From: Arlette.Lefebvre@f24.n3602.z1.fidonet.org (Arlette Lefebvre)
Newsgroups: misc.handicap
Subject: Chronic fatigue
Date: 7 Oct 92 16:42:29 GMT
Reply-To: Arlette.Lefebvre@f24.n3602.z1.fidonet.org
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[This is from the AbleNews Conference]

                  Chronic Fatigue Syndrome
                 A Pamphlet for Physicians
        U.S. Department of Health and Human Services

                   Public Health Service
               National Institutes of Health
                 NIH Publication No. 92-484
                          May 1992
                     Table of Contents
Page 1
                  Chronic Fatigue Syndrome
                        Introduction

Chronic fatigue syndrome (CFS) is an illness characterized by debilitating fatigue and several flu-like symptoms such as pharyngitis, adenopathy, low-grade fever, myalgia, arthralgia, headache, difficulty concentrating, and exercise intolerance.  These nonspecific symptoms can make the syndrome difficult to identify.  Profound fatigue -- the earmark of the disorder -- usually comes on suddenly and persists or relapses throughout the course of the illness. But unlike the short-term fatigue and malaise that 





often accompanies an acute infection, by definition, CFS symptoms linger for at least 6 months, and often for years.

Chronic fatigue is a common complaint in primary care practice.  No evidence exists to suggest that most patients with chronic fatigue have CFS.  Indeed, CFS is probably an uncommon cause of chronic fatigue.

When evaluating patients with chronic fatigue of unknown origin, physicians can use the definition of CFS in the Appendix as a guide.  This detailed definition was developed for research use under the leadership of the Centers for Disease Control.  It was published in Annals of Internal Medicine in March 1988.  Because the disease is still poorly understood, however, the outlined criteria should be considered provisional.

Most investigators studying CFS believe that the syndrome has many possible causes.  For example, various infectious agents often trigger the onset of CFS.  Preliminary research also shows a variety of immunologic disturbances in some patients.  No single pattern of disturbances appears consistently, however, and in general, patients are not clinically immunocompromised: they do not develop opportunistic infections.  In fact, the character, epidemiology, and prognosis of CFS is quite distinct from that of 





major immune deficiency disorders such as AIDS. Several different latent viruses also appear to be reactivated in some CFS patients, although reactivation has not been shown in all patients, and it is not clear that any of these viruses are causally related to CFS or its symptoms.  Many patients with CFS also present with anxiety or depression.  In summary, as with most chronic illness, CFS has both physical and psychiatric manifestations.

                        Epidemiology

Most cases of CFS are sporadic: the patient does not have a close contact who has developed a similar illness. Infrequently, however, close contacts, including family members, become ill with CFS at about the same time.  During the past 60 years, several apparent epidemics of this illness affecting various communities or relatively large numbers of co-workers have been reported.  Clusters of CFS cases are unusual, however, and it is not generally thought that people with CFS need to be isolated in any way.





  The clinical and laboratory findings of sporadic versus epidemic cases have yet to be compared.

While the typical patient seeking medical care for CFS is a white woman in her thirties, patients of all ages (including the very young and very old), both sexes, many races, and all socioeconomic groups have been affected.  CDC and NIAID-sponsored researchers have studies under way to try to estimate the prevalence of this disorder.

               A bientot, I hope...?

                                               Docteur Froggie.
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