ME is not mould intolerance; mould intolerance is not ME

Messages
236
Likes
509
Location
Medford NJ
I may start a new thread. The 10 degree weather is tough. I am slipping back to my “ cfs” . I got an electric bkanket for trying to deal with sleeping outside, I cheated and slept inside and ate sugar and too much holidays and slid back,cfs ugh . . Going outside tonight. This takes willpower. Spent a blah day mostly on the sofa. Figures it is the coldest winter in 13 years.
 

Pyrrhus

Senior Member
Messages
4,172
Likes
12,819
Location
U.S., Earth
Likewise, in the case of the Lake Tahoe outbreak, Lake Tahoe survivor @Erik Johnson points out that in the year of the epidemic, a bright green cyanobacteria (toxic algae) started growing all over the beach of Lake Tahoe, which he found made him a little sick. Erik says that a toxic cyanobacteria called Microcystis which periodically grows in the Boca Reservoir (located just north of Lake Tahoe) sometimes results in contamination of the water supplies of both Reno and Lake Tahoe. So this Microcystis toxic cyanobacteria may have been one of the biotoxins present during the outbreak.
I would also point out that Dr. Chia has an alternate explanation. Dr. Chia notes that the local water department was forced to release untreated sewage into Lake Tahoe right before the Lake Tahoe outbreak. Dr. Chia wonders whether enterovirus in the untreated sewage was kept alive inside the natural lake amoebae, leading to swimmers catching enterovirus by accidentally swallowing lake water.
 
Messages
236
Likes
509
Location
Medford NJ
I would also point out that Dr. Chia has an alternate explanation. Dr. Chia notes that the local water department was forced to release untreated sewage into Lake Tahoe right before the Lake Tahoe outbreak. Dr. Chia wonders whether enterovirus in the untreated sewage was kept alive inside the natural lake amoebae, leading to swimmers catching enterovirus by accidentally swallowing lake water.
This seems plausible. I myself find mold is a big factor. I do not think anyone is right or wrong here.

I really think gut issues environmental issues “ Lyme” will all pan out to be part of a similar “ disorder”.

We need bio markers . I avoided mold but also took anti parasite medications. I did extensive probiotics ( gut) per Ken Lassesen.

Ultimately mold and ( brain retraining (not psychotherapy) is moving me forward.

I would just go down the list and start trying what seems plausible to your own situation.
 
Messages
4,409
Likes
5,014
Location
Vermont, school in Western MA
Dual-factor theory of ME/CFS

One argument that may link mold, biotoxins and other chemical toxins to triggering ME/CFS is the fact that ME/CFS can appear in severe yet very localized infectious epidemic outbreaks.

The London 1955 Royal Free Hospital ME/CFS outbreak is one example of a very localized epidemic which afflicted 1 in 10 of the hospital staff, but affected very few people outside the hospital, in spite of the virus being pretty contagious; and the 1984 Lake Tahoe outbreak is another localized outbreak that was severe, but did not spread to the rest of the country.

I always found it very perplexing that infectious epidemic outbreaks of ME/CFS could cause such severe disease, and yet not spread much further than the localized environment, apart from perhaps some sporadic appearing as the virus spreads outwards. To me, that makes it impossible that epidemic ME/CFS is caused by a virus alone, because if it were just a virus, then that virus would have spread to the whole region or country, and caused the same devastation throughout.

But it seems that as these viruses leave the vicinity of these outbreaks, they lose most of their ability to cause ME/CFS.

To my mind, that means there must have been some local cofactor (such as a toxin) present only in the vicinity of the outbreak — a cofactor which in combination with the virus then causes ME/CFS. And as soon as the virus spreads further than the local area containing the toxic cofactor, the virus loses most of its ability to trigger ME/CFS.

So this argument presents the logical requirement for such a cofactor, and this then makes us consider the possibility of mold, biotoxin or toxic chemical cofactors being present only in the vicinity of the outbreak, acting in tandem with the virus to trigger ME/CFS.


In the case of Royal Free Hospital, there were investigations into possible toxic chemicals in the hospital environment (including investigations into the use of pesticides, chemicals used in the kitchen and catering, and the paints and materials used during renovations; ref: 1). These investigations came back negative.

However, I think back in 1955, nobody would have been aware of toxic mold (as there was no knowledge about mold toxicity then), and so would not have looked for it. Thus it is conceivable that there may have been water damage and a toxic mold growth in communal staff rooms in one or more of the hospital buildings, which in combination with the virus, caused the Royal Free outbreak. If the mold infested rooms were used by staff only, that could also explain why it was mostly only the hospital staff who contracted ME/CFS, with very few hospital patients being affected.


