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CDC Grand Rounds: Chronic Fatigue Syndrome — Advancing Research and Clinical Education
Elizabeth R. Unger, PhD, MD1; Jin-Mann Sally Lin, PhD1; Dana J. Brimmer, PhD1; Charles W. Lapp, MD2; Anthony L. Komaroff, MD3; Avindra Nath, MD4; Susan Laird, MSN5; John Iskander, MD6 (View author affiliations)
https://www.cdc.gov/mmwr/volumes/65/wr/mm655051a4.htm#B1_down
Intro:
Chronic fatigue syndrome (CFS) is a complex and serious illness that is often misunderstood.
Experts have noted that the terminology “chronic fatigue syndrome” can trivialize this illness and stigmatize persons who experience its symptoms (1).
The name was coined by a group of clinicians convened by CDC in the late 1980s to develop a research case definition for the illness, which, at the time, was called chronic Epstein-Barr virus syndrome.
The name CFS was suggested because of the characteristic persistent fatigue experienced by all those affected and the evidence that acute or reactivated Epstein-Barr virus infection was not associated with many cases (2).
However, the fatigue in this illness is striking and quite distinct from the common fatigue everyone experiences.
A variety of other names have been used, including myalgic encephalomyelitis (ME), ME/CFS, chronic fatigue immune dysfunction, and most recently, systemic exertion intolerance disease (3).
The lack of agreement about nomenclature need not be an impediment for advancing critically needed research and education. The term ME/CFS will be used in this article.
ME/CFS is a Significant Public Health Problem
Extrapolating from the three U.S. population-based studies, it is estimated that at least one million persons in the United States suffer from ME/CFS (4–6).
These studies indicate that ME/CFS is three to four times more common in women than in men.
Persons of all racial and ethnic backgrounds are affected; however, the illness is more prevalent in minority and socioeconomically disadvantaged groups.
The highest prevalence of illness is in persons aged 40–50 years, but the age range is broad and includes children and adolescents.
ME/CFS patients, their families, and society all bear significant costs associated with this illness.
These include direct medical costs for provider visits and medications and indirect costs of lost productivity.
In the United States, the estimated annual cost of lost productivity ranges from 9–37 billion dollars, and for direct medical costs, ranges from 9–14 billion dollars, with nearly one quarter of direct medical expenses paid directly by patients and their families (7–9).
When ME/CFS occurs in patients aged <25 years, these patients might not achieve their full educational potential, resulting in a life-long impact on their earnings (7).
ME/CFS patients have significant functional impairment as illustrated by findings from CDC’s ongoing study of patients in seven clinics of ME/CFS specialists (Figure).
Functioning of ME/CFS patients, as measured by subscale scores on the 36-Item Short Form Survey (SF-36), were well below those of healthy persons except for the two subscales reflecting mental and emotional functioning.
Despite the severity of their illness, ME/CFS patients face significant barriers to receiving appropriate health care.
A population-based study in Georgia found that 55% of persons with ME/CFS reported at least one barrier to health care; for example, 10% had financial barriers to seeking needed health care (10).
Most persons with ME/CFS identified in population surveys have been ill >5 years and only approximately half continue to seek medical care (4–6). Further, only approximately 20% received a diagnosis, emphasizing the need for more physician education about this illness.
Read more at the link above...
(Each sentence was given a new paragraph to make reading easier)
Elizabeth R. Unger, PhD, MD1; Jin-Mann Sally Lin, PhD1; Dana J. Brimmer, PhD1; Charles W. Lapp, MD2; Anthony L. Komaroff, MD3; Avindra Nath, MD4; Susan Laird, MSN5; John Iskander, MD6 (View author affiliations)
https://www.cdc.gov/mmwr/volumes/65/wr/mm655051a4.htm#B1_down
Intro:
Chronic fatigue syndrome (CFS) is a complex and serious illness that is often misunderstood.
Experts have noted that the terminology “chronic fatigue syndrome” can trivialize this illness and stigmatize persons who experience its symptoms (1).
The name was coined by a group of clinicians convened by CDC in the late 1980s to develop a research case definition for the illness, which, at the time, was called chronic Epstein-Barr virus syndrome.
The name CFS was suggested because of the characteristic persistent fatigue experienced by all those affected and the evidence that acute or reactivated Epstein-Barr virus infection was not associated with many cases (2).
However, the fatigue in this illness is striking and quite distinct from the common fatigue everyone experiences.
A variety of other names have been used, including myalgic encephalomyelitis (ME), ME/CFS, chronic fatigue immune dysfunction, and most recently, systemic exertion intolerance disease (3).
The lack of agreement about nomenclature need not be an impediment for advancing critically needed research and education. The term ME/CFS will be used in this article.
ME/CFS is a Significant Public Health Problem
Extrapolating from the three U.S. population-based studies, it is estimated that at least one million persons in the United States suffer from ME/CFS (4–6).
These studies indicate that ME/CFS is three to four times more common in women than in men.
Persons of all racial and ethnic backgrounds are affected; however, the illness is more prevalent in minority and socioeconomically disadvantaged groups.
The highest prevalence of illness is in persons aged 40–50 years, but the age range is broad and includes children and adolescents.
ME/CFS patients, their families, and society all bear significant costs associated with this illness.
These include direct medical costs for provider visits and medications and indirect costs of lost productivity.
In the United States, the estimated annual cost of lost productivity ranges from 9–37 billion dollars, and for direct medical costs, ranges from 9–14 billion dollars, with nearly one quarter of direct medical expenses paid directly by patients and their families (7–9).
When ME/CFS occurs in patients aged <25 years, these patients might not achieve their full educational potential, resulting in a life-long impact on their earnings (7).
ME/CFS patients have significant functional impairment as illustrated by findings from CDC’s ongoing study of patients in seven clinics of ME/CFS specialists (Figure).
Functioning of ME/CFS patients, as measured by subscale scores on the 36-Item Short Form Survey (SF-36), were well below those of healthy persons except for the two subscales reflecting mental and emotional functioning.
Despite the severity of their illness, ME/CFS patients face significant barriers to receiving appropriate health care.
A population-based study in Georgia found that 55% of persons with ME/CFS reported at least one barrier to health care; for example, 10% had financial barriers to seeking needed health care (10).
Most persons with ME/CFS identified in population surveys have been ill >5 years and only approximately half continue to seek medical care (4–6). Further, only approximately 20% received a diagnosis, emphasizing the need for more physician education about this illness.
Read more at the link above...
(Each sentence was given a new paragraph to make reading easier)