Question

A friend of mine has recently had several weeks of post-viral fatigue following a nasty chest infection that she caught at Christmas. Fortunately, she’s now almost back to normal. But this set me thinking about what advice we should pass on to someone we know who gets an infection, and isn’t getting over it as quickly as they should. In particular, is anything they can do to reduce the risk of an episode of prolonged post-viral fatigue progressing into ME/CFS?

Answer

Firstly, it is not unusual to feel fatigued for a few weeks after a nasty viral infection. However, if this persists, the possibility of a post-viral fatigue syndrome should be discussed with their GP — because, as you correctly point out, post-viral fatigue can sometimes turn into ME/CFS. We suggest that anyone in this position goes back to their GP who can take a proper history and do a few basic tests if appropriate.

If someone does have a post-viral fatigue syndrome the most important part of management will be pacing their activities (physical, mental, and emotional) in a way that is carefully balancing rest and activity and is not going beyond their mental or physical limitations and exacerbating their symptoms. This will inevitably involve a period of changes to normal routine — especially involving housekeeping, education and work — and a period of good old-fashioned ‘convalescence'. Sadly, this is something that has largely gone out of fashion as far as medical management is concerned.

Good quality sleep and a healthy balanced diet are also important in aiding the recovery process in post-viral fatigue. But I'm afraid there is no evidence that any specific drug treatment, or vitamins and supplements, is of any value in reducing the length or severity, or helping to prevent it develop into ME/CFS.