"Post-infectious Disease Syndrome" - 1988 Review

I thought this was kind of interesting. It's a pretty detailed review of the then current state of knowledge about ME (called here a "post-infectious disease syndrome") from 1988. That's the same year that the CDC created the first "CFS" case definition.

Post-infectious disease syndrome
B. A. Bannister
Postgrad Med J 1988 64: 559-567

http://pmj.bmj.com/content/64/753/559.full.pdf

In addition to a good thumbnail history of the disease as well as a good description of its symptoms (26 years ago), it includes a discussion of the possible role that enteroviruses might play.

Some of the material is dated, I'm sure, but I found this bit intriguing...

If I read that right, he's suggesting that the disease might be the result of exposure to more than one pathogen, perhaps two closely spaced enterovirus exposures, not just one.

I'd imagine that would make the cause much more difficult to pin down since exposure to only one pathogen would be insufficient.

Anyway, it's striking that the disease was being written about with such clarity in 1988... and then they came up with "CFS"...

 

Its amazing that its almost 30yrs since that review was posted.

Not much has changed since and i think it just about hits the nail on the head with this illness not being caused by 1 infection but maybe multiple infections and immune dysfunction.

Its disappointing that not more treatments have been found since and makes it more believable of some sort of conspiracy theory exists.

I could imagine reading that in 1988 and thinking wow there not far from working this out but here we are 30 yrs on. I hope that in another 30yrs time someone isnt reading this post and saying not much has changed in 60yrs??

 

That will probably be us still

 

This resembles my two hit hypothesis. Its entirely possible that an initial enteroviral infection could prime the immune system, then some subsequent enteroviral infection might trigger a heightened immune response. There is also the question of what turns a lytic enteroviral infection into a a non-lytic one. This might have something to do with the trigger.

 

I can't find it at the moment, but I'm all but certain that I recall one researcher who maintained that ME/"CFS" was often preceded by a gastro-intestinal infection something like six months before onset. That would be consistent with my case in which a stomach flu actually sent me to the doctor (I never went to the doctor in those days) about 4 months prior to the onset of ME. The actual ME onset came on the heels of a severe infection with what I presume to have been influenza (it occurred on the tail end of that year's seasonal influenza outbreak).

It does make me wonder about a two hit hypothesis in which the first hit primes you and the second initiates onset.

 

My onset was a 3 hit, i was still in a post viral state from cmv when i got chickenpox and was still in a post viral state from chickenpox when i was hit with ebv.

Maybe the initial infection lowers our defence and lets others get it and further damages us? Cant say i had a gastro bug but i do fit into the herpes virus sub group.

 

I would agree with this in my case too. The iinitial viral hit followed by a series of vaccines. I don't know when I was infected with h.pylori because I didn't experience symptoms, but looking back I suspect I may have had this infection before the viral/vaccine hit and the symptoms started when my immune defense was shot.