Elizabeth Unger

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Elizabeth (Beth) R. Unger, MD, PhD, is the Chief of the Chronic Viral Disease Branch (CVDB), Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases at the Centers for Disease Control and Prevention (CDC), Atlanta, Georgia. chronic fatigue syndrome (CFS) research falls under her department. She has worked at the CDC since 1997 and replaced Dr. William Reeves as Chief of CVDB in 2010.[1] Dr. Unger has done extensive research at the CDC on the human papillomavirus (HPV).

In 2002-2003, Dr Unger was on the team that tested the validity of 1994 CDC case definition of CFS, known as the empirical definition or Fukuda criteria, via the Wichita Clinical Study. The study, according to the CDC, "identifies persons with CFS in a precise manner that can be readily reproduced by both investigators and clinicians."[2][3] Many researchers continued to use the Fukuda criteria for research.

Chronic Fatigue Syndrome Advisory Committee[edit | edit source]

Dr. Unger has represented the Centers for Disease Control and Prevention (CDC) on the Chronic Fatigue Syndrome Advisory Committee (CFSAC), for the U.S. Department of Health and Human Services as an Ex Officio Member.

Education[edit | edit source]

Dr. Unger received an undergraduate degree in chemistry at Lebanon Valley College, Annville, PA and her PhD and MD in the Division of Biologic Sciences at the University of Chicago. Her residency and fellowship was completed at Pennsylvania State University Medical Center.[1]

Awards[edit | edit source]

Notable publications related to ME/CFS[edit | edit source]

  • 2003, Prevalence and Incidence of Chronic Fatigue Syndrome in Wichita, Kansas - (Full Text)
  • 2003, Identification of ambiguities in the 1994 chronic fatigue syndrome research case definition and recommendations for resolution[4] - (Full Text)
  • 2004, Factor analysis of symptoms among subjects with unexplained chronic fatigue: what can we learn about chronic fatigue syndrome?[5] - (Abstract)
  • 2005, Chronic Fatigue Syndrome – A clinically empirical approach to its definition and study.[3]
  • 2005, Psychometric properties of the CDC Symptom Inventory for assessment of Chronic Fatigue Syndrome[6] - (Full Text)
  • 2006, Sleep characteristics of persons with chronic fatigue syndrome and non-fatigued controls: results from a population-based study[7] - (Full Text)
  • 2007, Perception versus polysomnographic assessment of sleep in CFS and non-fatigued control subjects: results from a population-based study[8] - (Full Text)
  • 2009, An evaluation of exclusionary medical/psychiatric conditions in the definition of chronic fatigue syndrome[9] - (Full Text)
  • 2012, Minimum data elements for research reports on CFS[10] - (Full text)
  • 2013, Acute psychosocial stress-mediated changes in the expression and methylation of perforin in chronic fatigue syndrome[11] - (Full Text)
  • 2014, Chronic Fatigue Syndrome: The Current Status and Future Potentials of Emerging Biomarkers[12] - (Full Text)
  • 2014, Decreased basal ganglia activation in subjects with chronic fatigue syndrome: association with symptoms of fatigue[13] - (Full Text)
  • 2015, Pathway-focused genetic evaluation of immune and inflammation related genes with chronic fatigue syndrome[14] - (Full Text)
  • 2015, Early menopause and other gynecologic risk indicators for chronic fatigue syndrome in women[15] - (Full Text)
  • 2016, Telomere Length Analysis in Chronic Fatigue Syndrome[16] - (Full Text)
  • 2016, CDC Grand Rounds: Chronic Fatigue Syndrome — Advancing Research and Clinical Education. Morbidity and Mortality Weekly Report[17] - (Full Text)
  • 2016, CDC Multi-site Clinical Assessment of CFS
  • 2016, Methods of applying the 1994 case definition of chronic fatigue syndrome - impact on classification and observed illness characteristics - (Full Text)
  • 2017, Multi-Site Clinical Assessment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (MCAM): Design and Implementation of a Prospective/Retrospective Rolling Cohort Study[18] - (Full Text)
  • 2018, A Common Language for Clinical Research Studies: The National Institute of Neurological Disorders and Stroke (NINDS) and Centers for Disease Control and Prevention (CDC) Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Common Data Elements (CDEs)[19] - (Abstract)
  • 2019, Assessment of ME/CFS (Myalgic Encephalomyelitis/Chronic Fatigue Syndrome): A Case Study for Health Care Providers[20] - (Full text)
  • 2019, Endometriosis as a Comorbid Condition in Chronic Fatigue Syndrome (CFS): Secondary Analysis of Data from a CFS Case-Control study[21] - (Abstract)

