }}</ref>

<ref name="JaimeS20160505">{{citation | author = Jaime S | authorlink1 = Jaime S | title = Progressive Brain Changes in Patients with Chronic Fatigue Syndrome: Are our Brains Starved of Oxygen?
| website = #MEAction | date = 2016-05-05
| url = http://www.meaction.net/2016/05/05/progressive-brain-changes-in-patients-with-chronic-fatigue-syndrome-are-our-brains-starved-of-oxygen/ }}</ref>

<ref name="Shan2016">{{citation | last1 = Shan | first1 = ZY | authorlink1 = Zack Shan | last2 = Kwiatek | first2 = R | authorlink2 = Richard Kwiatek | last3 = Burnet | first3 = R | authorlink3 = Richard Burnet | last4 = Del Fante | first4 = P | authorlink4 = Peter Del Fante | last5 = Staines | first5 = DR | authorlink5 = Donald Staines | last6 = Marshall-Gradisnik | first6 = SM | authorlink6 = Sonya Marshall-Gradisnik | last7 = Barnden | first7 = LR | authorlink7 = Leighton Barnden | title = Progressive brain changes in patients with chronic fatigue syndrome: A longitudinal MRI study | journal = Journal of magnetic resonance imaging: JMRI | date = 2016-04-28 | pmid = 27123773 | doi = 10.1002/jmri.25283
| url = http://onlinelibrary.wiley.com/doi/10.1002/jmri.25283/abstract;jsessionid=070BE1111DE3D52AC62FD00B68E96028.f03t01 }}</ref>


</references>

Names of myalgic encephalomyelitis and chronic fatigue syndrome

2023-04-10T14:16:40Z

Justin Reilly:

The name [[myalgic encephalomyelitis]] (ME) was coined by Dr. [[Melvin Ramsay]] following the [[1955 Royal Free Hospital outbreak]]<ref>{{Cite journal | last = | first = | date = 1957-10-19 | title = An Outbreak of Encephalomyelitis in the Royal Free Hospital Group, London, in 1955|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1962472/|journal=British Medical Journal|volume=2|issue=5050 | pages = 895–904|issn=0007-1447|pmc=|pmid=13472002|via=}}</ref> and is a portmanteau of several of the key signs and symptoms of the disease: myalgic ([[muscle pain]]), encephalo ([[brain]]), myel ([[spinal cord]]), itis ([[inflammation]]).<ref>{{Cite web|url=http://www.investinme.org/Article%20010-Encephalopathy%20Hooper.shtml | title = Invest in ME Research - The Terminology of ME & CFS | last = Hooper | first = Malcolm | date = Feb 2005 | website = [[Invest in ME Research]]|archive-url=|archive-date=|url-status=|access-date=2018-08-13}}</ref>

Several other names have been used or proposed throughout the history of the disease, including [[atypical polio]], [[1948-49 Akureyri outbreak|Icelandic disease]], benign myalgic encephalomyelitis, [[epidemic neuromyasthenia]], [[chronic fatigue syndrome]] (CFS), and [[systemic exertion intolerance disease]] (SEID). This has lead to much confusion as a variety of names have been used at different times to describe discrete [[List of outbreaks|outbreaks]], a wider and potentially more heterogenous population of sporadic cases, and with a wide variety of [[Definitions of myalgic encephalomyelitis and chronic fatigue syndrome|case definitions]].

A survey by [[The MEAction Network]] in 2016 found that the majority of patients prefer the name myalgic encephalomyelitis (69% said “ME” was an acceptable name) to other names including ME/CFS (28% said acceptable) and chronic fatigue syndrome (only 6% found acceptable).<ref>{{Cite web|url=http://www.meaction.net/2016/08/07/meaction-rfi-poll-report-1-of-3/ | title = #MEAction RFI Poll Report (Part 1 of 3) {{!}} #MEAction | last = | first = | date = Aug 7, 2016|website = [[The MEAction Network]]|language=en-US|archive-url=|archive-date=|url-status=|access-date=2018-08-13}}</ref> <ref>{{Cite web|url=https://www.nih.gov/sites/default/files/research-training/initiatives/mecfs/rfi-patient-organizations.pdf|title=ME Action Survey|last=|first=|authorlink=|last2=|first2=|authorlink2=|date=|website=|archive-url=|archive-date=|url-status=|access-date=}}</ref> Most government agencies and researchers around the world now use the term [[ME/CFS]].{{Citation needed}}

== Criteria defining ME, CFS, and ME/CFS ==
{{Main article |page_name = Definitions of myalgic encephalomyelitis and chronic fatigue syndrome}}

Patients that meet the [[International Consensus Criteria]] (ICC) defining ME are usually more severely impaired than patients that meet the [[Canadian Consensus Criteria]] (CCC) defining ME/CFS, or the minimum symptoms defined in the criteria for patients with SEID which also defines ME/CFS. Researchers believe all patients meeting these criteria, including [[Fukuda criteria]] (with [[post-exertional malaise]]) defining CFS, are experiencing brain inflammation.{{Citation needed}}

== References ==
{{Reflist}}

Names of myalgic encephalomyelitis and chronic fatigue syndrome

2023-04-10T14:13:16Z

Justin Reilly:

The name [[myalgic encephalomyelitis]] (ME) was coined by Dr. [[Melvin Ramsay]] following the [[1955 Royal Free Hospital outbreak]]<ref>{{Cite journal | last = | first = | date = 1957-10-19 | title = An Outbreak of Encephalomyelitis in the Royal Free Hospital Group, London, in 1955|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1962472/|journal=British Medical Journal|volume=2|issue=5050 | pages = 895–904|issn=0007-1447|pmc=|pmid=13472002|via=}}</ref> and is a portmanteau of several of the key signs and symptoms of the disease: myalgic ([[muscle pain]]), encephalo ([[brain]]), myel ([[spinal cord]]), itis ([[inflammation]]).<ref>{{Cite web|url=http://www.investinme.org/Article%20010-Encephalopathy%20Hooper.shtml | title = Invest in ME Research - The Terminology of ME & CFS | last = Hooper | first = Malcolm | date = Feb 2005 | website = [[Invest in ME Research]]|archive-url=|archive-date=|url-status=|access-date=2018-08-13}}</ref>

Several other names have been used or proposed throughout the history of the disease, including [[atypical polio]], [[1948-49 Akureyri outbreak|Icelandic disease]], benign myalgic encephalomyelitis, [[epidemic neuromyasthenia]], [[chronic fatigue syndrome]] (CFS), and [[systemic exertion intolerance disease]] (SEID). This has lead to much confusion as a variety of names have been used at different times to describe discrete [[List of outbreaks|outbreaks]], a wider and potentially more heterogenous population of sporadic cases, and with a wide variety of [[Definitions of myalgic encephalomyelitis and chronic fatigue syndrome|case definitions]].

A survey by [[The MEAction Network]] in 2016 found that the majority of patients prefer the name myalgic encephalomyelitis (69% said “ME” was an acceptable name) to other names including ME/CFS (28% said acceptable) and chronic fatigue syndrome (only 6% said acceptable).<ref>{{Cite web|url=http://www.meaction.net/2016/08/07/meaction-rfi-poll-report-1-of-3/ | title = #MEAction RFI Poll Report (Part 1 of 3) {{!}} #MEAction | last = | first = | date = Aug 7, 2016|website = [[The MEAction Network]]|language=en-US|archive-url=|archive-date=|url-status=|access-date=2018-08-13}}</ref> <ref>{{Cite web|url=https://www.nih.gov/sites/default/files/research-training/initiatives/mecfs/rfi-patient-organizations.pdf|title=ME Action Survey|last=|first=|authorlink=|last2=|first2=|authorlink2=|date=|website=|archive-url=|archive-date=|url-status=|access-date=}}</ref> Most government agencies and researchers around the world now use the term [[ME/CFS]].{{Citation needed}}

== Criteria defining ME, CFS, and ME/CFS ==
{{Main article |page_name = Definitions of myalgic encephalomyelitis and chronic fatigue syndrome}}

Patients that meet the [[International Consensus Criteria]] (ICC) defining ME are usually more severely impaired than patients that meet the [[Canadian Consensus Criteria]] (CCC) defining ME/CFS, or the minimum symptoms defined in the criteria for patients with SEID which also defines ME/CFS. Researchers believe all patients meeting these criteria, including [[Fukuda criteria]] (with [[post-exertional malaise]]) defining CFS, are experiencing brain inflammation.{{Citation needed}}

== References ==
{{Reflist}}

Names of myalgic encephalomyelitis and chronic fatigue syndrome

2023-04-10T14:01:53Z

Justin Reilly:/* Criterion defining ME, CFS, and ME/CFS */

The name [[myalgic encephalomyelitis]] (ME) was coined by Dr. [[Melvin Ramsay]] following the [[1955 Royal Free Hospital outbreak]]<ref>{{Cite journal | last = | first = | date = 1957-10-19 | title = An Outbreak of Encephalomyelitis in the Royal Free Hospital Group, London, in 1955|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1962472/|journal=British Medical Journal|volume=2|issue=5050 | pages = 895–904|issn=0007-1447|pmc=|pmid=13472002|via=}}</ref> and is a portmanteau of several of the key signs and symptoms of the disease: myalgic ([[muscle pain]]), encephalo ([[brain]]), myel ([[spinal cord]]), itis ([[inflammation]]).<ref>{{Cite web|url=http://www.investinme.org/Article%20010-Encephalopathy%20Hooper.shtml | title = Invest in ME Research - The Terminology of ME & CFS | last = Hooper | first = Malcolm | date = Feb 2005 | website = [[Invest in ME Research]]|archive-url=|archive-date=|url-status=|access-date=2018-08-13}}</ref>

Several other names have been used or proposed throughout the history of the disease, including [[atypical polio]], [[1948-49 Akureyri outbreak|Icelandic disease]], benign myalgic encephalomyelitis, [[epidemic neuromyasthenia]], [[chronic fatigue syndrome]] (CFS), and [[systemic exertion intolerance disease]] (SEID). This has lead to much confusion as a variety of names have been used at different times to describe discrete [[List of outbreaks|outbreaks]], a wider and potentially more heterogenous population of sporadic cases, and with a wide variety of [[Definitions of myalgic encephalomyelitis and chronic fatigue syndrome|case definitions]].

