In M.E., the illness, the disease process, its investigation and pathology starts on the day the patient ceases to be well. In CFS, the Atlanta based CDC has decreed that the disease process starts only on the first day of the sixth month. It is my belief that the initial CDC definition, was created by a group of well meaning researchers and physicians who, with two or three exceptions, had for all purposes never routinely seen or examined CFS patients. It is a telling fact, that with the exception of two, perhaps three, of the original sixteen authors of the CDC definition, the majority have never again published on CFS or ever routinely seen and examined any CFS patients. Definitions are not diseases, they are often simply the best descriptions that physicians and researchers can offer, with their always imperfect knowledge, to describe a disease.
Good definitions are good because they correspond closely to the disease state being described.
It is thus important that those that attempt to define any disease or illness to have long term clinical experience with patients with this illness. There is simply no place for the bureaucrat in defining illness. All definition of epidemic or infectious illness must be based upon persistent clinical examination of the afflicted patient, an understanding and exploration of the environmental factors producing that illness, and pathophysiological examination of tissue from those patients. For similar reasons, I believe that the inclusion of psychiatrists in the defining of an epidemic and obviously disease of infectious origin, simply muddies the water for any serious understanding of that disease. A serious attempt must be made to look at epidemic disease as and where that disease starts.