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Epidemiology of myalgic encephalomyelitis and chronic fatigue syndrome
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== <span id="riskfactors">Risk factors </span>== === Genetics === {{Main article| page_name = Genetics of chronic fatigue syndrome}} Five percent of children of mothers with ME/CFS later developed the illness.<ref name="Underhill2010">{{Cite web | url=http://www.njcfsa.org/wp-content/uploads/2010/09/Pregnancy-in-Women-with-ME-CFS.pdf | title=Pregnancy in Women with Chronic Fatigue Syndrome (ME/CFS) | last = Underhill | first = Rosemary | authorlink = Rosemary Underhill | date = 2009 | website = New Jersey Chronic Fatigue Syndrome Association, Inc.|archive-url=|archive-date=|access-date=4 February 2020}}</ref> === Infection === [[Infection]]s are a risk factor for the development of ME/CFS.<ref name="CDC-Etiology">{{Cite web | url=https://www.cdc.gov/me-cfs/healthcare-providers/presentation-clinical-course/etiology-pathophysiology.html | title = Etiology and Pathophysiology {{!}} Presentation and Clinical Course {{!}} Healthcare Providers {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | date = 2018-11-08 | website = [[Centers for Disease Control and Prevention]]|language=en-us|access-date=2019-01-31}}</ref> The vast majority of people diagnosed with ME/CFS report that their illness began after a virus or other infection, especially [[Epstein-Barr virus]], [[Ross River virus]] and [[Q fever]].<ref name="CDC-causes-2018" /><ref name="Chu2019">{{Cite journal | last = Chu | first = Lily | author-link = Lily Chu | last2 = Valencia | first2 = Ian J. | authorlink2 = Ian Valencia | last3 = Garvert | first3 = Donn W. | author-link3 = Donn Garvert | last4 = Montoya | first4 = Jose G. | author-link4 = Jose Montoya | date = Feb 5, 2019 | title = Onset Patterns and Course of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | url =https://www.frontiersin.org/articles/10.3389/fped.2019.00012/abstract|journal=Frontiers in Pediatrics|volume=7|issue=12 | pages = |doi=10.3389/fped.2019.00012|quote=|via=}}</ref> One study found recurrent infections since the onset of ME/CFS increased the risk of more severe post-exertional malaise.<ref name="Ghali2020" /> === Bodily response to physical or emotional stress === An accident, physical [[trauma]], [[Guide for patients having surgery|anesthetics]], or significant emotional [[stress]] have been reported by some patients prior to onset of symptoms.<ref name="CDC-Etiology" /> According to the CDC, this may cause a physical response by affecting body chemistry including the [[HPA axis]], levels of [[CRH|corticotrophin-releasing hormone]] (CRH), the stress hormone [[cortisol]] and others.<ref name="CDC-causes-2018">{{Cite web | url=https://www.cdc.gov/me-cfs/about/possible-causes.html | title = Possible Causes {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) {{!}} CDC | last = Centers for Disease Control | first = | authorlink = Centers for Disease Control and Prevention | date = 2019-05-15 | website = [[Centers for Disease Control and Prevention]]|language=en-us|archive-url=|archive-date=|access-date=2020-05-24}}</ref> === Environmental factors === [[Mold]] or toxin exposure is an expected trigger although specific environmental factors with ME/CFS have not been established.<ref name="CDC-Etiology" /><ref name="ICP2011primer" />{{Rp|1-2}}
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