A survey by [[The MEAction Network]] in 2016 found that the majority of patients prefer the name myalgic encephalomyelitis (69% said “ME” was an acceptable name) to other names including chronic fatigue syndrome (only 6% said “CFS” was acceptable).<ref>{{Cite web|url=http://www.meaction.net/2016/08/07/meaction-rfi-poll-report-1-of-3/ | title = #MEAction RFI Poll Report (Part 1 of 3) {{!}} #MEAction | last = | first = | date = Aug 7, 2016|website = [[The MEAction Network]]|language=en-US|archive-url=|archive-date=|url-status=|access-date=2018-08-13}}</ref> Most government agencies and researchers around the world now use the term [[ME/CFS]].{{Citation needed}}

== Criteria defining ME, CFS, and ME/CFS ==
{{Main article |page_name = Definitions of myalgic encephalomyelitis and chronic fatigue syndrome}}

Patients that meet the [[International Consensus Criteria]] (ICC) defining ME are usually more severely impaired than patients that meet the [[Canadian Consensus Criteria]] (CCC) defining ME/CFS, or the minimum symptoms defined in the criteria for patients with SEID which also defines ME/CFS. Researchers believe all patients meeting these criteria, including [[Fukuda criteria]] (with [[post-exertional malaise]]) defining CFS, are experiencing brain inflammation.{{Citation needed}}

== References ==
{{Reflist}}

Names of myalgic encephalomyelitis and chronic fatigue syndrome

2023-04-10T13:59:54Z

Justin Reilly:Quantity

The name [[myalgic encephalomyelitis]] (ME) was coined by Dr. [[Melvin Ramsay]] following the [[1955 Royal Free Hospital outbreak]]<ref>{{Cite journal | last = | first = | date = 1957-10-19 | title = An Outbreak of Encephalomyelitis in the Royal Free Hospital Group, London, in 1955|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1962472/|journal=British Medical Journal|volume=2|issue=5050 | pages = 895–904|issn=0007-1447|pmc=|pmid=13472002|via=}}</ref> and is a portmanteau of several of the key signs and symptoms of the disease: myalgic ([[muscle pain]]), encephalo ([[brain]]), myel ([[spinal cord]]), itis ([[inflammation]]).<ref>{{Cite web|url=http://www.investinme.org/Article%20010-Encephalopathy%20Hooper.shtml | title = Invest in ME Research - The Terminology of ME & CFS | last = Hooper | first = Malcolm | date = Feb 2005 | website = [[Invest in ME Research]]|archive-url=|archive-date=|url-status=|access-date=2018-08-13}}</ref>

Several other names have been used or proposed throughout the history of the disease, including [[atypical polio]], [[1948-49 Akureyri outbreak|Icelandic disease]], benign myalgic encephalomyelitis, [[epidemic neuromyasthenia]], [[chronic fatigue syndrome]] (CFS), and [[systemic exertion intolerance disease]] (SEID). This has lead to much confusion as a variety of names have been used at different times to describe discrete [[List of outbreaks|outbreaks]], a wider and potentially more heterogenous population of sporadic cases, and with a wide variety of [[Definitions of myalgic encephalomyelitis and chronic fatigue syndrome|case definitions]].

A survey by [[The MEAction Network]] in 2016 found that the majority of patients prefer the name myalgic encephalomyelitis (69% said “ME” was an acceptable name) to other names including chronic fatigue syndrome (only 6% said “CFS” was acceptable).<ref>{{Cite web|url=http://www.meaction.net/2016/08/07/meaction-rfi-poll-report-1-of-3/ | title = #MEAction RFI Poll Report (Part 1 of 3) {{!}} #MEAction | last = | first = | date = Aug 7, 2016|website = [[The MEAction Network]]|language=en-US|archive-url=|archive-date=|url-status=|access-date=2018-08-13}}</ref> Most government agencies and researchers around the world now use the term [[ME/CFS]].{{Citation needed}}

== Criterion defining ME, CFS, and ME/CFS ==
{{Main article |page_name = Definitions of myalgic encephalomyelitis and chronic fatigue syndrome}}

Patients that meet the [[International Consensus Criteria]] (ICC) defining ME are usually more severely impaired than patients that meet the [[Canadian Consensus Criteria]] (CCC) defining ME/CFS, or the minimum symptoms defined in the criteria for patients with SEID which also defines ME/CFS. Researchers believe all patients meeting these criteria, including [[Fukuda criteria]] (with [[post-exertional malaise]]) defining CFS, are experiencing brain inflammation.{{Citation needed}}

== References ==
{{Reflist}}

Forgotten Plague

2018-11-10T04:53:16Z

Justin Reilly:typo

[[File:Forgotten Plague.jpeg|400px|thumb|right]]

'''''Forgotten Plague''''' is a documentary film about [[Ryan Prior]], an [[ME/CFS]] patient and journalist and his journey to understand the disease.

== Plot ==
Ryan Prior’s life imploded October 22, 2006, when he was struck down by a disease that dozens of doctors were powerless to diagnose, let alone treat. Against great odds, he becomes a reporter and ventures to tell the story of his suffering and improbable recovery. He is shocked that millions globally remain sidelined by the same disease, many bedridden for decades.

Forgotten Plague is a journey into the hidden world of [[myalgic encephalomyelitis]] ([[chronic fatigue syndrome]]). It is a chilling tale of our medical system’s failures in addressing many chronic, complex diseases. Yet it is also a riveting story of science’s remarkable ability to transform medicine and improve human life itself.<ref>{{Cite web|url=http://www.forgottenplague.com/|title=Forgotten Plague|last=|first=|date=|website=|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-10}}</ref>

'''IMDB Page:''' An afflicted journalist embarks on a quest to find out why the [[CDC]] and medical system have neglected his disease and left millions sidelined from life. <ref>{{Cite web|url=http://www.imdb.com/title/tt4223204/|title=Forgotten Plague|last=Prior|first=Ryan|last2=Castillo|first2=Nicole|date=2015|website=IMDB|archive-url=|archive-date=|dead-url=|access-date=}}</ref>

==Interviews in documentary==
*[[David Tuller]] - New York Times, UC Berkeley
*[[Ian Lipkin]], MD - Columbia University
*[[Jose Montoya]], MD - Stanford University
*[[Anthony Komaroff]], MD - Harvard University
*[[Michael VanElzakker]], PhD - Tufts University
*[[Leonard Jason]], PhD - DePaul University
*Lori Chapo-Kroger, RN - Pandora Org
*[[Derek Enlander]], MD - Mt. Sinai Hospital
*[[Hillary Johnson]] - Author of ''[[Osler's Web]]: Inside the Labyrinth of Chronic Fatigue Syndrome''
*Roger King - Former Economist for U.N. Agencies and Author of ''[[Love and Fatigue in America]]''
*[[Linda Tannenbaum]] - [[Open Medicine Foundation]]
*[[Andreas Kogelnik]], MD, PhD - Open Medicine Institute
*[[David Kaufman]], MD - Open Medicine Institute
*[[Ronald Davis]], PhD - Director, Stanford Genome Technology Research Center and [[Open Medicine Foundation]] Collaborator
*Ashley Davis - Director, Chronic Fatigue Syndrome Research Center at Stanford University
*[[Staci Stevens]], MS - Director, [[Workwell Foundation]]
*[[Christopher Snell]], PhD - Professor of Exercise Science, University of the Pacific, [[Workwell Foundation]]
*[[Mark VanNess]], PhD - Associate Professor of Exercise Science, University of the Pacific, [[Workwell Foundation]]
*[[Daniel Peterson]], MD - Sierra Internal Medicine and [[Simmaron Research]]
*Janet Smith, MD - Simmaron Research Board Member
*Chitra Bhakta, MD - Orange County Integrative Medical Center
*Jane Xenos, D.O. - Independent Physician
*[[Judy Mikovits]], PhD - Microbiologist
*[[Charles Lapp]], MD - Physician, Hunter-Hopkins Center
*[[Nancy Klimas]], MD - Physician, [[Institute for Neuro Immune Medicine]]
*[[Gordon Broderick]], PhD - Computer scientist, [[Institute for Neuro Immune Medicine]]
*Lubov Nathanson, PhD - Research scientist, Genomics
*William Pridgen, MD - Surgeon
*Carol Duffy, PhD - Microbiologist
*[[Jamison Hill]] - Former Bodybuilder with ME/CFS
*[[Toni Bernhard]] - Author, ''How To Be Sick''

== Available DVD and Streaming ==
*[https://www.amazon.com/Forgotten-Plague-Prior-Nicole-Castillo/dp/B01BUOM4HG Amazon]

*Music From The Documentary "Forgotten Plague" By: David Conley available free on [https://www.spotify.com/us/ Spotify].

