It's not impossible for ebv cmv hhv6 to be the initial trigger, maybe more common then your indicating. I say this as the dubbo studies followed people (adults)after glandular fever infections as well as other viruses. It was about 10% who ended up with ongoing fatigue. Cmv mono that was apart of my cfs onset at the age of 31. Again I think it's a sub group thing and whenever cfs is researched there's always this ebv group that pop up. Dr Peterson has mentioned that this herpes sub group are the group that they can potentially improve or maybe cure as there's treatments available.
We are just all unique with infections and immune issues but all have cfs me. When they eventually work this mess out, I think we are all going to need different treatments. It would make it easier if there was just one universal cause
It's not
impossible for HHV-6 or EBV to be the initial triggers, sure, but if these are triggers, they are very rare ones.
If HHV-6 were a main triggering virus of ME/CFS, then we would see most cases of ME/CFS appearing in babies of the ago 0 to 3 years old, since that is the period were the vast majority of people pick up HHV-6.
Likewise, if EBV were a main triggering virus of ME/CFS, then we would see most cases of ME/CFS appearing in the teenage years, when most people pick up EBV (usually from kissing one of their teenage girlfriends or boyfriends).
Though EBV is a special case. It is known that some people develop chronic infections when they first catch EBV, and the symptoms of those chronic EBV infections can be pretty much identical to ME/CFS, even though these EBV infection do often clear up after a year or so. (In fact, I often suspect that people who say that they were cured of their ME/CFS after just a few years probably only had EBV-driven ME/CFS symptoms in the first place, which as stated, tend to clear up anyway).
Another issue is this: in spite of the fact that you often hear people say "
ME/CFS is a condition of unknown etiology," this is not really correct, because we know that ME/CFS can be caused by parvovirus B19, Chlamydia pneumoniae, Coxiella burnetii, and Giardia lamblia. So in these cases, ME/CFS is in fact a condition of
known etiology — and most of these cases of ME/CFS are pretty treatable too (except Giardia lamblia etiologies, I think).
My guess would be that most of the
unknown cases of ME/CFS will in fact turn out to be caused by enterovirus, which being a "stealth virus" — enterovirus hides away inside cells in its non-cytopathic form — would explain why in these unknown cases of ME/CFS, it is hard to find any evidence of infection (apart from a few herpes family virus reactivations). Once we have better and easier ways of detecting this non-cytopathic stealth form of enterovirus through lab blood tests, then I think this may revolutionize the field of ME/CFS.
The very fact that in these unknown cases of ME/CFS, it is hard to find any evidence of infection, makes enterovirus a strong candidate for the cause of these unknown cases: because enterovirus is the only virus I am aware of that has this non-cytopathic "stealth virus" form that hides away from detection. It is often observed that ME/CFS is triggered by some respiratory virus, but then regular blood tests cannot find any evidence of an active infection with the virus. This fact really points the finger at enterovirus — a respiratory virus which in chronic infections cannot be easily detected by normal lab blood tests.
It would great in future if we would create some wearable digital device that would somehow record the appearance in our blood or saliva of every new antibody response, and log these antibody responses in a file. Then every human being would have a complete record of every new pathogen that hit them throughout their lives. It would then be much easier to work out the cause and effect relationship between catching a pathogen and the subsequent appearance of a disease.
With such a technology, each of us would know the identity of the respiratory pathogen that triggered our ME/CFS.
If only there were some way to use say visible or infrared light to detect antibodies. Then you could wear say a wristwatch that would shine a light into your skin say every hour, and detect any newly-appearing antibodies, and record these in a memory chip within the watch. That would be a great advance.
Dr Chia is doing the next best thing to this: he
published a longitudinal study looking at people who were hospitalized for enterovirus infection, and observing how many of these enterovirus infectees went on to develop ME/CFS soon after. He found that 3 of these infectees went on to develop ME/CFS (out of how many infectees in total, I am not sure).