Talks and interviews[edit | edit source]

Grand Rounds Video
Grand Rounds Presentation Slide Deck


Online presence[edit | edit source]

Learn more[edit | edit source]

See also[edit | edit source]

References[edit | edit source]

  1. ↑ 1.0 1.1 "Myalgic Encephalomyelitis/Chronic Fatigue Syndrome". Centers for Disease Control and Prevention. August 8, 2019. Retrieved September 3, 2019.
  2. ↑ http://www.cdc.gov/cfs/case-definition/1994.html
  3. ↑ 3.0 3.1 Reeves, William C.; Wagner, Dieter; Nisenbaum, Rosane; Jones, James F.; Gurbaxani, Brian; Solomon, Laura; Papanicolaou, Dimitris A.; Unger, Elizabeth R.; Vernon, Suzanne D.; Heim, Christine (December 15, 2005). "Chronic Fatigue Syndrome – A clinically empirical approach to its definition and study". BMC Medicine. 3 (1): 19. doi:10.1186/1741-7015-3-19. ISSN 1741-7015. PMC 1334212. PMID 16356178.
  4. ↑ Reeves, W.C.; Lloyd, A.; Vernon, S.D.; Klimas, N.; Jason, L.A.; Bleijenberg, G.; Evengard, B.; White, P.D.; Nisenbaum, R.; Unger, E. (2003), "Identification of ambiguities in the 1994 chronic fatigue syndrome research case definition and recommendations for resolution", BMC Health Services Research, 3 (25), doi:10.1186/1472-6963-3-25
  5. ↑ Nisenbaum, R; Reyes, M; Unger, ER; Reeves, W (February 2004). "Factor analysis of symptoms among subjects with unexplained chronic fatigue: what can we learn about chronic fatigue syndrome?". J Psychosom Res. 56 (2): 171-8. doi:10.1016/S0022-3999(03)00039-4. PMID 15016574.
  6. ↑ Wagner, Dieter; Nisenbaum, Rosane; Heim, Christine; Jones, James F.; Unger, Elizabeth R.; Reeves, William C. (2005). "Psychometric properties of the CDC Symptom Inventory for assessment of Chronic Fatigue Syndrome". Population Health Metrics. 3 (8): 1. doi:10.1186/1478-7954-3-8.
  7. ↑ Reeves, W.C.; Heim, C.; Maloney, E.M.; Youngblood, L.S.; Unger, E.R.; Decker, M.J.; Jones, J.F.; Rye, D.B. (2006). "Sleep characteristics of persons with chronic fatigue syndrome and non-fatigued controls: results from a population-based study". BMC Neurology. 6 (41). doi:10.1186/1471-2377-6-41.
  8. ↑ Majer, M; Jones, JF; Unger, E; Youngblood, LS; Decker, MJ; Gurbaxani, B; Heim, C; Reeves, WC (2007). "Perception versus polysomnographic assessment of sleep in CFS and non-fatigued control subjects: results from a population-based study". BMC Neurology. 7 (40). doi:10.1186/1471-2377-7-40. PMID 18053240.
  9. ↑ Jones, James F; Lin, Jin-Mann S; Maloney, Elizabeth M; Boneva, Roumiana S; Nater, Urs M; Unger, Elizabeth R; Reeves, William C (December 2009). "An evaluation of exclusionary medical/psychiatric conditions in the definition of chronic fatigue syndrome". BMC Medicine. 7 (1). doi:10.1186/1741-7015-7-57. ISSN 1741-7015. PMC 2768736. PMID 19818157.
  10. ↑ Jason, LA; Unger, ER; Dimitrakoff, JD; Fagin, AP; Houghton, M; Cook, DB; Marshall, GD, Jr; Klimas, N; Snell, C (2012). "Minimum data elements for research reports on CFS". Brain, Behavior, Immunology. 26 (3): 401-6. doi:10.1016/j.bbi.2012.01.014. PMID 22306456.
  11. ↑ Falkenberg, Virginia R; Whistler, Toni; Murray, Janna R; Unger, Elizabeth R; Rajeevan, Mangalathu S (2013). "Acute Psychosocial Stress-Mediated Changes in the Expression and Methylation of Perforin in Chronic Fatigue Syndrome". Genetics and Epigenetics. 5: 1–9. doi:10.4137/GEG.S10944. PMC 4222335. PMID 25512702.
  12. ↑ Fischer, David B.; William, Arsani H.; Strauss, Adam C.; Unger, Elizabeth R.; Jason, Leonard; Marshall, Jr, Gailen D.; Dimitrakoff, Jordan D. (2014). "Chronic Fatigue Syndrome: The Current Status and Future Potentials of Emerging Biomarkers". Fatigue: Biomedicine, Health & Behavior. 2 (2): 93-109. doi:10.1080/21641846.2014.906066.