== Reviews ==
*Oct 2, 2015, [http://www.huffingtonpost.com/bill-johnson-ii/forgotten-plague-a-must-s_b_8230262.html HuffPost Health Forgotten Plague: A Must See Documentary]<ref>{{Cite web|url=https://www.huffingtonpost.com/bill-johnson-ii/forgotten-plague-a-must-s_b_8230262.html|title=Forgotten Plague: A Must See Documentary|last=Johnson III|first=Bill|date=2015-10-02|website=HuffPost|language=en|access-date=2018-08-10|archive-url=|archive-date=|dead-url=}}</ref> [http://www.me-gids.net/module-ME_CVS_docs-viewpub-tid-1-pid-1459.html?utm_source=twitterfeed&utm_medium=twitter&utm_campaign=me-gids-news ME-gids Forgotten Plague: Een documentaire die je gezien moet hebben (Dutch translation)]

== Featured in media reporting ==
* [[Chronic Fatigue: Missing Millions (Carte Blanche DSTV)]]

== Credits ==
Directors:
[[Nicole Castillo]]... director
Ryan Prior... (co-director)

Writers:
Ryan Prior

Producers:
Nicole Castillo ... co-producer
Mona Eliassen-Taliaferro... executive producer
Travis Preston ... consulting producer
Ryan Prior ... executive producer / producer
Justin Reilly ... senior producer
Giridhar Subramanian... producer

Music: David Conley

Cinematography: Nicole Castillo

Film Editing: Travis Preston ... editor Annie Laurie Medonis... assistant editor

Sound: Nicole Castillo ... sound mixer Dan Schaefer ... sound editor

Camera and Electrical: Nicole Castillo ... camera operator

Animation: Sam Alkaitis ... animator Zakk Bottomley ... animator

Music: Henry Adams ... musician: cello David Conley ... conductor / music editor / musician: acoustic guitar / musician: keyboards Kathleen Crawford... musician: cello Melissa Loga ... composer: additional music / musician: viola Eric Roper ... music recordist Esther Tonea ... musician: cello<ref>https://www.imdb.com/title/tt4223204/fullcredits?ref_=tt_ql_1</ref>

== The Blue Ribbon Foundation ==
In the spirit of a true grassroots organization, [[The Blue Ribbon Foundation]] started as an idea, which manifested into a documentary (Forgotten Plague), and eventually shaped a movement.

The Blue Ribbon Foundation’s mission is to foster a national public dialogue that can lead to finding the cause, cure, and prevention of neuro-immune diseases.<ref>{{Cite news|url=http://theblueribbonfoundation.org/about-us/|title=About Us|date=2013-11-07|work=The Blue Ribbon Foundation|access-date=2018-08-10|language=en-US}}</ref>

== The Blue Ribbon Fellowship ==
The summer between the first and second years of medical school is sometimes described as the last “free time” medical students have. However, most driven medical students will pursue research fellowships to set themselves up for success in competitive residency programs. We have launched a highly competitive fellowship in neuro-immune medicine for students from across the nation or the world to study with leaders in the field. The goal of [[The Blue Ribbon Fellowship]] is to foster a new generation of physicians devoted to solving complex neuro-immune diseases.<ref>{{Cite news|url=http://theblueribbonfoundation.org/blue-ribbon-fellowship/|title=Blue Ribbon Fellowship|date=2013-11-07|work=The Blue Ribbon Foundation|access-date=2018-08-10|language=en-US}}</ref>

== Online Presence ==
*[https://www.facebook.com/CFSDocumentary Facebook]
*[http://www.forgottenplague.com/ Website]
*[https://www.youtube.com/channel/UCJMJsysciXerH2X8F6rcVgw YouTube]

==See also==
*[[I Remember Me]]
*[[Unrest]]
*[[Voices from the Shadows]]

==Learn more==
*2016, [http://www.thewishdish.com/telling-story-forgotten-plague-chronic-fatigue-syndrome/ Telling the Story of a Forgotten Plague: Chronic Fatigue Syndrome]
== References ==
<references />

[[Category:Film]]

Forgotten Plague

2018-11-10T04:52:16Z

Justin Reilly:/* Credits */

[[File:Forgotten Plague.jpeg|400px|thumb|right]]

'''''Forgotten Plague''''' is a documentary film about [[Ryan Prior]], an [[ME/CFS]] patient and journalist and his journey to understand the disease.

== Plot ==
Ryan Prior’s life imploded October 22, 2006, when he was struck down by a disease that dozens of doctors were powerless to diagnose, let alone treat. Against great odds, he becomes a reporter and ventures to tell the story of his suffering and improbable recovery. He is shocked that millions globally remain sidelined by the same disease, many bedridden for decades.

Forgotten Plague is a journey into the hidden world of [[myalgic encephalomyelitis]] ([[chronic fatigue syndrome]]). It is a chilling tale of our medical system’s failures in addressing many chronic, complex diseases. Yet it is also a riveting story of science’s remarkable ability to transform medicine and improve human life itself.<ref>{{Cite web|url=http://www.forgottenplague.com/|title=Forgotten Plague|last=|first=|date=|website=|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-10}}</ref>

'''IMDB Page:''' An afflicted journalist embarks on a quest to find out why the [[CDC]] and medical system have neglected his disease and left millions sidelined from life. <ref>{{Cite web|url=http://www.imdb.com/title/tt4223204/|title=Forgotten Plague|last=Prior|first=Ryan|last2=Castillo|first2=Nicole|date=2015|website=IMDB|archive-url=|archive-date=|dead-url=|access-date=}}</ref>

==Interviews in documentary==
*[[David Tuller]] - New York Times, UC Berkeley
*[[Ian Lipkin]], MD - Columbia University
*[[Jose Montoya]], MD - Stanford University
*[[Anthony Komaroff]], MD - Harvard University
*[[Michael VanElzakker]], PhD - Tufts University
*[[Leonard Jason]], PhD - DePaul University
*Lori Chapo-Kroger, RN - Pandora Org
*[[Derek Enlander]], MD - Mt. Sinai Hospital
*[[Hillary Johnson]] - Author of ''[[Osler's Web]]: Inside the Labyrinth of Chronic Fatigue Syndrome''
*Roger King - Former Economist for U.N. Agencies and Author of ''[[Love and Fatigue in America]]''
*[[Linda Tannenbaum]] - [[Open Medicine Foundation]]
*[[Andreas Kogelnik]], MD, PhD - Open Medicine Institute
*[[David Kaufman]], MD - Open Medicine Institute
*[[Ronald Davis]], PhD - Director, Stanford Genome Technology Research Center and [[Open Medicine Foundation]] Collaborator
*Ashley Davis - Director, Chronic Fatigue Syndrome Research Center at Stanford University
*[[Staci Stevens]], MS - Director, [[Workwell Foundation]]
*[[Christopher Snell]], PhD - Professor of Exercise Science, University of the Pacific, [[Workwell Foundation]]
*[[Mark VanNess]], PhD - Associate Professor of Exercise Science, University of the Pacific, [[Workwell Foundation]]
*[[Daniel Peterson]], MD - Sierra Internal Medicine and [[Simmaron Research]]
*Janet Smith, MD - Simmaron Research Board Member
*Chitra Bhakta, MD - Orange County Integrative Medical Center
*Jane Xenos, D.O. - Independent Physician
*[[Judy Mikovits]], PhD - Microbiologist
*[[Charles Lapp]], MD - Physician, Hunter-Hopkins Center
*[[Nancy Klimas]], MD - Physician, [[Institute for Neuro Immune Medicine]]
*[[Gordon Broderick]], PhD - Computer scientist, [[Institute for Neuro Immune Medicine]]
*Lubov Nathanson, PhD - Research scientist, Genomics
*William Pridgen, MD - Surgeon
*Carol Duffy, PhD - Microbiologist
*[[Jamison Hill]] - Former Bodybuilder with ME/CFS
*[[Toni Bernhard]] - Author, ''How To Be Sick''

== Available DVD and Streaming ==
*[https://www.amazon.com/Forgotten-Plague-Prior-Nicole-Castillo/dp/B01BUOM4HG Amazon]

*Music From The Documentary "Forgotten Plague" By: David Conley available free on [https://www.spotify.com/us/ Spotify].

