that's way above my pay grade. But I've seen quite a lot of large datasets and I think those spikes are pretty unusual – more likely to have specific explanations, than to be noise.
My feeling is the first spike may just be noise particularly looking at the overall trend as the surounding years are lower. But the red spike does look a little different - However, data does this sometimes and it could be due to more people getting ME but equally it could be due to some sampling issue such as more people joining patient organizations that year due to increased publicity etc (although I might expect that to smooth out over a few years?).
I don't think the data can say anything definative but it does perhaps suggest an interesting possibility that could be monitored such as ensuring onset is recorded in patient records to see if increased onset happens after wider spread disease but follow ups would also be necessary to see if people recover.
I am wondering if there is a peak of occurance of ME after an emdemic or local disease outbreak tells us something interesting? Are people preconditioned and a virus triggers and if so is this preconditioning a temporary state? I'm wondering if there are different hypothesises in terms of mechanism which would lead to different stats and that could be explored with a mathematical model?