Likewise, in the case of the Lake Tahoe outbreak, Lake Tahoe survivor @Erik Johnson points out that in the year of the epidemic, a bright green cyanobacteria (toxic algae) started growing all over the beach of Lake Tahoe, which he found made him a little sick. Erik says that a toxic cyanobacteria called Microcystis which periodically grows in the Boca Reservoir (located just north of Lake Tahoe) sometimes results in contamination of the water supplies of both Reno and Lake Tahoe. So this Microcystis toxic cyanobacteria may have been one of the biotoxins present during the outbreak.

Erik also points out that people who were living or working in buildings he knew to be moldy were more likely to get ME/CFS during the Lake Tahoe outbreak (Erik had had a lifelong mold allergy, so was familiar with which buildings in the area had a mold problem).

Erik Johnson has been championing the theory that toxic mold and biotoxins were the cofactors behind the Lake Tahoe outbreak ever since that outbreak occurred.

For Erik, it was mold avoidance that was key to recovering from his Lake Tahoe ME/CFS (but remember that Erik was mold sensitive anyway, so this treatment may not work for other ME/CFS patients).

Erik sometimes posts on this forum (see his posts here).


So I think the localized nature of the above ME/CFS outbreaks suggests a dual-factor theory for ME/CFS, where a virus may only cause ME/CFS in combination with some immune suppressing factor, such as a toxin.

One fact that tends to corroborate this dual causal factor theory is Dr John Chia's discovery that an acute viral infection + corticosteroids often triggers ME/CFS (see this post for details of Chia's corticosteroid discovery).

Dr Chia investigated thousands of ME/CFS patients' case histories, and noted that ME/CFS was often triggered in these patients when corticosteroids were prescribed during the course of an acute infection. Corticosteroids weaken the immune response, so it seem that when the immune response is weakened during the time of an acute infection when you first catch a virus linked to ME/CFS, that creates the conditions necessary for the virus to trigger ME/CFS.

So with acute viral infection + corticosteroids, we see another example of the dual causal factor theory of ME/CFS.

I think to toxic algae or mold may have analogous immunosuppressive effects to corticosteroids, weakening the immune response in such a way that allows the virus to trigger ME/CFS.
Have you considered copying this and making it into a page on me-pedia , hip? I believe that you have phrased it very well.

In addition have you read this : https://cfsuntied.net/2014/12/04/an...eOOZqwphK_sbu-2nVEg15rnvLBXXBKjt7MDbwQ-WlJdH4
Sort of expands on the theory and the idea of “how did molds become this toxigenic”/different possible environmental causes
 
Messages
4,409
Likes
5,014
Location
Vermont, school in Western MA
I would also point out that Dr. Chia has an alternate explanation. Dr. Chia notes that the local water department was forced to release untreated sewage into Lake Tahoe right before the Lake Tahoe outbreak. Dr. Chia wonders whether enterovirus in the untreated sewage was kept alive inside the natural lake amoebae, leading to swimmers catching enterovirus by accidentally swallowing lake water.
Erik also discussed the sewage. He saw something green come out of the Sewer grates and thinks there may have been a different kind of mold than stachybotrus, people have theorized it was a mold that produces penitrem a. E also wrote about how the sewers were places in which nano particles that could combine with mold could grow
 