== Reviews ==
*Oct 2, 2015, [http://www.huffingtonpost.com/bill-johnson-ii/forgotten-plague-a-must-s_b_8230262.html HuffPost Health Forgotten Plague: A Must See Documentary]<ref>{{Cite web|url=https://www.huffingtonpost.com/bill-johnson-ii/forgotten-plague-a-must-s_b_8230262.html|title=Forgotten Plague: A Must See Documentary|last=Johnson III|first=Bill|date=2015-10-02|website=HuffPost|language=en|access-date=2018-08-10|archive-url=|archive-date=|dead-url=}}</ref> [http://www.me-gids.net/module-ME_CVS_docs-viewpub-tid-1-pid-1459.html?utm_source=twitterfeed&utm_medium=twitter&utm_campaign=me-gids-news ME-gids Forgotten Plague: Een documentaire die je gezien moet hebben (Dutch translation)]

== Featured in media reporting ==
* [[Chronic Fatigue: Missing Millions (Carte Blanche DSTV)]]

== Credits ==
Directors:
<nowiki>[[Nicole Castillo]]</nowiki>... director
Ryan Prior... (co-director)

Writers:
Ryan Prior

Producers:
Nicole Castillo ... co-producer
Mona Eliassen-Taliaferro... executive producer
Travis Preston ... consulting producer
Ryan Prior ... executive producer / producer
Justin Reilly ... senior producer
Giridhar Subramanian... producer

Music: David Conley

Cinematography: Nicole Castillo

Film Editing: Travis Preston ... editor Annie Laurie Medonis... assistant editor

Sound: Nicole Castillo ... sound mixer Dan Schaefer ... sound editor

Camera and Electrical: Nicole Castillo ... camera operator

Animation: Sam Alkaitis ... animator Zakk Bottomley ... animator

Music: Henry Adams ... musician: cello David Conley ... conductor / music editor / musician: acoustic guitar / musician: keyboards Kathleen Crawford... musician: cello Melissa Loga ... composer: additional music / musician: viola Eric Roper ... music recordist Esther Tonea ... musician: cello<ref>https://www.imdb.com/title/tt4223204/fullcredits?ref_=tt_ql_1</ref>

== The Blue Ribbon Foundation ==
In the spirit of a true grassroots organization, [[The Blue Ribbon Foundation]] started as an idea, which manifested into a documentary (Forgotten Plague), and eventually shaped a movement.

The Blue Ribbon Foundation’s mission is to foster a national public dialogue that can lead to finding the cause, cure, and prevention of neuro-immune diseases.<ref>{{Cite news|url=http://theblueribbonfoundation.org/about-us/|title=About Us|date=2013-11-07|work=The Blue Ribbon Foundation|access-date=2018-08-10|language=en-US}}</ref>

== The Blue Ribbon Fellowship ==
The summer between the first and second years of medical school is sometimes described as the last “free time” medical students have. However, most driven medical students will pursue research fellowships to set themselves up for success in competitive residency programs. We have launched a highly competitive fellowship in neuro-immune medicine for students from across the nation or the world to study with leaders in the field. The goal of [[The Blue Ribbon Fellowship]] is to foster a new generation of physicians devoted to solving complex neuro-immune diseases.<ref>{{Cite news|url=http://theblueribbonfoundation.org/blue-ribbon-fellowship/|title=Blue Ribbon Fellowship|date=2013-11-07|work=The Blue Ribbon Foundation|access-date=2018-08-10|language=en-US}}</ref>

== Online Presence ==
*[https://www.facebook.com/CFSDocumentary Facebook]
*[http://www.forgottenplague.com/ Website]
*[https://www.youtube.com/channel/UCJMJsysciXerH2X8F6rcVgw YouTube]

==See also==
*[[I Remember Me]]
*[[Unrest]]
*[[Voices from the Shadows]]

==Learn more==
*2016, [http://www.thewishdish.com/telling-story-forgotten-plague-chronic-fatigue-syndrome/ Telling the Story of a Forgotten Plague: Chronic Fatigue Syndrome]
== References ==
<references />

[[Category:Film]]

Forgotten Plague

2018-11-10T04:50:32Z

Justin Reilly:imdb cite

[[File:Forgotten Plague.jpeg|400px|thumb|right]]

'''''Forgotten Plague''''' is a documentary film about [[Ryan Prior]], an [[ME/CFS]] patient and journalist and his journey to understand the disease.

== Plot ==
Ryan Prior’s life imploded October 22, 2006, when he was struck down by a disease that dozens of doctors were powerless to diagnose, let alone treat. Against great odds, he becomes a reporter and ventures to tell the story of his suffering and improbable recovery. He is shocked that millions globally remain sidelined by the same disease, many bedridden for decades.

Forgotten Plague is a journey into the hidden world of [[myalgic encephalomyelitis]] ([[chronic fatigue syndrome]]). It is a chilling tale of our medical system’s failures in addressing many chronic, complex diseases. Yet it is also a riveting story of science’s remarkable ability to transform medicine and improve human life itself.<ref>{{Cite web|url=http://www.forgottenplague.com/|title=Forgotten Plague|last=|first=|date=|website=|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-10}}</ref>

'''IMDB Page:''' An afflicted journalist embarks on a quest to find out why the [[CDC]] and medical system have neglected his disease and left millions sidelined from life. <ref>{{Cite web|url=http://www.imdb.com/title/tt4223204/|title=Forgotten Plague|last=Prior|first=Ryan|last2=Castillo|first2=Nicole|date=2015|website=IMDB|archive-url=|archive-date=|dead-url=|access-date=}}</ref>

==Interviews in documentary==
*[[David Tuller]] - New York Times, UC Berkeley
*[[Ian Lipkin]], MD - Columbia University
*[[Jose Montoya]], MD - Stanford University
*[[Anthony Komaroff]], MD - Harvard University
*[[Michael VanElzakker]], PhD - Tufts University
*[[Leonard Jason]], PhD - DePaul University
*Lori Chapo-Kroger, RN - Pandora Org
*[[Derek Enlander]], MD - Mt. Sinai Hospital
*[[Hillary Johnson]] - Author of ''[[Osler's Web]]: Inside the Labyrinth of Chronic Fatigue Syndrome''
*Roger King - Former Economist for U.N. Agencies and Author of ''[[Love and Fatigue in America]]''
*[[Linda Tannenbaum]] - [[Open Medicine Foundation]]
*[[Andreas Kogelnik]], MD, PhD - Open Medicine Institute
*[[David Kaufman]], MD - Open Medicine Institute
*[[Ronald Davis]], PhD - Director, Stanford Genome Technology Research Center and [[Open Medicine Foundation]] Collaborator
*Ashley Davis - Director, Chronic Fatigue Syndrome Research Center at Stanford University
*[[Staci Stevens]], MS - Director, [[Workwell Foundation]]
*[[Christopher Snell]], PhD - Professor of Exercise Science, University of the Pacific, [[Workwell Foundation]]
*[[Mark VanNess]], PhD - Associate Professor of Exercise Science, University of the Pacific, [[Workwell Foundation]]
*[[Daniel Peterson]], MD - Sierra Internal Medicine and [[Simmaron Research]]
*Janet Smith, MD - Simmaron Research Board Member
*Chitra Bhakta, MD - Orange County Integrative Medical Center
*Jane Xenos, D.O. - Independent Physician
*[[Judy Mikovits]], PhD - Microbiologist
*[[Charles Lapp]], MD - Physician, Hunter-Hopkins Center
*[[Nancy Klimas]], MD - Physician, [[Institute for Neuro Immune Medicine]]
*[[Gordon Broderick]], PhD - Computer scientist, [[Institute for Neuro Immune Medicine]]
*Lubov Nathanson, PhD - Research scientist, Genomics
*William Pridgen, MD - Surgeon
*Carol Duffy, PhD - Microbiologist
*[[Jamison Hill]] - Former Bodybuilder with ME/CFS
*[[Toni Bernhard]] - Author, ''How To Be Sick''

== Available DVD and Streaming ==
*[https://www.amazon.com/Forgotten-Plague-Prior-Nicole-Castillo/dp/B01BUOM4HG Amazon]

*Music From The Documentary "Forgotten Plague" By: David Conley available free on [https://www.spotify.com/us/ Spotify].

