Chronic Fatigue Syndrome

Chronic Fatigue Syndrome

Chronic fatigue syndrome (CFS) is an illness characterized by prolonged, debilitating fatigue severe enough to affect one or more aspects of a person's life (work, home, school or social). It is also characterized by multiple nonspecific symptoms such as headaches, recurrent sore throats, muscle and joint pains, memory and concentration difficulties. Profound fatigue, the hallmark of the disorder, can come on suddenly or gradually and persists or recurs throughout the period of illness. Unlike the short-term disability of an illness such as the flu, CFS symptoms linger for at least six months and often for years. The cause of CFS remains unknown. The U.S. Centers for Disease Control and Prevention (CDC) estimate that 85 percent of those with CFS are women, and that the condition is most common in people in their 40s and 50s. Chronic fatigue syndrome can affect any sex, race or socioeconomic class, however. And although CFS is much less common in children than in adults, children can develop the illness, particularly during the teen years. It can be as disabling as multiple sclerosis and chronic obstructive pulmonary disease. The prevalence of CFS is difficult to measure because the illness can be difficult to diagnose, but, in general, it is estimated that about one million persons in the U.S. have a CFS-like condition, according to the CDC. Studies at DePaul University in Chicago, place the estimates even higher. The CDC notes that the condition takes a tremendous personal and social toll, costing approximately nine billion dollars a year to the nation and twenty thousand dollars per family Chronic fatigue syndrome does not appear to be a new illness, although it has only recently been assigned its name. Relatively small outbreaks of similar disorders have been described in medical literature since the 1930s. Furthermore, case reports of comparable illnesses date back several centuries. Interest in what now is called CFS was renewed in the mid-1980s after several studies found slightly higher levels of antibodies to the Epstein-Barr virus (EBV) in people with CFS-like symptoms than in healthy individuals. Most of these people had experienced an episode of infectious mononucleosis (sometimes called mono or the "kissing disease") a few years before they began to experience the chronic, incapacitating symptoms of CFS. As a result, for a time, the CFS-like illness became popularly termed "chronic EBV." Further investigation revealed that elevated EBV antibodies were not indicative of CFS, since healthy people can have high EBV antibodies and some people with CFS don't have elevated levels. The illness was named chronic fatigue syndrome because the name reflects the most common symptom: long-term, persistent fatigue. Today, CFS also is known as myalgic encephalomyelitis (ME), postviral fatigue syndrome, and chronic fatigue and immune dysfunction syndrome (CFIDS). It is important to note, however, that the word "fatigue" is extremely misleading. Fatigue is but one symptom among many that make up this illness, and it doesn't reflect the significance of other disabling symptoms. The word also adds to generalized misunderstanding and trivialization of the illness. There are no published data to indicate that CFS is contagious, that it can be transmitted through intimate or casual contact or by blood transfusion, or that people with CFS need to be isolated in any way. CFS often begins abruptly, but may also come on gradually. The sudden onset frequently follows a respiratory, gastrointestinal or other acute including mononucleosis Other cases develop after emotional or physical traumas such as serious accidents, bereavement or surgery. A study from the CDC shows there may be a genetic component to CFS. Specifically, researchers reported that people affected with CFS appeared to have an impaired response to physical and psychological stressors due to abnormally functioning brain and immune system-related genes. This is an important first step towards better ways to diagnose and treat CFS. Although CFS can persist for many years, long-term studies indicate that CFS generally is not a progressive illness. Symptoms are usually most severe in the first year or two. Thereafter, the symptoms typically stabilize, then persist chronically, wax and wane, or improve. For some people with CFS, however, symptoms can get worse over time. It appears that while the majority of people with CFS partially recover, only a few fully recover while others experience a cycle of recovery and relapse. However, there's no way to predict which category you might fall into. Overall recovery rates for CFS are still unknown. One 2005 review of published studies found that patients' improvement rates varied from eight percent to 63 percent, with an average of 40 percent of patients showing improvement during follow up. Full recovery from CFS appears to be rare, with an average of only five to 10 percent of patients going into and sustaining total remission.