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I can't say I've heard lots of stories where whole families become ill. I think I've heard of a couple. The only one I know personally where more than a couple family members are now ill (although most of the ill family members are 85% functional, so wouldn't technically qualify as PWME) has persistent Lyme disease with ME-like symptoms including PEM in at least one case.I've heard lots of stories over the years where whole families become ill. Perhaps it depends on the pathogen/s involved. Some may be more highly infectious than others.
We just simply don't know at this point.
So, yes, I'd agree it may depend on the pathogen involved. In the case of Lyme-triggered ME/CFS, it may simply be that all family members were bitten by infected ticks at the same outdoor family event, for example, rather than a person-to-person transmission. Other pathogens may be easily contagious person-to-person, but controlled by healthy immune systems.
Indeed, we really don't know much about transmissibility at this point. All we have are very broad patterns (mostly isolated cases, some parent-child pairs, a few outbreaks) which may fall apart as ME diagnosis improves. At the moment it appears we do not have to worry about transmitting ME to casual contacts since that type of transmission doesn't fit the known distribution of patients at all. Hopefully, some researcher will get this sorted out in the next 10 years or so.
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