== Reviews ==
*Oct 2, 2015, [http://www.huffingtonpost.com/bill-johnson-ii/forgotten-plague-a-must-s_b_8230262.html HuffPost Health Forgotten Plague: A Must See Documentary]<ref>{{Cite web|url=https://www.huffingtonpost.com/bill-johnson-ii/forgotten-plague-a-must-s_b_8230262.html|title=Forgotten Plague: A Must See Documentary|last=Johnson III|first=Bill|date=2015-10-02|website=HuffPost|language=en|access-date=2018-08-10|archive-url=|archive-date=|dead-url=}}</ref> [http://www.me-gids.net/module-ME_CVS_docs-viewpub-tid-1-pid-1459.html?utm_source=twitterfeed&utm_medium=twitter&utm_campaign=me-gids-news ME-gids Forgotten Plague: Een documentaire die je gezien moet hebben (Dutch translation)]

== Featured in media reporting ==
* [[Chronic Fatigue: Missing Millions (Carte Blanche DSTV)]]

== Credits ==
Directors:
Nicole Castillo... director
Ryan Prior... (co-director)

Writers:
Ryan Prior

Producers:
Nicole Castillo ... co-producer
Mona Eliassen-Taliaferro... executive producer
Travis Preston ... consulting producer
Ryan Prior ... executive producer / producer
Justin Reilly ... senior producer
Giridhar Subramanian... producer

Music: David Conley

Cinematography: Nicole Castillo

Film Editing: Travis Preston ... editor Annie Laurie Medonis... assistant editor

Sound: Nicole Castillo ... sound mixer Dan Schaefer ... sound editor

Camera and Electrical: Nicole Castillo ... camera operator

Animation: Sam Alkaitis ... animator Zakk Bottomley ... animator

Music: Henry Adams ... musician: cello David Conley ... conductor / music editor / musician: acoustic guitar / musician: keyboards Kathleen Crawford... musician: cello Melissa Loga ... composer: additional music / musician: viola Eric Roper ... music recordist Esther Tonea ... musician: cello<ref>https://www.imdb.com/title/tt4223204/fullcredits?ref_=tt_ql_1</ref>

== The Blue Ribbon Foundation ==
In the spirit of a true grassroots organization, [[The Blue Ribbon Foundation]] started as an idea, which manifested into a documentary (Forgotten Plague), and eventually shaped a movement.

The Blue Ribbon Foundation’s mission is to foster a national public dialogue that can lead to finding the cause, cure, and prevention of neuro-immune diseases.<ref>{{Cite news|url=http://theblueribbonfoundation.org/about-us/|title=About Us|date=2013-11-07|work=The Blue Ribbon Foundation|access-date=2018-08-10|language=en-US}}</ref>

== The Blue Ribbon Fellowship ==
The summer between the first and second years of medical school is sometimes described as the last “free time” medical students have. However, most driven medical students will pursue research fellowships to set themselves up for success in competitive residency programs. We have launched a highly competitive fellowship in neuro-immune medicine for students from across the nation or the world to study with leaders in the field. The goal of [[The Blue Ribbon Fellowship]] is to foster a new generation of physicians devoted to solving complex neuro-immune diseases.<ref>{{Cite news|url=http://theblueribbonfoundation.org/blue-ribbon-fellowship/|title=Blue Ribbon Fellowship|date=2013-11-07|work=The Blue Ribbon Foundation|access-date=2018-08-10|language=en-US}}</ref>

== Online Presence ==
*[https://www.facebook.com/CFSDocumentary Facebook]
*[http://www.forgottenplague.com/ Website]
*[https://www.youtube.com/channel/UCJMJsysciXerH2X8F6rcVgw YouTube]

==See also==
*[[I Remember Me]]
*[[Unrest]]
*[[Voices from the Shadows]]

==Learn more==
*2016, [http://www.thewishdish.com/telling-story-forgotten-plague-chronic-fatigue-syndrome/ Telling the Story of a Forgotten Plague: Chronic Fatigue Syndrome]
== References ==
<references />

[[Category:Film]]

Forgotten Plague

2018-11-10T04:48:01Z

Justin Reilly:credits

[[File:Forgotten Plague.jpeg|400px|thumb|right]]

'''''Forgotten Plague''''' is a documentary film about [[Ryan Prior]], an [[ME/CFS]] patient and journalist and his journey to understand the disease.

== Plot ==
Ryan Prior’s life imploded October 22, 2006, when he was struck down by a disease that dozens of doctors were powerless to diagnose, let alone treat. Against great odds, he becomes a reporter and ventures to tell the story of his suffering and improbable recovery. He is shocked that millions globally remain sidelined by the same disease, many bedridden for decades.

Forgotten Plague is a journey into the hidden world of [[myalgic encephalomyelitis]] ([[chronic fatigue syndrome]]). It is a chilling tale of our medical system’s failures in addressing many chronic, complex diseases. Yet it is also a riveting story of science’s remarkable ability to transform medicine and improve human life itself.<ref>{{Cite web|url=http://www.forgottenplague.com/|title=Forgotten Plague|last=|first=|date=|website=|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-10}}</ref>

'''IMDB Page:''' An afflicted journalist embarks on a quest to find out why the [[CDC]] and medical system have neglected his disease and left millions sidelined from life. <ref>{{Cite web|url=http://www.imdb.com/title/tt4223204/|title=Forgotten Plague|last=Prior|first=Ryan|last2=Castillo|first2=Nicole|date=2015|website=IMDB|archive-url=|archive-date=|dead-url=|access-date=}}</ref>

==Interviews in documentary==
*[[David Tuller]] - New York Times, UC Berkeley
*[[Ian Lipkin]], MD - Columbia University
*[[Jose Montoya]], MD - Stanford University
*[[Anthony Komaroff]], MD - Harvard University
*[[Michael VanElzakker]], PhD - Tufts University
*[[Leonard Jason]], PhD - DePaul University
*Lori Chapo-Kroger, RN - Pandora Org
*[[Derek Enlander]], MD - Mt. Sinai Hospital
*[[Hillary Johnson]] - Author of ''[[Osler's Web]]: Inside the Labyrinth of Chronic Fatigue Syndrome''
*Roger King - Former Economist for U.N. Agencies and Author of ''[[Love and Fatigue in America]]''
*[[Linda Tannenbaum]] - [[Open Medicine Foundation]]
*[[Andreas Kogelnik]], MD, PhD - Open Medicine Institute
*[[David Kaufman]], MD - Open Medicine Institute
*[[Ronald Davis]], PhD - Director, Stanford Genome Technology Research Center and [[Open Medicine Foundation]] Collaborator
*Ashley Davis - Director, Chronic Fatigue Syndrome Research Center at Stanford University
*[[Staci Stevens]], MS - Director, [[Workwell Foundation]]
*[[Christopher Snell]], PhD - Professor of Exercise Science, University of the Pacific, [[Workwell Foundation]]
*[[Mark VanNess]], PhD - Associate Professor of Exercise Science, University of the Pacific, [[Workwell Foundation]]
*[[Daniel Peterson]], MD - Sierra Internal Medicine and [[Simmaron Research]]
*Janet Smith, MD - Simmaron Research Board Member
*Chitra Bhakta, MD - Orange County Integrative Medical Center
*Jane Xenos, D.O. - Independent Physician
*[[Judy Mikovits]], PhD - Microbiologist
*[[Charles Lapp]], MD - Physician, Hunter-Hopkins Center
*[[Nancy Klimas]], MD - Physician, [[Institute for Neuro Immune Medicine]]
*[[Gordon Broderick]], PhD - Computer scientist, [[Institute for Neuro Immune Medicine]]
*Lubov Nathanson, PhD - Research scientist, Genomics
*William Pridgen, MD - Surgeon
*Carol Duffy, PhD - Microbiologist
*[[Jamison Hill]] - Former Bodybuilder with ME/CFS
*[[Toni Bernhard]] - Author, ''How To Be Sick''

== Available DVD and Streaming ==
*[https://www.amazon.com/Forgotten-Plague-Prior-Nicole-Castillo/dp/B01BUOM4HG Amazon]

*Music From The Documentary "Forgotten Plague" By: David Conley available free on [https://www.spotify.com/us/ Spotify].

== Reviews ==
*Oct 2, 2015, [http://www.huffingtonpost.com/bill-johnson-ii/forgotten-plague-a-must-s_b_8230262.html HuffPost Health Forgotten Plague: A Must See Documentary]<ref>{{Cite web|url=https://www.huffingtonpost.com/bill-johnson-ii/forgotten-plague-a-must-s_b_8230262.html|title=Forgotten Plague: A Must See Documentary|last=Johnson III|first=Bill|date=2015-10-02|website=HuffPost|language=en|access-date=2018-08-10|archive-url=|archive-date=|dead-url=}}</ref> [http://www.me-gids.net/module-ME_CVS_docs-viewpub-tid-1-pid-1459.html?utm_source=twitterfeed&utm_medium=twitter&utm_campaign=me-gids-news ME-gids Forgotten Plague: Een documentaire die je gezien moet hebben (Dutch translation)]

== Featured in media reporting ==
* [[Chronic Fatigue: Missing Millions (Carte Blanche DSTV)]]

== Credits ==
Directors:
Nicole Castillo... director
Ryan Prior... (co-director)

Writers:
Ryan Prior

Producers: Nicole Castillo ... co-producer Mona Eliassen-Taliaferro... executive producer Travis Preston ... consulting producer Ryan Prior ... executive producer / producer Justin Reilly ... senior producer Giridhar Subramanian... producer

Music: David Conley

Cinematography: Nicole Castillo

Film Editing: Travis Preston ... editor Annie Laurie Medonis... assistant editor

Sound: Nicole Castillo ... sound mixer Dan Schaefer ... sound editor

Camera and Electrical: Nicole Castillo ... camera operator

Animation: Sam Alkaitis ... animator Zakk Bottomley ... animator

Music: Henry Adams ... musician: cello David Conley ... conductor / music editor / musician: acoustic guitar / musician: keyboards Kathleen Crawford... musician: cello Melissa Loga ... composer: additional music / musician: viola Eric Roper ... music recordist Esther Tonea ... musician: cello

== The Blue Ribbon Foundation ==
In the spirit of a true grassroots organization, [[The Blue Ribbon Foundation]] started as an idea, which manifested into a documentary (Forgotten Plague), and eventually shaped a movement.