Messages
4,409
Likes
5,014
Location
Vermont, school in Western MA
@Hip , Erik also says there have continued to be a disproportionate number of new cases of illness in Tahoe, although recently the school was renovated and apparently doesn’t feel “bad” anymore. He also apparently spoke to David bell about the lyndonville outbreak. David bell told him that a lot of the cases happened in one school. I’m not sure why there haven’t been outbreaks since then if this theory is true but perhaps they just haven’t been reported as well. After all the cdc seemed to want to dissuade people from the idea that this was contagious , (which was perhaps half true). At first I thought Erik was odd, but now I am convinced that he has some really good ideas here. I don’t believe that enough basic epidemiology is being done by researchers here and it’s disappointing. It may not be possible to actually collect physical evidence from Tahoe anymore, although I’m unsure if cheney still has blood samples, but I would think that interviewing surviving patients would be a priority, especially ones with such impressive recoveries as Erik. I’m sure researchers hear a lot of miracle cure recovery stories but this one is plausible—from someone who was documented as being very sick (I’m sure was in cheney and Peterson’s records) and probably had similar lab abnormalities to many classic cfs patients (Erik said these are used to admit patients to the ampligen program that he was going to do). Then he climbed mount Whitney ten times. I understand Erik has alienated basically all of the researchers and even prominent advocates by being impatient and angry with them. Yet I feel others must still push for this research. One thing I will say is I think this paradigm has unique challenges for researchers. I don’t know that the levels of mycotoxins or cyanotocins that would trigger the illness would even be detectable in blood. And this nanoparticle thing seems to imply that the mycotoxins become more bioavailable or something., and even that the nanoparticles themselves could cause some kind of “cell danger response”. So I’m not sure that even the OMF could easily rule this out through blood analysis. However it wouldn’t be impossible to do an animal model of this. Erik did at least get one sample of one of the molds that was sustaining or causing his illness —and it was stachybotrus chartarum. However there were posited outdoor biotoxins that were probably involved , which were not identified

Many patients have benefited from extreme mold avoidance, and yet, that’s not really true recovery. They stay reactive. So I think we all want research into this phenomenon.
 
Messages
4,409
Likes
5,014
Location
Vermont, school in Western MA
as you said, there are some confounding factors with the “desert experiment”, like that you get more sunlight. But if sunlight was that big a deal I think we’d see many more patients reporting getting better from vitamin d megadosing or from sunbathing in general. However the effect of the desert experiment is not that people recover overnight , but mainly that they supposedly “unmask” and are thus more sensitive to mold in their environment and able to tell if it may effect they. Apparently Jen Brea found the mold in her house more apparent once she got back from Moab. So one could be living in mold—like someone whose eating gluten, And not be able to tell one is sick from it. But once away for sufficiently long that one is not being affected by it, one apparently becomes much more sensitive. Jen Brea has said she things this is all due to mcas. But I’m not so sure. I’m not sure using a dehumidifier would be as good an experiment. The problem apparently is that many people who are ill are affected by even small quantities of mycotoxins. Even if you killed all of the mold colonies and got rid of the spores, the mycotoxins are apparently harder to get rid of—I’ve seen some claims in the literature that UV light and ozone can decompose trichothecenes which are of note, but not sure how practical that is and how much is needed. The mycotoxins apparently tend to stick to surfaces. I realize this sounds like someone who is attached to a theory and saying anyone who hasn’t benefited from it hasn’t done the experiment right. But if these properties of molds and mycotoxins exist, it makes sense it would be hard to do a controlled experiment. I also don’t particularly like this theory. I don’t want it to be true. It would be horrible to recover to an extent but then have to avoid basically everywhere and trash all my possessions etc
 

Hip

Senior Member
Messages
17,241
Likes
38,654
Have you considered copying this and making it into a page on me-pedia , hip? I believe that you have phrased it very well.
I'd certainly like to draw attention to this dual-factor theory, but I don't think it could go on MEpedia, as usually such encyclopedias don't host original ideas (it has to be published elsewhere first). The basic idea comes from Erik, which has been published in his book, and perhaps his version could go on MEpedia; but in the above post I've tried to generalize the dual-factor theory.

This generalized dual-factor theory has the potential to connect a lot of dots, and to explain how ME/CFS usually occurs:
  • I think it would apply to most ME/CFS infectious outbreaks that remained localized, like the Lake Tahoe ME/CFS outbreak of 1984, the Royal Free outbreak of 1955, and lots of others, as a local environmental toxin + acute virus etiology.
  • It could explain the Gulf War illness ME/CFS cases, where there was substantial organophosphate exposure, and it's been supposed some circulating virus (as some GWI cases infected family members when they came back home from the war). So this is a organophosphate + acute virus etiology.
  • It would explain Dr John Chia's discovery that immune-weakening corticosteroids + acute virus often triggers ME/CFS.
  • It would explain why chronic major stress often occurs just before someone comes down with ME/CFS: chronic stress releases immune-weakening cortisol, so if you were unfortunate enough to catch a virus during that time of stress, in the dual-factor theory, this stress + acute virus combo may lead to ME/CFS. This stress + acute virus etiology is pretty much identical in its mechanics to Dr Chia's corticosteroids + acute virus etiology. Several studies have found chronic major stress in the year before ME/CFS appeared, see: 1 2 3 4
  • It would apply to Dr Joseph Brewer's findings that ME/CFS patients are often exposed to mold via water-damaged buildings not long before they first developed ME/CFS; possibly the mold weakens the immune system and allows any ME/CFS-associated virus you were unfortunate enough to catch at the same time to trigger ME/CFS. So this is a water-damaged building mold + acute virus etiology.

