Recent years have brought growing recognition of the need for clinical criteria for myalgic encephalomyelitis (ME), which is also called chronic fatigue syndrome (CFS). An Expert Subcommittee of Health Canada established the Terms of Reference, and selected an Ex- pert Medical Consensus Panel representing treating physicians, teaching faculty and researchers. A Consensus Workshop was held on March 30 to April 1, 2001 to culminate the review process and establish consensus for a clinical working case definition, diagnostic protocols and treatment protocols. We present a systematic clinical working case definition that

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Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols

Background: Most previous estimates of the prevalence of chronic fatigue syndrome (CFS) have derived largely from treated populations, and have been biased by differential access to health care treatment linked with sex, ethnic identification, and socioeconomic status. Objective: To assess the point prevalence of CFS in an ethnically diverse random community sample. Design and Participants: A sample of 28 673 adults in Chicago, Ill, was screened by telephone, and those with CFS-like symptoms were medically evaluated. Main Outcome Measures and Analyses: Selfreport questionnaires, psychiatric evaluations, and complete medical examinations with laboratory testing were used to diagnose patients with CFS. Univariate and multivariate statistical techniques were used to delineate the overall rate of CFS in this population, and its relative prevalence was subcategorized by sex, ethnic identification, age, and socioeconomic status. Results: There was a 65.1% completion rate for the telephone interviews during the first phase of the study. Findings indicated that CFS occurs in about 0.42% (95% confidence interval, 0.29%-0.56%) of this random community-based sample. The highest levels of CFS were consistently found among women, minority groups, and persons with lower levels of education and occupational status.

https://jamanetwork.com/journals/jamainternalmedicine/articlepdf/415556/ioi90161.pdf

A community-based study of chronic fatigue syndrome.

OBJECTIVE: Chronic fatigue syndrome is an illness characterized by disabling fatigue of at least 6 months, accompanied by several other symptoms. This review summarizes the current state of knowledge about chronic fatigue syndrome. METHOD: The case definition, prevalence, clinical presentation, evaluation, and prognosis of chronic fatigue syndrome are discussed. Research on the pathophysiology and treatment of chronic fatigue syndrome is reviewed. RESULTS: Chronic fatigue syndrome is diagnosed on the basis of symptoms. Patients with chronic fatigue syndrome experience significant functional impairment. Pathophysiological abnormalities exist across many domains, suggesting that chronic fatigue syndrome is a heterogeneous condition of complex and multifactorial etiology. Evidence also is beginning to emerge that chronic fatigue syndrome may be familial. Although chronic fatigue syndrome has significant symptom overlap and comorbidity with psychiatric disorders, several lines of research suggest that the ill...

Chronic fatigue syndrome: a review.

Chronic Fatigue Syndrome (CFS) is not a single diagnostic entity. It is a symptom complex which can be reached by many different routes. The conceptual model of CFS needs to be changed from one determined by a single cause/agent to one in which dysfunction is the end stage of a multifactorial process. Although it is important to recognise the role of factors that precipitate the condition, greater understanding is required of factors that predispose individuals to develop the illness, and those that perpetuate disability.

Chronic fatigue syndrome. Summary of a report of a joint committee of the Royal Colleges of Physicians, Psychiatrists and General Practitioners.

Background: Chronic fatigue syndrome (CFS) is a debilitatingillnesswithnoknowncauseoreffectivetherapy. Population-based epidemiologic data on CFS prevalence and incidence are critical to put CFS in a realistic context for public health officials and others responsible for allocating resources and for practicing physicians when examining and caring for patients. Methods: We conducted a random digit–dialing survey and clinical examination to estimate the prevalence of CFS in the general population of Wichita, Kan, and a 1-year follow-up telephone interview and clinical examination to estimate the incidence of CFS. The survey included 33997 households representing 90316 residents. This report focuses on 7162 respondents aged 18 to 69 years. Fatigued (n=3528) and randomly selected nonfatigued (n=3634) respondents completed telephone questionnaires concerning fatigue, other symptoms, and medical history. The clinical examination included the Diagnostic Interview Schedule for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, laboratory testing, and a physical examination. Results: The overall weighted point prevalence of CFS, adjusted for nonresponse, was 235 per 100000 persons (95% confidence interval, 142-327 per 100000 persons). TheprevalenceofCFSwashigheramongwomen,373per 100000 persons (95% confidence interval, 210-536 per 100000 persons), than among men, 83 per 100000 persons (95% confidence interval, 15-150 per 100000 persons).Amongsubjectsnonfatiguedandfatiguedforless than 6 months, the 1-year incidence of CFS was 180 per 100000 persons (95% confidence interval, 0-466 per 100000 persons). Conclusions: Chronic fatigue syndrome constitutes a major public health problem. Longitudinal follow-up of this cohort will be used to further evaluate the natural history of this illness. Arch Intern Med. 2003;163:1530-1536

https://jamanetwork.com/journals/jamainternalmedicine/articlepdf/215827/ioi20498.pdf

Prevalence and Incidence of Chronic Fatigue Syndrome in Wichita, Kansas

The epidemiology of chronic fatigue in San Francisco

An exploratory case-control study was conducted to assess whether the many reported differences in the immune function of chronic fatigue syndrome (CFS) patients are detectable in rigorously defined cases of CFS. Although many studies have reported differences between cases and controls in various measures of immune function, none of these differences were found in all studies. In this study, no differences were found in white blood cell numbers; immune complex, complement, or serum immunoglobulin levels; delayed type hypersensitivity and allergic responses; NK cell function; and proliferative responses to mitogens and antigens. Marginal differences were detected in cytokine responses and in cell surface markers in the total CFS population. However, when the patients were subgrouped by type of disease onset (gradual or sudden) or by how well they were feeling on the day of testing, more pronounced differences were seen.

https://www.jstor.org/stable/info/30130004

Immune Responses Associated with Chronic Fatigue Syndrome: A Case-Control Study

Fatiguing illness among employees in three large state office buildings, California, 1993: Was there an outbreak?

Objective: To study various risk factors previously reported to be associated with chronic fatigue syndrome (CFS). Design: Case-control study. Setting: Metropolitan Atlanta CFS surveillance registr...

Lea Steele

Papers

The epidemiology of chronic fatigue in San Francisco

Immune Responses Associated with Chronic Fatigue Syndrome: A Case-Control Study

Fatiguing illness among employees in three large state office buildings, California, 1993: Was there an outbreak?

Risk Factors for Chronic Fatigue Syndrome: A Case-Control Study