  13. ↑ Miller, Andrew H.; Jones, James F.; Drake, Daniel F.; Tian, Hao; Unger, Elizabeth R.; Pagnoni, Giuseppe (May 23, 2014). "Decreased Basal Ganglia Activation in Subjects with Chronic Fatigue Syndrome: Association with Symptoms of Fatigue". PLoS ONE. 9 (5): e98156. doi:10.1371/journal.pone.0098156. ISSN 1932-6203. PMC 4032274. PMID 24858857.
  14. ↑ Rajeevan, Mangalathu S.; Dimulescu, Irina; Murray, Janna; Falkenberg, Virginia R.; Unger, Elizabeth R. (August 1, 2015). "Pathway-focused genetic evaluation of immune and inflammation related genes with chronic fatigue syndrome". Human Immunology. 76 (8): 553–560. doi:10.1016/j.humimm.2015.06.014. ISSN 0198-8859.
  15. ↑ Boneva, Roumiana S.; Lin, Jin-Mann S.; Unger, Elizabeth R. (August 2015). "Early menopause and other gynecologic risk indicators for chronic fatigue syndrome in women". Menopause (New York, N.Y.). 22 (8): 826–834. doi:10.1097/GME.0000000000000411. ISSN 1072-3714. PMC 5745581. PMID 25647777.
  16. ↑ Unger, ER; Murray, J; Oakley, LP; Lin, JM; Rajeevan, MS (2016). "Telomere Length Analysis in Chronic Fatigue Syndrome". The FASEB Journal. 30 (1): lb459.
  17. ↑ Unger, ER; Lin, JS; Brimmer, DJ; Lapp, CW; Komaroff, AL; Nath, A; Laird, S; Iskander, J (2016). "CDC Grand Rounds: Chronic Fatigue Syndrome — Advancing Research and Clinical Education". Morbidity and Mortality Weekly Report. 65 (5051): 1434–1438. doi:10.15585/mmwr.mm655051a4. -
  18. ↑ Unger, Elizabeth R.; Lin, Jin-Mann S.; Tian, Hao; Natelson, Benjamin H; Lange, Gudrun; Vu, Diana; Blate, Michelle; Klimas, Nancy G.; Balbin, Elizabeth G.; Bateman, Lucinda; Allen, Ali; Lapp, Charles W.; Springs, Wendy; Kogelnik, Andreas M.; Phan, Catrina C.; Danver, Joan; Podell, Richard N.; Fitzpatrick, Trisha; Peterson, Daniel L.; Gottschalk, C. Gunnar; Rajeevan, Mangalathu S.; MCAM Study Group (2017), "Multi-Site Clinical Assessment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (MCAM): Design and Implementation of a Prospective/Retrospective Rolling Cohort Study.", American Journal of Epidemiology, 1–10, doi:10.1093/aje/kwx029
  19. ↑ Feldman R, Gay K, Ala'i S, Esterlitz J, Sheikh M, Tanveer S, Joseph K, Unger E, Whittemore V (April 10, 2018). "Common Language for Clinical Research Studies: The National Institute of Neurological Disorders and Stroke (NINDS) and Centers for Disease Control and Prevention (CDC) Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Common Data Elements (CDEs)". Neurology. 90 (15 Supplement).
  20. ↑ Brimmer, Dana; Jones, James; Boneva, Roumiana; Campbell, Charlotte; Lin, Jin-Mann; Unger, Elizabeth (2016). "Assessment of ME/CFS (Myalgic Encephalomyelitis/Chronic Fatigue Syndrome): A Case Study for Health Care Providers". MedEdPORTAL Publications. 12. doi:10.15766/mep_2374-8265.10527. PMID 30984868.
  21. ↑ Boneva, Roumiana S.; Lin, Jin-Mann S.; Wieser, Friedrich; Nater, Urs M.; Ditzen, Beate; Taylor, Robert N.; Unger, Elizabeth R. (April 2018). "Endometriosis as a Comorbid Condition in Chronic Fatigue Syndrome (CFS): Secondary Analysis of Data from a CFS Case-Control study". Frontiers in Pediatrics. doi:10.3389/fped.2019.00195.
  22. ↑ "Chronic Fatigue Syndrome: It's Real, and We Can Do Better". medscape.com. February 25, 2019. Retrieved February 25, 2019.
  23. ↑ "IIMEC14 14th Invest in ME Reseaerch International ME Conference 2019". Invest in ME Research. Retrieved February 26, 2020.