This generalized dual-factor theory could also explain why when some people catch ME/CFS-associated viruses like enterovirus or EBV they come down with ME/CFS; but most others who catch the same virus do not develop ME/CFS from the virus. The people who develop ME/CFS from the acute virus may at the time be also exposed to one of these second factors such as stress, organophosphates, mold or other biotoxins.

Further reading on this dual factor theory in this post.
 
Last edited:
Messages
81
Likes
155
I read Julie's book. My understanding was that mold avoidance was crucial in her recovery; the psychic work merely got her reactivity down. She actively avoids mold today.

I'd like to know where the evidence for the claim "mould makes no difference to millions of ME sufferers" comes from, which the OP repeated frequently early in this thread.

@SueJohnPat I'm very interested in your story and would love it if you started a new thread about it and tagged me in it! :)
 
Messages
4,409
Likes
5,014
Location
Vermont, school in Western MA
Yes, the title of the thread is basically tautological or circular reasoning. We dont yet know the cause of me/cfs despite many claims to the contrary. If mold intolerance that people with me/cfs like symptoms were experiencing were sniffles and wheezing and signs of a "mere" allergy that was easily alleviated by simply avoiding mold (rather than a complex innate immune response mediated by exposures and sensitization to toxins that dont easily leave the body , and also are immune suppressing which means they can worsen viral infections) then I might agree with the original post. Of course ME is a serious illness and not a simple allergy. But "mold intolerance " is shorthand for a very complex phenomenon not homologous or even analogous to simple allergy, and many ICC ME sufferers, such as myself , benefit from mold avoidance even if we have other things going on, such as structural neuro issues or infections.
 
Messages
81
Likes
155
Yes, the title of the thread is basically tautological or circular reasoning. We dont yet know the cause of me/cfs despite many claims to the contrary. If mold intolerance that people with me/cfs like symptoms were experiencing were sniffles and wheezing and signs of a "mere" allergy that was easily alleviated by simply avoiding mold (rather than a complex innate immune response mediated by exposures and sensitization to toxins that dont easily leave the body , and also are immune suppressing which means they can worsen viral infections) then I might agree with the original post. Of course ME is a serious illness and not a simple allergy. But "mold intolerance " is shorthand for a very complex phenomenon not homologous or even analogous to simple allergy, and many ICC ME sufferers, such as myself , benefit from mold avoidance even if we have other things going on, such as structural neuro issues or infections.
What kind of mold avoidance are you doing?

I recently did two months of mold avoidance tent camping. I seem to have made some improvements, but it wasn't totally clear to me. Now I've gone back to house living and after a few months am declining again. Everything with me is very gradual, including onset of ME/CFS. I don't have dramatic responses like many others. So I'm still not sure about anything -- I like to be able to replicate the results before I say with confidence what's causing what. It may have just been the act of camping helped me, and that mold avoidance wasn't necessary. I'm hoping that's the case, since extreme mold avoidance is very expensive and all consuming.

I'm sure it's been discussed, but now Julie R has made it public that mold avoidance stopped helping her a couple years ago, and she very recently got CCI surgery. Which raises a lot of questions for me.
 

borko2100

Senior Member
Messages
149
Likes
409
I think most people support environmental and diet-related theories, because they imply that there exists an (easily) achievable cure. This doesn't apply just to ME. Such theories are supposed to offer a cure for all kinds of things, despite non existent or limited scientific evidence.

Unfortunately, in reality, most chronic diseases are either incurable, or only curable by risky surgical treatments or lifelong drug therapies. Very rarely is the solution as easy as not eating certain foods, avoiding moldy buildings, lifestyle changes, etc. For some people, this reality is depressing and unacceptable, leading to cognitive biases and support of dodgy and unproven theories.

That being said, I do believe that ME/CFS could make you more sensitive to mold. After all, it makes people sensitive to nearly anything, so mold might just be one more of those things.
 
Messages
4,409
Likes
5,014
Location
Vermont, school in Western MA
What kind of mold avoidance are you doing?

