Expert Answers from the Times

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George

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This was just posted on the times. It's not a very good Q & A but it's a few more bits of the puzzle.

http://consults.blogs.nytimes.com/2009/11/24/expert-answers-on-chronic-fatigue-syndrome/?pagemode=print

Here are some excerpts from the Q. and A.

Q. Dr. Klimas, Do you have any thoughts as to how many C.F.S. patients are under the radar because they were not eager to sign up for a wastebasket diagnosis, or otherwise frustrated out of the medical system early on?

A. Currently only 16 percent to 17 percent of the people with chronic fatigue syndrome whose symptoms are severe enough to meet the case definition for the illness have been diagnosed. Whether this is coming from the patient, as you suggest, or a medical community that does not know how or is reluctant to make the diagnosis is less clear.


Q.Have there been clusters or outbreaks of chronic fatigue syndrome, as some have described? And if there were outbreaks, doesnt that make it more likely to be contagious and less likely that the exposure came from exposures between great-great-grandparents and maintained for generations as latent infections, or as infections from early experiences of any sexual partner in a chain of partners?

A. Dr. Klimas responds: These clusters of post-infectious chronic fatigue syndrome are very interesting. Studies by Andrew Lloyd and colleagues showed the one and only predictor of persistent illness after an acute infection was the severity of that initial infection. No psychiatric factors were shown to predict who remains ill.

Some very common infections seem to set off C.F.S. and lead to several theories about the disease. My favorite theory is that any infection that can activate the immune system in a profound way could allow a hidden latent virus or viruses to reactivate and perpetuate a chronic illness. Anything that suppresses the immune system, like some treatments for cancer, might do the same thing, causing profound fatigue in some recovered cancer patients years after chemotherapy.

But why can one person do well and another stay ill after the same infection? Genetics may play a role, but this concept of a vulnerable population with latent XMRV infection is intriguing.

Q. Are There Two Viruses Linked With Chronic Fatigue Syndrome?

A. Dr. Klimas responds: Elaine DeFreitass work and that of Dr. Michael Holmes of New Zealand both involved scanning electron micrographs of viruses. Their findings look a great deal like those that were published in the recent Science article by Dr. Lombardi and colleagues, which Ms. Grady wrote about in The Times,) that found a possible link between chronic fatigue syndrome and the XMRV retrovirus. Could they be looking at the same virus? I dont really know, because I am not a laboratory virologist. But it makes good sense to me.

I remember in the early 1990s a member of our laboratory, Dr. Roberto Patarca, found evidence of production of an enzyme called reverse transcriptase in our cell cultures, more evidence of an active retroviral infection. So the key thing now is for another reputable lab to find the same thing in chronic fatigue syndrome. Then we will see what happens next.
 
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This was just posted on the times. It's not a very good Q & A but it's a few more bits of the puzzle.

http://consults.blogs.nytimes.com/2009/11/24/expert-answers-on-chronic-fatigue-syndrome/?pagemode=print
hiya George

Love it - the NYTImes is on top of this story! Best coverage world-wide I'd say.

I added this to the media - no discussion thread as well so it's there for the record.

Here's another excerpt from the Q. and A. that I thought was well done:

In the population-based Georgia study conducted by the Centers for Disease Control and Prevention, investigators used a broader case definition and identified a population with C.F.S. that was fivefold larger than previous prevalence studies. That study may have included people with other disorders that cause fatigue, and I would expect to see up to a fivefold difference when compared with a more tightly defined group
I can imagine myself doing that dance where the fists float around in circles one way and the hips rotate the other while I sing "go Nancy, go Nancy"

islandfinn:D
 

Jerry S

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Thanks, George!

I'm a regular NY Times reader and missed this. It's great to see Dr. Klimas answering readers' questions.

If you go to the online non-pagemode version of Consults, comments can be left.
 
G

George

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Cooooool I'm going back for comments! Thanks

I'm a regular NY Times reader and missed this. It's great to see Dr. Klimas answering readers' questions.

If you go to the online non-pagemode version of Consults, comments can be left.
Like Koan said in another post we are getting some serious press these days. Makes me want to think about the happy dance. ;)