The Blue Ribbon Foundation’s mission is to foster a national public dialogue that can lead to finding the cause, cure, and prevention of neuro-immune diseases.<ref>{{Cite news|url=http://theblueribbonfoundation.org/about-us/|title=About Us|date=2013-11-07|work=The Blue Ribbon Foundation|access-date=2018-08-10|language=en-US}}</ref>

== The Blue Ribbon Fellowship ==
The summer between the first and second years of medical school is sometimes described as the last “free time” medical students have. However, most driven medical students will pursue research fellowships to set themselves up for success in competitive residency programs. We have launched a highly competitive fellowship in neuro-immune medicine for students from across the nation or the world to study with leaders in the field. The goal of [[The Blue Ribbon Fellowship]] is to foster a new generation of physicians devoted to solving complex neuro-immune diseases.<ref>{{Cite news|url=http://theblueribbonfoundation.org/blue-ribbon-fellowship/|title=Blue Ribbon Fellowship|date=2013-11-07|work=The Blue Ribbon Foundation|access-date=2018-08-10|language=en-US}}</ref>

== Online Presence ==
*[https://www.facebook.com/CFSDocumentary Facebook]
*[http://www.forgottenplague.com/ Website]
*[https://www.youtube.com/channel/UCJMJsysciXerH2X8F6rcVgw YouTube]

==See also==
*[[I Remember Me]]
*[[Unrest]]
*[[Voices from the Shadows]]

==Learn more==
*2016, [http://www.thewishdish.com/telling-story-forgotten-plague-chronic-fatigue-syndrome/ Telling the Story of a Forgotten Plague: Chronic Fatigue Syndrome]
== References ==
<references />

[[Category:Film]]

Individual quotes

2018-11-10T04:19:27Z

Justin Reilly:/* Patients and advocates */ add quote

== Researchers, scientists, doctors and professors ==

=== Good ===
*“I’m shocked that [[The Lancet]] published it…The [[PACE trial|PACE]] study has so many flaws and there are so many questions you’d want to ask about it that I don’t understand how it got through any kind of peer review.” He added, “Maybe The Lancet picked reviewers who agreed with the authors and raved about the paper, and the journal went along without digging into the details.”<ref>[http://www.meaction.net/2015/10/24/investigate-journalist-exposes-pace-trial/ #MEAction - Investigative Journalist Exposes PACE Trial - Ronald Davis]</ref> ~ Dr. [[Ronald Davis]]

*"I have a wish and a dream that medical & research societies in US apologise to [[ME/CFS]] patients"<ref>[https://voat.co/v/CFS/comments/584997 Dr. Montoya of the ME/CFS Initiative, Stanford: "I have a wish and a dream that medical & research societies in US apologise to MECFS patients" - CMRC 2015 Dr. Montoya - 2015]</ref> ~ Dr. [[Jose Montoya]]

*“PACE really attracts my attention because it’s so goddamned bad. It’s bad in its conduct, it’s bad in its reporting, and it’s fascinating that it’s going unchallenged. And it’s uncritically being passed on by journalists and the media with clear harm to patients.”<ref>[http://phoenixrising.me/archives/27787 James Coyne “lays waste” to PACE trial in Edinburgh - Phoenix Rising]</ref> ~ Professor [[James Coyne]]

*"Less than half the doctors in this country know the name of this illness. I don't know another illness like that.'<ref>[https://www.youtube.com/watch?v=4J5CRGPvgl4 Canary in a Coal Mine You Tube 00:05]</ref> ~ Dr. [[Nancy Klimas]]

*"Input from the patients is absolutely critical for any disease that you want to study."<ref>[http://www.meaction.net/2016/02/16/transcripts-and-slides-from-dr-naths-talk-on-nih-study/ Transcripts and Slides from Dr Nath’s talk on NIH study - #MEAction - CDC Grand Rounds Dr. Avindra Nath - 2/16/16]</ref> ~ Dr. [[Avindra Nath]]

*"This illness is wicked."<ref>[https://www.youtube.com/watch?v=Qxb356oX6cI This illness is wicked - ME - Youtube 1:19 - Nancy Klimas]</ref> ~ Dr. [[Nancy Klimas]]

*"The germ is nothing; the terrain is everything."<ref>[https://twitter.com/MBVanElzakker/status/453540676635201536 "The germ is nothing; the terrain is everything."]</ref> ~ [[Michael VanElzakker]] quoting Louis Pasteur in reference to the [[Vagus nerve infection hypothesis]]

*"Fatigue is not a disease, and it's not even a symptom. Fatigue is an alarm system." @6:02<ref>[https://www.youtube.com/watch?v=wJB95m4FLa0 "Fatigue is not a disease, and its not even a symptom. Fatigue is an alarm system." @6:02]</ref> ~ Dr. [[Jarred Younger]]

*"There is nothing that you hold dear that this illness cannot take from you. Nothing."<ref>[http://www.njmecfsa.org/2010/02/13/skeptical-of-skeptics/ "There is nothing that you hold dear that this illness cannot take from you. Nothing."]</ref> ~ Thomas L. English, MD

*"Given what we have learned in the past eight years about this illness, it is intellectually embarrassing to suggest that ME is a psychological illness."<ref>[http://niceguidelines.blogspot.co.uk/2015/01/exercise-physiologist-prof-kellerit-is.html "Given what we have learned in the past eight years about this illness, it is intellectually embarrassing to suggest that ME is a psychological illness."]</ref> ~ [[Betsy Keller]], PhD

*"Because the complaints of patients were so many and often seemingly bizarre, I often attempted to disclaim them as being real. But I learned that you patients were always right and I was always wrong. In studying this disease, one must always have an open mind. This disease teaches the physician to be humble."<ref>[http://www.oocities.org/sezar99q/MECFSInfectiousVenulitis.html "Because the complaints of patients were so many and often seemingly bizarre, I often attempted to disclaim them as being real. But I learned that you patients were always right and I was always wrong. In studying this disease, one must always have an open mind. This disease teaches the physician to be humble."]</ref> ~ Dr. Erich Ryll

*"Ultimately the best way to prevent suicide in ME/CFS will be to find effective disease-modifying treatments or cures for it." <ref>[http://wames.org.uk/cms-english/2016/05/chu-says-suicide-in-mecfs-not-always-linked-to-depression-and-anxiety/ "Ultimately the best way to prevent suicide in ME/CFS will be to find effective disease-modifying treatments or cures for it."]</ref> ~ Dr. [[Lily Chu]]

*“(CFS patients) feel effectively the same every day as an AIDS patient feels two months before death; the only difference is that the symptoms can go on for never-ending decades.” ~ Prof. Mark Loveless, Head of the AIDS and ME/CFS Clinic at Oregon Health Sciences University<ref>[http://www.whitneydafoe.com/news/ “(CFS patients) feel effectively the same every day as an AIDS patient feels two months before death; the only difference is that the symptoms can go on for never-ending decades.”]</ref>

*"My H.I.V. patients for the most part are healthy and hearty thanks to three decades of intense and excellent research and billions of dollars invested. Many of my C.F.S. patients, on the other hand, are terribly ill and unable to work or care for their families. I split my clinical time between the two illnesses [AIDS and CFS], and I can tell you if I had to choose between the two illnesses (in 2009) I would rather have H.I.V. But C.F.S., which impacts a million (to 4 million) people in the United States alone, has had a small fraction of the research dollars directed towards it.” ~ Dr. [[Nancy Klimas]], AIDS and CFS researcher and clinician, University of Miami<ref>[http://www.whitneydafoe.com/news/ “My H.I.V. patients for the most part are healthy and hearty thanks to three decades of intense and excellent research and billions of dollars invested. Many of my C.F.S. patients, on the other hand, are terribly ill and unable to work or care for their families. I split my clinical time between the two illnesses (AIDS and CFS), and I can tell you if I had to choose between the two illnesses (in 2009) I would rather have H.I.V. But C.F.S., which impacts a million (to 4 million) people in the United States alone, has had a small fraction of the research dollars directed towards it.”]</ref>

*"Subjective measures of sick people before & after they are repeatedly told, "You're not sick" is a social psych study, not a clinical trial."<ref>[https://twitter.com/postersandme/status/766265142795526144/photo/1 "Subjective measures of sick people before & after they are repeatedly told, "You're not sick" is a social psych study, not a clinical trial."]</ref> ~ [[Michael VanElzakker]]

