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Disease Management Clinical Decisions

Chronic Fatigue Syndrome



e. Correct.

CFS was first defined in 1988 after an "epidemic" of the disease came about in Incline Village, Nevada in 1984.(2) The CDC evaluated the patients in this epidemic and the initial leading theory of causation was an infectious process. Initial studies from this cohort suggested EBV as a possible etiologic agent based on serologic testing, but subsequent studies on larger cohorts and other control populations refuted this assertion. Despite such evidence the terms chronic EBV or "chronic mono" are still frequently used for the condition. Furthermore, no causality has been clearly demonstrated for any underlying etiology or trigger. The disease was ultimately labeled chronic fatigue syndrome in 1988 because the name does not imply a known pathology.(3) 

Over the years many terms have been incorrectly used to describe CFS. Chronic immune dysfunction syndrome (CFIDS) is frequently used interchangeably with CFS, and is the preferred term used by many including, one of the largest patient advocacy groups in the U.S. But to others, the term CFIDS implies a known pathophysiology and for this reason is not universally preferred.(3) Another diagnostic term, myalgic encephalomyelitis (ME) is frequently used for CFS outside the US and also implies a known pathophysiology, but ME has its own case definition, separate from CFS.(4) Fibromyalgia, while it does share some overlapping symptoms and features with CFS, is a separate entity and should not be used interchangeably.