Centers for Disease Control and Prevention (CDC) - The Centers for Disease Control and Prevention is a U.S. government agency dedicated to epidemiology and public health. It operates under the auspices of the Department of Health and Human Services.

See Centers for Disease Control and Prevention.

Chronic Fatigue Syndrome Advisory Committee (CFSAC) - (sometimes pronounced SIF-SACK) A US government advisory council that met twice per year, covering current topics related to Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Meetings usually lasted for two days and the results were presented to the Secretary of Health and Human Services (HHS). After 15 years, on September 5, 2018, CFSAC's charter was not renewed by the Department of HHS, effectively dissolving the committee without notice or warning.

See Chronic fatigue syndrome advisory committee.

ganglion A ganglion is a group of neuron cell bodies in the peripheral nervous system. Plural: ganglia / ganglions

Centers for Disease Control and Prevention (CDC) - The Centers for Disease Control and Prevention is a U.S. government agency dedicated to epidemiology and public health. It operates under the auspices of the Department of Health and Human Services.

myalgic encephalomyelitis (M.E.) - A disease often marked by neurological symptoms, but fatigue is sometimes a symptom as well. Some diagnostic criteria distinguish it from chronic fatigue syndrome, while other diagnostic criteria consider it to be a synonym for chronic fatigue syndrome. A defining characteristic of ME is post-exertional malaise (PEM), or post-exertional neuroimmune exhaustion (PENE), which is a notable exacerbation of symptoms brought on by small exertions. PEM can last for days or weeks. Symptoms can include cognitive impairments, muscle pain (myalgia), trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, among others. An estimated 25% of those suffering from ME are housebound or bedbound. The World Health Organization (WHO) classifies ME as a neurological disease.

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