Incidence age is bimodal for [ME/CFS], with higher severity burden for early onset disease, 2026, McGrath et al

It's likely to be substantial contributor, but it doesn't explain the first peak. Srr figure 3E4 for DecodeME onset ages, infectious and nucleosis, other infections and non-infectious also show a an early onset spike.

Yep, it'd be possible to suggest explanations for pretty much any age peak, but it doesn't mean they actually apply.

It's interesting that the peaks are preserved across time despite significant social changes. When I got ME/CFS (mid-70s), the vast majority of the population left school and started work at 16. They had a level of financial independence almost immediately, often lived separately from their parents, and many had their children in their 20s. That timeline would look pretty different now.
 
Anecdotally Mono really screwed me up from 16-17ish. I don’t think I would have qualified for me/cfs but I was sick for months if not a year pretty much constantly. I think I had strep 5-6x that year and was constantly testing positive for mono IGA. Then fine for 10 years. Looking at these peaks is quite interesting.

My identical twin brother was also hit by mono at the same time but did not have such a severe reaction during 16-17. He does not have ME either in adulthood.
 
On what is the based?

From the text in our paper:
Furthermore, while the incidence of glandular fever/infectious mononucleosis is 5 per
1,000 in the UK (44), it is an order of magnitude smaller (0.4 per 1,000) in Spain
(45), which in our dataset had the smallest early onset peak.
We cite NICE for uk and Merico-Coy et al 2020 for spain. Statista also provides an estimate here but we struggled to source it https://www.statista.com/statistics...ctious-mononucleosis-among-patients-in-spain/.
 
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Not well enough to look into this fully at the moment but re the Statista statistics: try looking at the Spanish Health Ministry's SIAP/BDCAP data. I found this from 2012 on a quick search:

bdcap.jpg

Link
 
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Can the downward slope that starts around 40-50 years tell us something?

Does it mean that the risk of getting ME/CFS decreases once you reach that age?

To what extent could the data be confounded by e.g. underdiagnosis due to other health issues that might become more prevalent in the second half of life?

Could it be confounded by lower digital literacy and presence, creating a recruitment bias in the data?
 
Does it mean that the risk of getting ME/CFS decreases once you reach that age?

And maybe that the risk of being diagnosed with ME/CFS decreases?

My family and friends have found there's a different attitude to ill health in the second half of life. The older you get, the more seriously symptoms are taken. Referrals to specialists to rule in / out clinical suspicions happen sooner.

So it's possible there are fewer misdiagnoses of ME/CFS after middle age.
 
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