Historical Aspects of Chronic Fatigue Syndrome
There are over 1 million cases of chronic fatigue syndrome in the United States while another 4 million, it is believed, remain undiagnosed. It is a difficult condition to diagnose due to the number of symptoms it shares with other illnesses. It received the name "chronic fatigue syndrome" only 20 years ago by the Centers for Disease Control and Prevention in the United States. Its name and classification has changed much over the last 150 years as medical professionals attempt to weed out those symptoms which may not be involved in this mysterious condition.
1869: Dr. George Beard described a condition which shares many symptoms with present-day CFS (fatigue, anxiety, headache, impotence, neuralgia and depression) and named it neurasthenia, characterizing its seeming connection to the nervous system.
1948: A CFS-like epidemic occurred in Akureyri, Iceland following two reported cases of poliomyelitis. The epidemic was originally thought to be related to the recent polio cases. No poliovirus was ever isolated from a patient of the epidemic so the illness remained undiagnosed. Future outbreaks of a similar illness were labeled as Iceland Disease or Akureyri's Disease.
1956: Dr. A. Melvin Ramsay publishes an editorial in the Lancet entitled "A New Clinical Entity?" discussing the recent unexplainable CFS-like epidemics. A name first used in 1938 medical literature is adopted for the mysterious illness: Myalgic encephalomyelitis (ME).
1984: The U.S. finally pays attention to the strange illness when cases of it are reported in Lake Tahoe, NV and Lyndonville, NY.
1985: A consensus conference is held by the National Institute of Allergy and Infectious Diseases where the phrase "chronic Epstein-Barr virus (CEBV)" is used to describe illnesses with CFS-like symptoms. CEBV becomes the popular name for the disease for a short time.
1987: Marc Iverson and Alan Goldberg found the CEBV Association, which is later changed to the CFIDS Association of America after a suggestion by immunologist Seymour Grufferman. "Chronic fatigue immune dysfunction syndrome" is thought to better reflect the immune connection characteristic of the disease.
1988: The name "chronic fatigue syndrome" is proposed and adopted by the Centers for Disease Control in the United States. The "Holmes criteria" case definition is created to aid in research and diagnosis of the disease.
1990: Newsweek magazine features CFS as its November cover story. In the article the illness receives the nickname "yuppie flu" due to the fact that it is diagnosed most often in upper class women. The article certainly publicized the illness but gave it the reputation of being a psychosomatic disease.
1994: A revised case definition is issued by the CDC, known as the Fukuda or research definition: Two criteria must be met to be considered a CFS patient:
- Experience chronic fatigue for six months or longer with no connection to any other condition
- Experience at least four of the following symptoms simultaneously over the course of six months or more: pain in multiple joints without swelling or redness, markedly impaired short-term memory or concentration, tender lymph nodes, sore throat, muscle pain, headaches, unrefreshing sleep, or post-exertional fatigue lasting longer than 24 hours.
The name "chronic fatigue syndrome" continues to be debated as an inadequate description of the disease. Its unknown cause and variety of symptoms prevent it from being easily pigeon-holed. Therefore its name and definition will most likely continue to be revised and edited for years to come.
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