Where is the evidence that the triggers in the quote above are more common than the triggers in the quote below? Have adequate studies even been done to substantiate such a claim?
Dr Chia published
one letter detailing the probable causes of ME/CFS in 200 consecutive patients. Here you see that vaccination is the probable cause of 1.5% of cases of ME/CFS, toxic mold exposure is the probable cause 1% of cases of ME/CFS, whereas enterovirus he finds is the probable cause of 55% of cases. Surgery-triggered ME/CFS does not appear at all.
Epstein-Barr virus seems infrequent in Chia's list, at only 3% of ME/CFS cases, but I think the percentage of EBV-triggered ME/CFS is probably more like 20% of cases (I did a calculation
here that indicates this). Perhaps he does not get many EBV patients, because he is more known for his interest in enterovirus.
And if you spend long enough reading patient stories on these forums, and other ME/CFS literature, you get you own impression regarding how common each triggering factor is. You see vaccination triggers relatively rarely on these forums, but viral triggering is very common. And I have only seen two cases of surgery-triggered ME/CFS in the 6 years that I have been reading ME/CFS forums.
Of course, there needs to be more research looking at exactly what causes ME/CFS and how frequently it does so. And there are some other ideas about what might trigger ME/CFS, such Dr Lipkin's ideas that it is some bacteria in the gut. But there is no evidence for this gut bacteria theory at all at the moment; it's just an idea.
You've just said a few "occasional" triggers in the quote above and yet below you plough on as though these infections are the only trigger in the quote below.
If enterovirus is causing the bulk of ME/CFS cases as Dr Chia's figures suggest, then obviously you'd best try to explain that subset of ME/CFS first, because that's the subset of disease that affects the largest group of people.
It's possible that other triggers like vaccination might create slightly different versions of this disease, which may have a slightly different pathophysiology. But you get variations on the theme in many diseases, for example, there are 4 types of multiple sclerosis. You may get variations, but there will also be core features common to all variations. So this would not affect the hunt for a unified theory of ME/CFS.
If you claimed that some other triggers happen occasionally, then a theory based on these few infectious triggers is not very unifying at all.
That's not what I was talking about. What I tried to point out was that there is a strong link between ME/CFS and certain specific viruses, such as enterovirus and EBV. For the enterovirus ME/CFS research, which goes back to the 1970s and earlier, see
this post.
By contrast, there is no link whatsoever between ME/CFS and other common viruses, for example norovirus. Norovirus has never precipitated ME/CFS as far as we know, whereas enterovirus and EBV seem to do it all the time.
Therefore a unified theory would need to explain why enterovirus and EBV can trigger ME/CFS, but other viruses like norovirus cannot.