Ok, maybe that was a bad analogy.
The point I'm trying to make is if you take 100 random people who have CFS and test the group to see if they have a pathogen in common you aren't going to find one because they all got CFS in a different way. There could be 5 or 10 or more subgroups within that group of 100 people. The only way to find a pathogenic cause of the illness is to split those hundred people into their respective groups. Maybe you can only reasonably identify a strong bond between 5 of them, but it's still more effective than analyzing a larger group of people with totally unrelated diseases. Identifying the cause for those 5 people won't cure all 100, but we can do a few subgroups at a time and get them cured/treated, rather than focus on the 100 and cure none of them.
Think about Koch's first postulate for establishing a causative relationship between a microbe and a disease:
- The microorganism must be found in abundance in all organisms suffering from the disease, but should not be found in healthy organisms.
The way the CFS community has been going about it, it is impossible to satisfy this requirement.
(Edited for clarity)
Trying to subgroup according to how a person got sick (though this seems to be done with Gulf war syndrome with the vetarans which actually presents just like CFS) would be so hard as with lots of us it could of been many different things and what is it takes a multiple triggers to occur.
eg In my case before I got ME I'd gone through that year multiple Hep B vaccinations which were not working so they keep giving me more shots, I was living in a house which bathroom had no ventilation and hence the house developed a serious mold issue (the house also had a severe water issue with water leaking into the home and seeping up in between floor boards).
I'd also around that time been in accidents and ended with whiplash and having to see a chiro for neck injury. I also had a highly stressful life, trying to raise 2 young kids alone one who had a severe disability requiring a lot of care while trying to do full time study and I firstly got ill during exams or trying to meet deadlines with college assignments I was struggling to get done. So what was my ME trigger??? who knows. It could of been any of those things or none of those things or the whole combo of things.
or could of my ME be related to things I may of always had or an exposure when younger? I think I already had something wrong with my immune system due to just how bad I'd had EBV over 10 years before but I'd recovered from that after a term in bed, it never went into ME/CFS. ME/CFS runs in my family too, 3 family members developed it after me and when I read family history there also appears to have been another family member with ME before I was even born.
I also had very toxic chemical exposure as a child eg sheep dips along with chemicals illegally dumped into a paddock as they were too unsafe to be dumped the public dump... the girl who I used to horse ride with where the illegal dumping was at and the horses were kept in that paddock.. she developed ME too many years later possibly around the same time as I did (did my small town have a bit of an outbreak?).
My grandmother had exposure to an actual ME outbreak in the 1950s which affected 600? (the family ME/CFS come from that side of the family from my grandmother (she only had FM though) and that was around the time my father was bor). So anyway, it's impossible to know what contributed to me getting ME/CFS as an adult and I think lot of people do not know what caused them to develop this. Even if you think you know, it could well turn out not to be right and coincidental.
I personally subgroup according to actual symptoms and the whole symptom complex (though would say GWS is GWS so I guess I also do depending on how people ended up sick too if they know. There is also ME outbreaks but I have not heard of CFS outbreaks unless it's the CDC choosing to call CFS ME, obviously Lake Tahoe was an ME outbreak.