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Why glandular fever doesn't exist
Tuesday 20 April 2010
Why glandular fever doesn't exist
By Karen Fittall
WHATEVER happened to ...Chronic fatigue, Glandular Fever AND Seasonal Affective Disorder? Karen Fittall investigates the diseases that seem to have disappeared.
Chronic fatigue syndrome
When chronic fatigue syndrome (CFS) became a "named" illness in the 1980s, everyone knew someone who had it.
Skip to 2010, and it hardly rates a mention. But Professor Andrew Lloyd, from the University of New South Wales’ department of pathology, says the incidence of CFS remains unchanged. It’s believed as many as 0.7 per cent of the general population suffers from it, which in real terms means more than 125,000 Australian adults have CFS.
So why is it flying under the radar? Probably because it’s less controversial today. "Ten years ago, there was a question mark about the validity of the condition, or claims that it may simply be a psychiatric disorder, rather than a physical illness. Now that that controversy has been put to bed, we’ve seen a reduction in how much it makes the news," says Professor Lloyd.
The biggest misconception is that the type of fatigue it results in is similar to the everyday variety most of us experience. “Anyone who has ever felt tired believes they can identify with CFS and may think, ‘I often feel exhausted and manage to get on with it’. But the fatigue experienced by a person with CFS is entirely different,” says Professor Lloyd. For example, it can take a CFS sufferer days to recover from a walk around the block.
Thanks to research, we now know more about what the syndrome isn’t caused by, "but we still haven’t developed a diagnostic test for CFS, resolved the biological basis of the illness, or developed a curative treatment,” says Professor Lloyd. He adds that there is now a consensus that CFS is probably a neurochemical brain disorder, albeit a reversible one. :Although we still don’t know the exact nature of it."
Back in the 70s, statistics show that about one per cent of the teenage population got glandular fever. But Dr Rajiv Khanna, who heads the Australian Centre for Vaccine Development at the Queensland Institute of Medical Research (QIMR), suspects the disease is on the rise.
"I’d say the number of glandular fever cases has increased slightly over the years, particularly in developed countries where an increasing awareness of hygiene has meant more and more children aren’t coming into contact with the Epstein-Barr virus (EBV), which causes the disease, until adolescence or their teenage years."
About 95 per cent of adults are infected with EBV, but while most children in developing countries come into contact with it before the age of three, when it creates little effect, in developed countries, it’s thought that as many as 40 per cent of teenagers are still to contract it. At that age, the immune response is usually stronger, so the typical symptoms of glandular fever can be more severe.
So why is it flying under the radar? Because very few adults develop glandular fever, the main explanation is that as you grow older, you’re less likely to know people struck down by it, perhaps until your kids reach their teens. The biggest misconception is that you can get glandular fever more than once. You can’t. "You can get a ‘reactivation’, but very rarely would actual symptoms accompany this," Dr Khanna says.
Thanks to research, we now know it’s not the actual virus that causes the symptoms of glandular fever, it’s how the immune system responds that makes people sick. Based on this knowledge, QIMR experts have been working on a vaccine that will eventually train the immune system to deal with the virus without causing the debilitating symptoms.
Seasonal affective disorder
When seasonal affective disorder (SAD) hit the headlines in the 1980s, it felt like we finally had a medical explanation for the "winter blues". Thirty years on it’s estimated that, in some parts of the world, SAD affects 10 per cent of the population to varying degrees.
So why is it flying under the radar? It’s not flying under the radar so much as it just isn’t news anymore.
People may think that if you’ve ever felt down during winter, there’s a good chance you’ve got SAD. In fact, living in Australia, there’s a better chance that you don’t, with one study showing that as little as 0.5 per cent of our population is affected.
"Not only is it quite common for healthy people without depression to feel a bit low during winter when a lot of the activities associated with summer disappear,” says Dr Michael Baigent, Beyondblue’s clinical adviser, "but research shows that even on the dullest days in this country, there is enough light to satisfy the area of our brains that has been linked to SAD. Having said that, there’s no doubt that some people’s depression may be triggered by the changes that a different season brings about, but this isn’t related to actual light levels, so technically, it isn’t SAD."
Thanks to research, Dr Baigent says we now know "a lot more about the dose of sunlight that’s required to treat the condition. And we also know how to tackle it with other approaches and interventions as well."
Repetitive stress injury
In 1989, Telecom Australia reported a repetitive stress syndrome (RSI) “epidemic”: over a five-year period, the company received nearly 4000 reports of RSI from its workers. The worst affected? Staff members tapping away on keyboards.
Not long after, ergonomics hit the scene and RSI seemed to fade into the background. Or did it? The answer, according to Jodi Oakman, senior lecturer at La Trobe University’s Centre for Ergonomics and Human Factors, is yes and no.
"We’ve certainly become much better. In the late 80s we used to plonk people in front of a computer and provide no training about workplace health or ergonomics. So there’s been quite a dramatic change in that respect."
But recent reports show work-related RSIs are still wreaking havoc: according to Microsoft, RSI cases hit an all-time high two years ago, costing $US600 million ($A655) in lost working hours.
So why is it flying under the radar? There’s a good reason you won’t have heard the phrase RSI (or even Occupational Overuse Syndrome) much lately: it’s had a name change. The terms RSI and OOS have been replaced with the words musculoskeletal disorder (MSD), so it’s not necessarily the case that it’s not as prevalent, it’s just more likely to be called something different.
The biggest misconception about this condition is that the cause is always physical. "In fact, there are often many other factors involved in MSDs," Oakman says. “These include a person’s workload, how much support they get and their relationship with colleagues.” Hence the name change: both RSI and OOS imply the cause is purely physical and that’s not necessarily the case.
Thanks to research, we now know how to treat the condition more effectively. Oakman says that if the growing understanding of the other factors that contribute to MSDs are taken into account, there is more chance that an “injury” will be treated successfully.
Restless legs syndrome
Australia’s leading economic consulting firm, Access Economics, calls restless legs syndrome (RLS) the "most common medical condition most people have never heard of".
"RLS is certainly very common,” says Dominic Thyagarajan, professor of neuroscience at Monash University. “It has been estimated to affect five to 15 per cent of the population."
So why is it flying under the radar? Most likely because RLS is under diagnosed. "Patients don’t always recognise it as a disorder so don’t visit their doctor, or a doctor may not recognise the condition from the description the patient gives of their symptoms," Professor Thyagarajan says.
The biggest misconception about this condition is that it doesn’t cause too much disruption to someone’s life, but studies have shown that people with moderate to severe RLS get less sleep than patients with almost any other type of persistent sleep disorder. This means 53 per cent of RLS sufferers are likely to feel depressed.
Thanks to research, we now know a little more about what causes RLS, and genetics may have an important role to play, with a positive family history for RLS present in about 50 per cent of people with the condition.
The article originally appeared here.
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