*"What #PACEtrial called "CBT" is not normal CBT. Cancer patients see CBT therapists all the time and are not told, 'you're not really sick.'"<ref>[https://twitter.com/MBVanElzakker/status/765678606425198592 "What #PACEtrial called "CBT" is not normal CBT. Cancer patients see CBT therapists all the time and are not told, 'you're not really sick.'"]</ref> ~ Michael VanElzakker

=== Bad ===
*"I have previously made it clear that I think that PACE was a good trial; I once described it as a thing of beauty."<ref>[http://andrewgelman.com/2016/01/13/pro-pace/ Pro-PACE, anti-PACE - Statistical Modeling, Causal Inference, and Social Science]</ref> ~ Professor [[Simon Wessely]]

*"And so when you find people with thing like [[fibromyalgia]], you’re either going to be sick, bad, or weak – and the idea is really to find a fourth way – to realize that these atypical things are just a range of normal, that you’re not sick, bad, or weak, that you’re just dealing with the difficulties of just being a human."<ref>[http://www.meaction.net/2016/02/20/nih-lead-clinical-investigator-thinks-cfs-is-psychosomatic/ #MEAction Transcript - Video Interview with Dr. Brian Walitt]</ref> ~ Dr. [[Brian Walitt]]

*"If [ME/CFS] is all in your head, it's only because your head is part of your body."<ref>[http://www.medpagetoday.com/Neurology/GeneralNeurology/56772 NIH Gears Up for First-Ever Chronic Fatigue Study Patients' advocates share concerns about trial protocol, bias MedPage Today - The Gupta Guide - Shannon Firth]</ref> ~ Dr. [[Brian Walitt]]

=== Ugly ===

== Journalists and media ==

=== Good ===
*"I stopped somewhere just beyond 14,000 words — I mean, enough was enough. But, amazingly, I still hadn’t covered everything that had gone wrong in the PACE trial."<ref>[http://alumni.berkeley.edu/california-magazine/just-in/2015-11-30/reporter-excoriates-chronic-fatigue-syndrome-study-i-stopped Reporter Excoriates Chronic Fatigue Syndrome Study: I Stopped at 14,000 Words-Enough Was Enough - California Magazine -] [[David Tuller]] 11/18/2015</ref> ~ [[David Tuller]]

*2013, "I am a reporter and my beat is hell ... It is the hell of those who live with a disease that is incurable, has inadequate therapies, indifferent government attitudes, social stigma and no strong public voice…" ~ [[Llewellyn King]]<ref>http://voicesfromtheshadowsfilm.co.uk/2013/llewellyn-king-article-chronic-fatigue-syndrome-hidden-in-plain-sight/</ref>

=== Bad ===
*"There’s no easy fix for [[fibromyalgia]], a problem that seems to lurk in the gap between mind and body." ~ ''Family Practice News'' (On Dr. [[Brian Walitt]])<ref>[http://www.familypracticenews.com/specialty-focus/rheumatology/single-article-page/video-fibromyalgia-doesnt-fit-the-disease-model/e913134880916685f3005dac5459ab88.html Family Practice News on Dr. Brian Walitt 9/30/15]</ref>

=== Ugly ===
*“It was written up in [https://en.wikipedia.org/wiki/Rolling_Stone Rolling Stone] magazine and labeled the ‘[[Yuppie Flu]].’”<ref>[http://www.managedcaremag.com/archives/2010/10/chronic-fatigue-syndrome-poses-management-challenge Managed Care - William Atkinson - October 2010]</ref> ~ William Atkinson

== Celebrity patients ==
*“Fatigue is what we experience, but it is what a match is to an atomic bomb.”<ref>[http://scopeblog.stanford.edu/2014/10/22/unbroken-a-chronic-fatigue-patients-long-road-to-recovery/ SCOPE - Stanford Medicine -] [[Laura Hillenbrand]] - 10/22/14</ref> ~ [[Laura Hillenbrand]]

*"best of luck everyone, and keep up the good work "[[Invest in ME]]". it's a long hard struggle, but keep putting the boot in, and i'm sure that one day ME will get the recognition and the remedies that we so desperately desire. can't help thinking that in 50 years people will look back on these days as the ME dark ages. let's get into the light!"<ref>[http://ldifme.org/guestbook/#comment-2353540593 LDIFME - Awareness > Message from Stuart Murdoch - 11/11/2015]</ref> ~ [[Stuart Murdoch]]

*"I disappeared entirely and no one knew why. Among the people who hadn't a clue was me."<ref>[https://www.youtube.com/watch?v=IW11Je8pm20 Canary in a Coal Mine Preview - ME (CFS) 2:17]</ref> ~ [[Howard Bloom]]

== Patients and advocates ==
*"DYING"<ref>[https://www.facebook.com/cfsresearchcenter/photos/a.847535005318290.1073741828.630143697057423/973567226048400/?type=3&theater Chronic Fatigue Syndrome Research Center at Stanford University - Face Book - Whitney Dafoe - 12/29/2015]</ref> ~ [[Whitney Dafoe]]

*“You wake up one day with a bad flu and it never goes away. Ever.”<ref>TheAtlantic.com "Quoted: the best quotes we heard from our sources today," October, 8, 2015 [https://www.theatlantic.com/notes/2015/10/quoted-on-100815/409795/]</ref> ~ Justin Reilly (TheAtlantic.com quote of the day, 10/8/2015)

*"To conclude that activity avoidance causes fatigue (rather than fatigue being a direct cause of activity avoidance), is similar to concluding that a person has flu because they’ve taken a day off work, rather than the obvious conclusion that they’ve taken a day off work because they have flu."<ref>[https://pubpeer.com/publications/2A1DECF372E891487C3435A1677042 PubPeer Comment - Robert Courtney - 2/16/16]</ref> ~ [[Robert Courtney]]

*A Twitter Rant ~ [https://twitter.com/2lisaland/status/658264477192888321 @2lisaland] - "I think it's such a shame when disabled people feel uncomfortable using aids when healthy ppl buy any gadget that makes life easier for them"<ref>[https://twitter.com/2lisaland/status/658264477192888321 A Twitter Rant @2lisaland]</ref> ~ Lisa England

*"Think of Madoff or Enron in charge of a disease." #PACEtrial #CDC30YRS #MEclinics #OutcomeSwitching #CheaperThanResearch #FollowTheMoney<ref>[https://twitter.com/FibroMEcfs/status/699813469491605504 Twitter - @FibroMEcfs]</ref> ~ Fibro '73 ME/CFS '79

*"Eventually I received a diagnosis of 'chronic fatigue syndrome,' a name that feels insulting when your entire life has been stolen from you."<ref>[http://www.thewishdish.com/telling-story-forgotten-plague-chronic-fatigue-syndrome/ Telling the Story of a Forgotten Plague: Chronic Fatigue Syndrome - Wish Dish - Ryan Prior]</ref> ~ [[Ryan Prior]]

*"When the check came I couldn't sign my name...My brain was burning."<ref>[https://www.youtube.com/watch?v=IW11Je8pm20 Canary in a Coal Mine Preview - ME (CFS) - You Tube 2:09 - 2:15 Jen Brea]</ref> ~ [[Jennifer Brea]]

*“Jay Levy saw ten women," the doctor later recalled, "And he thought they were all hysterical. Then he saw a man, whose complaints he took seriously.”<ref>[https://www.goodreads.com/work/quotes/1139201-osler-s-web-inside-the-labyrinth-of-the-chronic-fatigue-syndrome-epidem Hillary Johnson from Osler's Web]</ref> ~ [[Hillary Johnson]] from [[Osler's Web]]

*When he ([[Brian Walitt]]) says that [[fibromyalgia]] is real to patients, he, of course, means it’s not real to him.<ref>[http://thoughtsaboutme.com/2016/02/21/brian-walitts-radical-bias-disorders-of-subjective-perception-mecfs-as-normal-life-experience/#comment-21873 Brian Walitt’s Radical Bias: Disorders of Subjective Perception, ME/CFS as Normal Life Experience? - J. K. Burmeister 2/21/16]</ref> ~ [[Jeannette Burmeister]]

*"For most patients [[CFS]] isn't a diagnosis, it's an accusation."<ref>[https://twitter.com/fabrahamwriter/status/701156441323917312 For most patients CFS isn't a diagnosis, it's an accusation - ~ @fabrahamwriter]</ref> ~ [https://twitter.com/fabrahamwriter @fabrahamwriter]

*"It’s the utter cluelessness about who we are that is disturbing." (About [[NIH Post-Infectious ME/CFS Study]])<ref>[http://www.meaction.net/2016/03/04/meactions-questions-for-nihs-intramural-study-team/ #MEAction’s Questions for NIH’s Intramural Study Team - Comments - Mary Schweitzer]</ref> ~ [[Mary Schweitzer]]

