From the New Scientist, 2 July 2015.
Misunderstood and neglected for more than 25 years, there is suddenly new hope for people diagnosed with what was once cruelly called “yuppy flu”
HAVING a condition that no one understands is bad enough. Having one that many also doubt the existence of is worse. Yet that has been the unenviable fate of millions of people diagnosed with chronic fatigue syndrome.
CFS first entered the medical lexicon in 1988 to describe a cluster of symptoms without an obvious cause that doctors were seeing in the Lake Tahoe area of Nevada. The principal symptom was debilitating tiredness, but people also complained of sore throats, headaches, muscle pain and various other manifestations of general malaise.
The lack of a clear biological cause, the fuzziness of the symptoms and the fact that many of the people diagnosed were young professionals opened the door to a smear campaign. The media were quick to dub CFS “yuppie flu”.
Although it has shaken off some of its more pejorative nicknames in recent years, CFS has struggled to lose the stigma. People with the syndrome still say they are not taken seriously, blamed for their illness, or accused of malingering. Treatments are often psychiatric, which are a great help to many but unintentionally add weight to the idea that CFS has no physical cause.
Over the years, medical groups have launched campaigns to have CFS taken more seriously. The latest was in February, when the US Institute of Medicine proposed making a clean break with the past by renaming it systemic exertion intolerance disease. This has not caught on as yet.
The unsatisfactory state of affairs is largely a reflection of the fact that we do not have a good biological explanation for CFS. That has not been for lack of trying, but even here the disease seems to be a magnet for controversy. A paper published in 2009 in Science claimed to have found an association between CFS and a mouse virus. The paper was later retracted after other teams failed to replicate the result.
Now there is hope of a breakthrough. Researchers in Norway have been trialling a drug normally used to knock out white blood cells in people with lymphoma and rheumatoid arthritis. Two thirds of the people who took it experienced major remission of CFS symptoms, essentially returning to normal life, with bursts of vitality unthinkable while they were ill (see “Antibody wipeout relieves symptoms of chronic fatigue syndrome”).
The discovery – which sprang from a serendipitous observation – offers more than just the promise of a much-needed treatment. It also suggests that the symptoms are somehow caused by antibodies originally produced to fight off an infection. The researchers speculate that they might disrupt blood flow, leaving muscles drained of energy.
If correct, this brings the scientific story full circle. CFS was initially suspected to be a “post-viral” syndrome – the lingering after-effects of an infection with Epstein-Barr. More importantly, it could offer people diagnosed with CFS both physical relief and psychological closure.
There are wider implications too. Pain and fatigue without an obvious cause account for a large percentage of visits to the doctor, and usually have an unsatisfactory outcome. On top of that, there are many other conditions – Morgellons, for example – that struggle for credibility. If the CFS mystery is finally solved, that offers hope to countless others struggling with unexplained symptoms. It may take another serendipitous discovery, but science is good at those.
This article appeared in print under the headline “Revitalised”.
HERE'S HOW WE COVERED THE STORY TWO DAYS AGO