I recently did two months of mold avoidance tent camping. I seem to have made some improvements, but it wasn't totally clear to me. Now I've gone back to house living and after a few months am declining again. Everything with me is very gradual, including onset of ME/CFS. I don't have dramatic responses like many others. So I'm still not sure about anything -- I like to be able to replicate the results before I say with confidence what's causing what. It may have just been the act of camping helped me, and that mold avoidance wasn't necessary. I'm hoping that's the case, since extreme mold avoidance is very expensive and all consuming.
I was doing primarily tent camping until it got too cold. I made a lot of progress with this. When I'm in pristine air the immediate effects on mood/cognition and air hunger are immediate even if the physical improvements take longer to manifest. Since it's been colder I've been bouncing around a lot of bad buildings and got worse rapidly. I'd rather do it in a camper trailer than tent... it would be more streamlined and easy to do but without the problems of conventional housing.

F
I'm sure it's been discussed, but now Julie R has made it public that mold avoidance stopped helping her a couple years ago, and she very recently got CCI surgery. Which raises a lot of questions for me.
I'm not sure that shes said that mold avoidance doesn't affect her positively anymore but rather that it wasnt sufficient anymore. In my case I think it will end up being necessary but not sufficient.
I think most people support environmental and diet-related theories, because they imply that there exists an (easily) achievable cure. This doesn't apply just to ME. Such theories are supposed to offer a cure for all kinds of things, despite non existent or limited scientific evidence.

Unfortunately, in reality, most chronic diseases are either incurable, or only curable by risky surgical treatments or lifelong drug therapies. Very rarely is the solution as easy as not eating certain foods, avoiding moldy buildings, lifestyle changes, etc. For some people, this reality is depressing and unacceptable, leading to cognitive biases and support of dodgy and unproven theories
In my view, in the case of "mold intolerance" it's almost the opposite... if the theory that the microbiome is getting worse (see the recent pnas article I posted on interactions btwn mold and nanoparticle pollution) and affecting our health drastically is true... that would be very upsetting and a hard thing to swallow for most people.

Also, the two people that I consider most prominent in spreading information about "mold avoidance" are Lisa Petrison and Erik Johnson. They don't sell supplements, they dont charge money , which many respect cfs doctors do (in large sums). They also have repeatedly said that they dont want to get everyone to live in a tent in the desert--their primary goal is to get researchers interested in what amounts to a very important clue in this illness.

There are a lot of quack doctors in the environmental illness field, I will give you that. But almost nobody is selling mold avoidance ad a miracle cure. It's a very difficult, counterintuitive lifestyle that's nearly impossible to do even if you have money, and even less possible with no money or assets, and even if it works it's more an ongoing treatment than cure... most people somehow become hypersensitized to the extent that they almost never go back to pre illness levels of reactivity.

In the "mold avoidance " community most of us dont want to sell others on the treatment, we want doctors and researchers to look into something that is destroying our lives. The locations effect on health is probably not all "mold", but probably does have something to do with chemicals disrupting the outdoor and indoor microbiomes. I do not believe it's a placebo. Many have accidentally noticed it. And the research into it has been very neglected. Out of thousands of me/cfs studies I can only think of one poorly designed one that studied this.

Many of the most severe ME patients died largely because their environmental sensitivities left them without a safe place to live, like anne ortegren and heather colman mcgill.

And as @Hip has pointed out more in depth and eloquently than I could, the "dual factor " theory of me/cfs makes a lot of sense in the context of the pattern of outbreaks.
 
Messages
4,409
Likes
5,014
Location
Vermont, school in Western MA
I was doing primarily tent camping until it got too cold. I made a lot of progress with this. When I'm in pristine air the immediate effects on mood/cognition and air hunger are immediate even if the physical improvements take longer to manifest. Since it's been colder I've been bouncing around a lot of bad buildings and got worse rapidly. I'd rather do it in a camper trailer than tent... it would be more streamlined and easy to do but without the problems of conventional housing.
I actually think that IF you can find good housing which is sort of like one in 100 chances with me/cfs it can be a better option than camping. Metal cargo trailer probably better tho. But a house, if it happens to be built well and not moldy--all concrete and steel, or some Adobe's that dont have wood frames and have brick floors, can be harder to contaminate than a tent or a van or porous bedding... and have more airflow
 

borko2100

Senior Member
Messages
149
Likes
409
I was doing primarily tent camping until it got too cold. I made a lot of progress with this. When I'm in pristine air the immediate effects on mood/cognition and air hunger are immediate even if the physical improvements take longer to manifest. Since it's been colder I've been bouncing around a lot of bad buildings and got worse rapidly. I'd rather do it in a camper trailer than tent... it would be more streamlined and easy to do but without the problems of conventional housing.

