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The following article was published in The National Journal Of Health & Recovery in the June, 1993 issue, pages 15-16.
Chronic Fatigue Syndrome: Many physicians still discount the validity of this devastating disease.
The disease known in The United States as Chronic Fatigue Syndrome (CFS), is a real disease that may well have been around for decades, perhaps centuries, and is still having a problem convincing doctors that it is a real disease. Most people with CFS, in our country, prefer the name Chronic Fatigue Immune Dysfunction Syndrome (CFIDS). In many other countries it is known by it's more appropriate name, Myalgic Encephalomyelitis, M.E., which means; My-muscle, algic-pain, Encephalo-brain, mye-spinal cord, itis-inflamation.
In most cases, there seems to be a clear-cut beginning to the disease, in as far as the pathology of the illness is concerned. Most patients can tell you the exact day that they became sick. Many people can point to a viral illness, a surgery or surgical procedure, a car accident or even child-birth, as the precursor of their illness. A basic problem that we have is that this disease is being named after one of it's major symptoms. Ironically, one that many people in our fast-paced society, suffer from. Most physicians will tell you that the chief complaint that they receive from their patients is that they are tired all of the time. This clearly doesn't mean that they have CFIDS, but with physicians hearing this complaint every day, may become complacent, and thus will discount the truly sick individual.
Throughout this century, CFS-like epidemics have surfaced that were well documented. The first such documentation came in 1934. Dr. Alexander Gilliam, published an epidemiological study of the Los Angeles County General Hospital staff epidemic. His study was the first detailed description of CFS. At the time it was termed to be Atypical Poliomyelitis, however, it differed immensely from Polio in that there was a very low mortality rate and the tendency of many of the symptoms to reappear following any minor physical or mental exhaustion was very high. Subsequently, there were other well documentated outbreaks similar to what we today call Chronic Fatigue Syndrome.
There are many hopotheses as to the cause of this very debilitating disease. Many focus on a number of factors that work in conjunction with each other to cause the body to be literally in constant war with whatever viruses are causing the disease. The multiple cause hypothesis consists of an infection or infections combined with environmental factors, that may include pollution and other toxins, and a genetic predisposition combined with a specific personality type. This usually being "The Go-Getter type." Recently, many physicians have focused on human Herpes Virus-6 (HHV-6), as playing some role in CFS. Many CFS patients have high antibodies to HHV-6, although everyone doesn't. Since it's discovery in 1986, HHV-6 has been receiving a lot of attention. Other Herpes Viruses have been studied as the culprit, but most are believed to be an effect not a cause. Other studies have concentrated on Retroviruses, which include HIV and HFV (Spuma Virus). It has pretty much been established that AIDS and CFIDS, while both affecting the Immune System, are almost the opposite of each other. CFIDS is a dysfunction where AIDS is a deficiency. Also, CFIDS is not believed to be terminal, where unfortunatley, AIDS is generally terminal. One final area that researchers are focusing on are Enteroviruses (Polio and Coxsackie B). Some researchers are beginning to ponder the fact that we might actually be dealing with a yet unidentified virus.
The main problem right now is getting more money allocated for research into the cause and treatments and for education and awareness, especially towards Physicians. Almost all epidemics and new diseases are met with skepticism from the medical community, elected officials and insurance companies. But in the case of CFS, more money needs to be allocated now. Because of the potential economic impact to our country, there is an obvious resistance towards legitimacy and towards increasing expenditures. And this is because, if the Government were to validify the fact that this disease is a real epidemic, they would be forced to spend a lot more money on CFS. And this would be difficult, with other disease such as AIDS, demanding more and more money. The difference is that a person with CFS, who used to be a productive, tax-paying member of society, could be on Medicare and Social Security Disability for decades.
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