*"I don't think anyone apart from #spoonies understands how horrific it is to be stuck in this middle ground, ambitious but not capable."<ref>[https://twitter.com/mindandthemagic/status/719890035286388736 "I don't think anyone apart from #spoonies understands how horrific it is to be stuck in this middle ground, ambitious but not capable."]</ref> ~ [https://twitter.com/mindandthemagic/status/719890035286388736 @mindandthemagic]

*"Telling someone w/ME you know how they feel bc you get tired is like telling someone w/cancer you know how they feel bc you stubbed your toe"<ref>[https://twitter.com/SKWixey/status/723897594238349313 Telling someone w/ME you know how they feel bc you get tired is like telling someone w/cancer you know how they feel bc you stubbed your toe]</ref> ~ [https://twitter.com/SKWixey @SKWixey]

*“Psychiatry has become the place where we shunt illnesses that we don’t yet understand.”<ref>[http://www.meaction.net/2016/07/04/jen-brea-gives-rallying-ted-talk/ Jen Brea @ TedSummit - MEAction]</ref> ~ [[Jennifer Brea]]

*"Will @Lancetpsychiatry PACE proved to be #MECFS Stonewall?"<ref>https://twitter.com/coyneoftherealm/status/661318252312694784</ref> ~ Dr. [[James Coyne]]

*"Instead of working to relieve patients of the burden of M.E, British medicine is working to relieve itself of the burden of M.E patients."<ref>[https://justpaste.it/10ksr Instead of working to relieve patients of the burden of M.E, British medicine is working to relieve itself of the burden of M.E patients.]</ref> ~ @batteredoldbook

== Advocacy organizations ==

== Government: Representatives and organizations ==

=== Good ===
*“Although I have heard of Chronic Fatigue Syndrome, I don’t have any expertise in it. … What I promise I will do when I get back is I will have the [[National Institutes of Health]] explain to me what they are doing, and to see if they can do more on this particular issue.”<ref>[http://sacfs.asn.au/news/2012/11/11_01_opinion_moving_forward_on_cfs.htm President Obama Response to Courtney Miller - 4/21/2011]</ref><ref>[https://www.youtube.com/watch?v=VsQcmKT3zSo Forgotten Plague Trailer #1 - Youtube 00:47]</ref> ~ President [https://en.wikipedia.org/wiki/Barack_Obama Barack Obama]

*"Health bureaucrats just sharply revised down estimates of how much research funding goes into trying to understand [[Myalgic Encephalomyelitis]] / [[Chronic Fatigue Syndrome]] ([[ME/CFS]]). They then clarified that there is no other Commonwealth support out there, either for people dealing with this condition, or for GPs. It is time this changed."<ref>[http://sacfs.asn.au/news/2016/02/02_12_senator_scott_ludlum_on_mecfs_research_funding_in_australia.htm SACFS - Senator Scott Ludlam 2/10/16]</ref> ~ Senator [[Scott Ludlam]]

*"I think that we have not cared for people with ME to a great enough extent. I think it is correct to say that we have not established proper health care services for these people, and I regret that."<ref>http://www.euro-me.org/news-Q42011-003.htm</ref> ~ Bjørn Guldvog, Deputy Director General of the Norwegian Directorate of Health

=== Bad ===

=== Ugly ===

== Others and anonymous ==
=== Good ===
*'"Recovery"... required ludicrously far-fetched imputations.'<ref>[https://docs.google.com/document/d/1C5Gk1kVacIeg41BfFO7xcNDEhr4W6L8ocuchnIh_wL4/edit?pref=2&pli=1 The PACE Trial, making up Recovery to suit themselves - Peter Kemp -2/17/16]</ref> ~ [[Peter Kemp]], MA

=== Bad ===

=== Ugly ===

== See also ==
[[List of Quotes]]

== References ==

[[Category:Quotations]]
<references />

Leila Pahlavi

2018-11-10T02:48:11Z

Justin Reilly:/* Illness */

'''Princess Leila Pahlavi''' (March 1970 - 10 June 2001) was the youngest daughter of Mohammad Reza Pahlavi, Shah of Iran, and his third wife, Farah Pahlavi. She reportedly lived with [[myalgic encephalomyelitis]] along with [[anorexia nervosa]] and [[depression]].

==Illness==
It is not clear when exactly Pahlavi was diagnosed with [[ME]], although by her late twenties she had begun to complain to her friends of [[headache]]s, [[muscle pain]], [[joint pain]], and [[Chronic fatigue (symptom)|chronic fatigue]].<ref name="guardian" /> She concurrently suffered from [[anorexia nervosa]] and [[depression]].<ref name="people" /> Her body became weakened as a result of her anorexia, bulimia,<ref>{{citation|url=http://www.telegraph.co.uk/news/uknews/1335290/Shahs-daughter-stole-to-fuel-her-drug-habit.html|title=Shah's daughter stole to fuel her drug habit|publisher=Telegraph.co.uk|last=Tweedie|first=Neil|date=2001-07-26|accessdate=2016-11-06}}</ref> severe [[stomachache]]s<ref name="guardian" /> and various [[food intolerances]].<ref name="people" /> Although her death at age 31 was initially attributed to [[myalgic encephalomyelitis]],<ref>''(2001-06-12), [http://articles.latimes.com/2001/jun/12/local/me-9491 Obituaries, Leila Pahlavi; Deposed Shah's Daughter], LA Times, retrived 2016-11-06''</ref> her autopsy revealed that she had overdosed on [[seconal]], a highly addictive drug she was prescribed to treat her chronic [[insomnia]]. Traces of cocaine were also found in her system.<ref name="guardian" />

Her father died of Non-Hodgkins Lymphoma, which has been associated with ME.

==Learn more==
*[https://en.wikipedia.org/wiki/Leila_Pahlavi Wikipedia - Leila Pahlavi]

==References==
<references>
<ref name="guardian">{{citation|url=https://www.theguardian.com/theobserver/2001/oct/14/features.magazine47|title= Death of a princess|publisher=theguardian.co.uk|last=Burke|first=Jason|date=2001-10-14|accessdate=2016-11-06}}</ref>
<ref name="people">{{citation|url=http://people.com/archive/burden-of-grief-vol-56-no-3/|title=Burden of Grief|publisher=people.com|last=Hewitt|first=Bill|date=2001-07-16|accessdate=2016-11-06}}</ref>
</references>

[[Category:Famous people with ME, CFS, and/or FMS]]
[[Category:Iranian famous people with ME, CFS, and/or FMS]]

Leila Pahlavi

2018-11-10T02:47:23Z

Justin Reilly:/* Illness */ father's illness

'''Princess Leila Pahlavi''' (March 1970 - 10 June 2001) was the youngest daughter of Mohammad Reza Pahlavi, Shah of Iran, and his third wife, Farah Pahlavi. She reportedly lived with [[myalgic encephalomyelitis]] along with [[anorexia nervosa]] and [[depression]].

==Illness==
It is not clear when exactly Pahlavi was diagnosed with [[ME]], although by her late twenties she had begun to complain to her friends of [[headache]]s, [[muscle pain]], [[joint pain]], and [[Chronic fatigue (symptom)|chronic fatigue]].<ref name="guardian" /> She concurrently suffered from [[anorexia nervosa]] and [[depression]].<ref name="people" /> Her body became weakened as a result of her anorexia, bulimia,<ref>{{citation|url=http://www.telegraph.co.uk/news/uknews/1335290/Shahs-daughter-stole-to-fuel-her-drug-habit.html|title=Shah's daughter stole to fuel her drug habit|publisher=Telegraph.co.uk|last=Tweedie|first=Neil|date=2001-07-26|accessdate=2016-11-06}}</ref> severe [[stomachache]]s<ref name="guardian" /> and various [[food intolerances]].<ref name="people" /> Although her death at age 31 was initially attributed to [[myalgic encephalomyelitis]],<ref>''(2001-06-12), [http://articles.latimes.com/2001/jun/12/local/me-9491 Obituaries, Leila Pahlavi; Deposed Shah's Daughter], LA Times, retrived 2016-11-06''</ref> her autopsy revealed that she had overdosed on [[seconal]], a highly addictive drug she was prescribed to treat her chronic [[insomnia]]. Traces of cocaine were also found in her system.<ref name="guardian" />

Her father, the Shah of Iran, died of Non-Hodgkins Lymphoma, which has been associated with ME.

==Learn more==
*[https://en.wikipedia.org/wiki/Leila_Pahlavi Wikipedia - Leila Pahlavi]

==References==
<references>
<ref name="guardian">{{citation|url=https://www.theguardian.com/theobserver/2001/oct/14/features.magazine47|title= Death of a princess|publisher=theguardian.co.uk|last=Burke|first=Jason|date=2001-10-14|accessdate=2016-11-06}}</ref>
<ref name="people">{{citation|url=http://people.com/archive/burden-of-grief-vol-56-no-3/|title=Burden of Grief|publisher=people.com|last=Hewitt|first=Bill|date=2001-07-16|accessdate=2016-11-06}}</ref>
</references>

[[Category:Famous people with ME, CFS, and/or FMS]]
[[Category:Iranian famous people with ME, CFS, and/or FMS]]