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Monday, October 19, 2009

Viral Cause for Chronic Fatigue?

Chronic Fatigue Patients Vindicated?

Imagine developing fatigue so profound you're almost unable to get out of bed, much less participate in activities requiring any physical effort. Now add to that muscle aches and pains and cognitive difficulties. To complete the picture, let's say these symptoms persist for months and are unrelieved by rest, no matter how much you get. The cause? Chronic fatigue syndrome or CFS, a much maligned syndrome even or especially largely disparaged by the medical establishment.

Now CFS and those afflicted by it may finally get some respect. That's because a potential viral cause for CFS has been identified by an astute researcher and published in this week's Science: Detection of an Infectious Retrovirus, XMRV, in Blood Cells of Patients with Chronic Fatigue Syndrome. XMRV, for xenotrophic murine leukemia virus-related virus, was found in 67% of 101 patients with the syndrome, while only about 4% of people without the syndrome were infected. When the researcher looked for antibodies to the virus, 95% of those with CFS had them, indicating that they had been exposed to the virus at some point.

Does this establish a cause and effect relationship, such as that for HIV and AIDS? No, not yet. Further studies will be needed to nail that down. But what it does do is point researchers in a direction for investigation, and in the short term, may legitimize CFS as a real physical illness and not a case of malingering.

Rick and I are both of the opinion that finding a virus lurking about is no surprise, and again, HIV is a great example. When 'acquired immune deficiency' came on the domestic scene in the 1980s, no one knew what was causing it. Rigorous investigation finally turned up HIV as the culprit, and now we know that a number of its cousins are important pathogens for animals as well. We also know from our experiences with 'bird' and 'swine' flu, that viruses that will ultimately end up as pathogens in people are fermenting in animal populations all the time. This may be one more example.

Other topics in this week's podcast include JAMA's early release articles on H1N1, and comparative effectiveness of methods to remove the prostate gland, and in Archives of Internal Medicine, whether your neighborhood could increase your chances of developing type 2 diabetes. Until next week, y'all live well.

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