Psychology today: Post-Infection Illness

[Sly Saint]

by

Ilene S. Ruhoy M.D., Ph.D.
Your Neurology

Post-infectious illness is nothing new. In neurology, as in other specialties, there are multiple diagnoses that occur following infection. This could happen immediately thereafter, a few weeks later, a few months later, or sometimes even longer. It is not necessarily the same as what we refer to as relapsing-remitting, as once the chronicity of the symptoms begins, there is never a real return to one's health baseline.

There are delayed effects of many exposures we are subject to, which include not only infectious organisms but also environmental contaminants, radiation, and even necessary therapeutic regimens such as chemotherapy.

In kids, we see post-infectious illnesses such as acute demyelinating encephalomyelitis (ADEM), transverse myelitis (TM), and febrile infection-related epilepsy syndrome (FIRES) as examples.

In adults, we see diagnoses such as Guillain Barre syndrome (GBS) and myalgic encephalomyelitis chronic fatigue syndrome (MECFS) as examples. Indeed, there has been recent research and dialogue regarding the potential of other diagnoses such as multiple sclerosis (MS) and Alzheimer’s disease (AD) as post-infectious processes.

We have seen the long-term effects of COVID-19. Commonly referred to as long Covid or long hauler or post-acute sequelae SARS-CoV-2 infection (PASC). Symptoms of post-Covid include chronic fatigue, exercise intolerance, difficulty breathing, cognitive changes, headaches, dizziness, hypersensitivities, sleep dysfunction, neuropathy, difficulty with focus and concentration, and more. This is very similar to what is seen in MECFS, so it is thought to be more of a systemic post-infectious illness.

These long-term effects can happen no matter the severity of the infection. Many patients with long Covid report having only mild symptoms with the acute infection, which were thought to be improving or resolving only to worsen again after some period later.

https://www.psychologytoday.com/gb/blog/your-neurology/202201/post-infection-illness

 

[Hoopoe]

I thought this was a good article for an audience that is not familiar with the topic.

 

[duncan]

I thought this was a good article for an audience that is not familiar with the topic.

Title aside. There is an assumption embedded in "post-infection" that also leads the reader. Set aside the assumptions and medical politics and let the Science (theory) write the article. For instance, I might as an alternative to post-infection try post-acute illness.

But agreed, pretty good piece.

 

[DokaGirl]

Good article which will as @strategist says reach some who don't know about this issue.

Interesting, that even mild COVID symptoms can lead to Long COVID which turns one's health and life upside down. That's how EBV was for me: not dramatic, not horrible, but left me with debilitating ME for over 3 decades, and counting.

As an aside, when I was diagnosed as hypothyroid, I was told it might have been caused by a virus.

However, my ME was just considered burn out or psychological, despite testing positive for EBV.

Plainly, there has been the idea that viruses can cause organ dysfunction, but the mistaken view that ME is psychological has long been preferred, as it serves a purpose for the insurance industry and governments.

 

[glennthefrog]

Good article which will as @strategist says reach some who don't know about this issue.

Interesting, that even mild COVID symptoms can lead to Long COVID which turns one's health and life upside down. That's how EBV was for me: not dramatic, not horrible, but left me with debilitating ME for over 3 decades, and counting.

As an aside, when I was diagnosed as hypothyroid, I was told it might have been caused by a virus.

However, my ME was just considered burn out or psychological, despite testing positive for EBV.

Plainly, there has been the idea that viruses can cause organ dysfunction, but the mistaken view that ME is psychological has long been preferred, as it serves a purpose for the insurance industry and governments.

exactly, just follow the money

 

[chrisb]

Plainly, there has been the idea that viruses can cause organ dysfunction, but the mistaken view that ME is psychological has long been preferred, as it serves a purpose for the insurance industry and governments

I find the early push to regard ME as neurasthenia by another name interesting in view of a find which I recently made.

The diagnosis (neurasthenia) brings with it no appreciable insight into pathology, frequently it has the special defect of guarding the patient against further detailed investigation ; in many neurological quarters the term is indeed falhng into disuse, as it is lacking in exactitude of expression.

This was written by Thomas Lewis in 1918 and appears at p48 of The soldier's heart and the effort syndrome. He recognised that many of the symptoms he described arose after infectious illness.

 

[Snow Leopard]

In kids, we see post-infectious illnesses such as acute demyelinating encephalomyelitis (ADEM), transverse myelitis (TM), and febrile infection-related epilepsy syndrome (FIRES) as examples.

In adults, we see diagnoses such as Guillain Barre syndrome (GBS) and myalgic encephalomyelitis chronic fatigue syndrome (MECFS) as examples.

This separation is strange - we see examples of both in both children and adults.

 

[DokaGirl]

I find the early push to regard ME as neurasthenia by another name interesting in view of a find which I recently made.

The diagnosis (neurasthenia) brings with it no appreciable insight into pathology, frequently it has the special defect of guarding the patient against further detailed investigation ; in many neurological quarters the term is indeed falhng into disuse, as it is lacking in exactitude of expression.

This was written by Thomas Lewis in 1918 and appears at p48 of The soldier's heart and the effort syndrome. He recognised that many of the symptoms he described arose after infectious illness.

Thank you @chrisb. This is interesting. And is an example of how very long it takes for medical science to overcome beliefs that the fault lies entirely with some patients when they become ill.

I think it is sad that neurasthenia patients haven't been "cleared of the charges" they were attention seeking, lazy, and psychologically challenged.

 

[Forbin]

Title aside. There is an assumption embedded in "post-infection" that also leads the reader. Set aside the assumptions and medical politics and let the Science (theory) write the article. For instance, I might as an alternative to post-infection try post-acute illness.

I was trying to think of something even more general that would include "injury" (which is not generally referred to as an "illness") and toxic exposure (which might not cause an acute illness). Both injury and toxic exposure seem to have triggered ME/CFS in some people.

The thing that seems common to all the triggers is the likelihood of a significant immune response. That immune response might initially go unnoticed, as seems to have been the case in some long-Covid cases. https://www.nytimes.com/2021/03/08/health/long-covid-asymptomatic.html

I'm not sure what that would be called. "Post-immune excursion"? Post-immune perturbation"? "Post-immune challenge"?