Fact Sheet
Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME/CFS)
The UK Chief Medical Officer has recently released a report on ME/CFS.1
The following is taken from a letter written to The Lancet in response
to the report. The authors of this article have ‘opposing’ viewpoints
on the illness, yet they have written it in an attempt to find common
ground and a way forward.
So where is the centre ground? First, there is agreement
with the report’s conclusion that the illness “is a relatively common
clinical condition, which can cause profound, often prolonged, illness
and disability, and can have a very substantial impact on the individual
and family.” It is also agreed that it can affect both sexes, and
a wide range of ages, including children.
The report makes plain that it will no longer be acceptable for clinicians
to state that they do not “believe” in CFS/ME. The report is
explicit: it states that “inaction… due to ignorance or denial
of the condition is not excusable.”2
Facts
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It is estimated that as many as 150 000 Australians have ME/CFS.
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Costs the Australian Government – $416 million dollars per
annum.
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In the USA, the National Institutes of Health (NIH), Centers for Disease Control and Prevention (CDC), Food and Drug Administration (FDA) and Social
Security Administration (SSA) all recognise ME/CFS as a
serious, often disabling illness.
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ME/CFS has been declared Number 1 Priority disease along with TB
and AIDS by the Centers for Disease Control and Prevention in USA.
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It is marked by unrelenting exhaustion, muscle pain, cognitive
disorders that patients call “brain fog,” and a myriad
of other physical symptoms.
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90% of patients have not been diagnosed and are not receiving proper
medical care for their illness.
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The severity of the illness varies with sufferers. Some sufferers
have mild symptoms and others are bedridden.
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Severe forms of ME/CFS can lead to paresis, seizures, intractable
headache, cardiac irregularities and gastrointestinal malfunction
with life-threatening complications – even death.
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There is no diagnostic test for ME/CFS. Despite this, doctors can
make a positive diagnosis based on the patient’s symptoms and history,
and by excluding other conditions.
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65% to 80% of people develop CFS suddenly (usually after developing
an infection, or series of infections)
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There is no known pharmacological or non-pharmacological cure for
ME/CFS. ME/CFS affects almost every system of the body having neurological,
gastrointestinal, cardiovascular and musculoskeletal features.
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Pharmacological treatments are a way off – we are in desperate
need for funding for research.
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It is hard to be definitive about the duration of the illness.
One study suggested the average length of the illness was 7.0 years.
Recovery tends to be spontaneous – some get better after 1
to 2 years, others more slowly. Few people get 100% better –
but with lifestyle changes many can lead a normal life, and on a
relative basis would classify themselves as ‘recovered.’
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Some researchers advocate Cognitive Behaviour Therapy (CBT) and
Graded Exercise Therapy (GET) as the only ‘proven’ therapies for
CFS. Consumer groups question a lot of this research – the
selection criteria, the methodology and the extent to which conclusions
can be generalised to the whole CFS population. This debate aside
it is important to note that researchers advocating CBT and GET
are not suggesting that CFS is ‘all in the mind’ nor to believe
them to be curative treatments – this is not the way press
releases are often interpreted.
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There is no dispute that CFS is different from anxiety and depression.
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Research has shown that ME/CFS is about twice times as common in
women: a rate similar to that of many autoimmune diseases, such
as multiple sclerosis and lupus.
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Compounding people’s troubles is a social isolation caused by chronic
illness; loss of capacity to earn an income and pain felt by others
disbelief the reality of the illness.
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The illness itself is poorly understood. Many believe ME/CFS is
simply feeling a bit tired all the time – but it is much more
than ‘chronic fatigue.’ People with ME/CFS suffer from profound
exhaustion (mental and physical), which is not alleviated by rest,
and can be severely exacerbated by only mild activity – this
distinguishes it from ‘chronic fatigue’ and ‘depression.’ Furthermore,
the symptoms are not just fatigue orientated as many patients suffer
from muscle pain, low blood pressure and have difficulty with short-term
memory and trouble thinking clearly.
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Few studies of ME/CFS in children and adolescents have been published.
It is well accepted that adolescents get CFS, although less frequently
than adults. Similarly, the severely ill have rarely been studied
– casting doubt on those who would try to apply research findings
generally to all CFS sufferers.
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A recent report has found CFS is a debilitating as MS, RA and lupus.
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Many pathogens such as the various mycoplasmas, Lyme disease, and
Q Fever have been implicated in the causation or propagation of
CFS. Unfortunately, PCR testing facilities are not yet available
in Adelaide. Yet even if they were, testing is still not 100% reliable
– our technology is inadequate to cope with the new diseases
of the 20th century.
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ME/CFS is recognised by the World Health Organisation.
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Canada has a government department specifically for CFS.
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Many people still believe that people with ME/CFS are ‘malingerers’
and ‘fakes.’ Until this misconception is debunked, people with ME/CFS
will always suffer misunderstanding and will battle to obtain the
rights that others with equally debilitating conditions receive
without question.
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Well known people who are or have suffered CFS (or CFS-like illness)
include:
References
1A good summary can be found here
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2The Lancet, Volume 359, Number 9301 (January
12, 2002)
Christopher Clark, Dedra Buchwald, Anne MacIntyre, Michael Sharpe,
Simon Wessely
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