INTRODUCTION
An infectious epidemic outbreak, characterized by acute onset of severe influenza like symptoms and accompanied by severe venous involvement, occurred in 1975 in a community hospital in Carmichael, a suburb of Sacramento, CA. Vascular features ranged from spontaneous bruising with numbness, tingling, and burning to painfully swollen veins. The severity of disease appeared to be associated with the extent of vascular sequelae. The hallmark symptom of painful veins appeared to be similar but more severe and extensive than the Epidemic Phlebodynia documented in three other hospital epidemics reported in 1953, 1957, and 1965 (1-3). Headaches, sore throat, fever, dizziness, runny nose, nausea and vomiting, severe exhaustion and weakness, severe generalized pain, disturbances of cognition/mentation, and nervous system abnormalities resembled Epidemic Neuromyasthenia (ENM), Chronic Fatigue Syndrome (CFS) and Myalgic Encephalomyelitis (ME). Today these illnesses are thought to represent the same and/or a spectrum of related disease states.