F
I'm not sure that shes said that mold avoidance doesn't affect her positively anymore but rather that it wasnt sufficient anymore. In my case I think it will end up being necessary but not sufficient.

In my view, in the case of "mold intolerance" it's almost the opposite... if the theory that the microbiome is getting worse (see the recent pnas article I posted on interactions btwn mold and nanoparticle pollution) and affecting our health drastically is true... that would be very upsetting and a hard thing to swallow for most people.

Also, the two people that I consider most prominent in spreading information about "mold avoidance" are Lisa Petrison and Erik Johnson. They don't sell supplements, they dont charge money , which many respect cfs doctors do (in large sums). They also have repeatedly said that they dont want to get everyone to live in a tent in the desert--their primary goal is to get researchers interested in what amounts to a very important clue in this illness.

There are a lot of quack doctors in the environmental illness field, I will give you that. But almost nobody is selling mold avoidance ad a miracle cure. It's a very difficult, counterintuitive lifestyle that's nearly impossible to do even if you have money, and even less possible with no money or assets, and even if it works it's more an ongoing treatment than cure... most people somehow become hypersensitized to the extent that they almost never go back to pre illness levels of reactivity.

In the "mold avoidance " community most of us dont want to sell others on the treatment, we want doctors and researchers to look into something that is destroying our lives. The locations effect on health is probably not all "mold", but probably does have something to do with chemicals disrupting the outdoor and indoor microbiomes. I do not believe it's a placebo. Many have accidentally noticed it. And the research into it has been very neglected. Out of thousands of me/cfs studies I can only think of one poorly designed one that studied this.

Many of the most severe ME patients died largely because their environmental sensitivities left them without a safe place to live, like anne ortegren and heather colman mcgill.

And as @Hip has pointed out more in depth and eloquently than I could, the "dual factor " theory of me/cfs makes a lot of sense in the context of the pattern of outbreaks.
I wish the theory was true, believe me. I sometimes wonder if it applies to me as well, given that I start feeling very bad when I don't leave the house for more than a week.

However, there doesn't seem to be much scientific evidence supporting it.

If it there is indeed such evidence, why haven't researches made human experiments testing the theory? A simple example: take a group of patients, put one half in a moldy building, the other in a very clean zero-mold building, let them live there for a month or two and then see if the no-mold group improves? That can't be that difficult can it?

Surely, if is there is good evidence, even if not scientific, researchers would jump in and do tests to see if it holds up. Take for example the CCI hypothesis. It started gaining traction less than 2 years ago and there's already researchers planning experiments that will put it to the test.
 

Hip

Senior Member
Messages
17,241
Likes
38,654
If it there is indeed such evidence, why haven't researches made human experiments testing the theory? A simple example: take a group of patients, put one half in a moldy building, the other in a very clean zero-mold building, let them live there for a month or two and then see if the no-mold group improves?
There is an inexplicable lack of research into mold illness. Dr Shoemaker has published lots of papers, but his work has not been replicated by independent researchers. I wish other researchers would look more into the effects of mycotoxins.

It would not be ethical to place people into an environment with mold toxins; but certainly you could an experiment where you move people with mold symptoms out of their moldy environment, and into a mold free home, and observe how their symptoms improve.

Oddly enough, there seems to be more concern and research on the way mycotoxins in animal feed affect the health livestock than the way mycotoxins in the home affect humans.
 
Messages
11,521
Likes
27,565
The people who develop ME/CFS from the acute virus may at the time be also exposed to one of these second factors such as stress, organophosphates, mold or other biotoxins.
Secondary factors remain- quite likely in my case.

I came down with Mono at 10, already had some type of compromised immune system..and I'm an surrounded by miles of Almond Orchards, and smudge pots. I continued to live in housing that abutted almond orchards and smudge pots for the next, oh, 10 years. Four bouts of Mono during this time.

I will also never know- in 2018, after 285,000 burns up surrounding me, I returned to the valley, got two severe gastrointestinal near death experiences two months apart, and I simply got MUCH MUCH worse ME...over that subsequent six months of stress, more toxins, more viruses, my theory of possible Nitrous Oxide poisoning events from the gastro, and our ME problem.

People were blowing ashes into the neighbors yards. Lawyers sending mailers of the toxins in the ash.