Post-infective and chronic fatigue syndromes precipitated by viral and non-viral pathogens: prospective cohort study
Top Cited Papers
- 1 September 2006
- Vol. 333 (7568), 575
- https://doi.org/10.1136/bmj.38933.585764.ae
Abstract
Objective To delineate the risk factors, symptom patterns, and longitudinal course of prolonged illnesses after a variety of acute infections. Design Prospective cohort study following patients from the time of acute infection with Epstein-Barr virus (glandular fever), Coxiella burnetii (Q fever), or Ross River virus (epidemic polyarthritis). Setting The region surrounding the township of Dubbo in rural Australia, encompassing a 200 km geographical radius and 104 400 residents. Participants 253 patients enrolled and followed at regular intervals over 12 months by self report, structured interview, and clinical assessment. Outcome measures Detailed medical, psychiatric, and laboratory evaluations at six months to apply diagnostic criteria for chronic fatigue syndrome. Premorbid and intercurrent illness characteristics recorded to define risk factors for chronic fatigue syndrome. Self reported illness phenotypes compared between infective groups. Results Prolonged illness characterised by disabling fatigue, musculoskeletal pain, neurocognitive difficulties, and mood disturbance was evident in 29 (12%) of 253 participants at six months, of whom 28 (11%) met the diagnostic criteria for chronic fatigue syndrome. This post-infective fatigue syndrome phenotype was stereotyped and occurred at a similar incidence after each infection. The syndrome was predicted largely by the severity of the acute illness rather than by demographic, psychological, or microbiological factors. Conclusions A relatively uniform post-infective fatigue syndrome persists in a significant minority of patients for six months or more after clinical infection with several different viral and non-viral micro-organisms. Post-infective fatigue syndrome is a valid illness model for investigating one pathophysiological pathway to chronic fatigue syndrome.Keywords
This publication has 30 references indexed in Scilit:
- Prolonged Illness after Infectious Mononucleosis Is Associated with Altered Immunity but Not with Increased Viral LoadThe Journal of Infectious Diseases, 2006
- Measurement of EBV‐IgG anti‐VCA avidity aids the early and reliable diagnosis of primary EBV infectionJournal of Medical Virology, 2003
- Acute sickness behaviour: an immune system-to-brain communication?Psychological Medicine, 2001
- Self-report disability in an international primary care study of psychological illnessJournal of Clinical Epidemiology, 1996
- Seroepidemiology of Chronic Fatigue Syndrome: A Case-Control StudyClinical Infectious Diseases, 1995
- Lack of Evidence for Infection with Known Human and Animal Retroviruses in Patients with Chronic Fatigue SyndromeClinical Infectious Diseases, 1994
- Cross-cultural Feasibility, Reliability and Sources of Variance of the Composite International Diagnostic Interview (CIDI)The British Journal of Psychiatry, 1991
- Chronic fatigue. A prospective clinical and virologic studyJAMA, 1990
- Antibody responses in acute and chronic Q fever and in subjects vaccinated against Q feverJournal of Medical Microbiology, 1985
- A scale to measure locus of control of behaviourPsychology and Psychotherapy: Theory, Research and Practice, 1984