Discussion in 'Diagnostic Guidelines' started by Sly Saint, Jul 30, 2020.
It is an interesting paper, but I think they miss an important point. Epidemic ME was a contagious disease with unknown aetiology, although circumstantial evidence suggests it was caused by a viral infection, possibly an enterovirus. The illness had an alarming tendency to trigger the postviral syndrome that we now call ME/CFS. Note that it was listed in the section “Inflammatory diseases of central nervous system” in ICD-8 (1969).
In the 1980s, focus shifted from the acute phase in the epidemics to the postviral condition. It was acknowledged that a syndrome with similar clinical presentation could be triggered by other infectious agents. The name postviral fatigue syndrome was introduced in ICD-10 (1994), and the illness moved to the section “Other disorders of the nervous system”.
I think it is very difficult to follow the history of ME/CFS, if you don’t make a distinction between the acute phase in epidemic ME on the one hand and the postviral sequel to epidemic ME and other viral agents—that we now call ME/CFS—on the other hand.
Yes. The difficulty arises when some people conclude that it is therefore unnecessary to counter the suggestion that the "post-viral" effects of epidemic ME were hysteria.
The lesson of the RFH was that there was an unidentified and possibly unknown pathogen which, even by McEvedy's data, led to an ongoing illness in approximately 10% of those infected - seven out of seventy odd, rather than the headline figure of one remaining ill for up to a year.
Looks like a reasonable overview
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