Search tips
Search criteria 


Logo of jrsocmedLink to Publisher's site
J R Soc Med. 1988 June; 81(6): 326–329.
PMCID: PMC1291623

Postviral fatigue syndrome: persistence of enterovirus RNA in muscle and elevated creatine kinase.


Enterovirus-specific probes have been prepared by reverse transcription of conserved sequences in purified Coxsackie B2 virus genomic RNA and molecular cloning techniques. These probes were used in quantitative slot blot hybridizations to test for the presence of enterovirus-specific RNA in skeletal muscle biopsy specimens from 96 patients who had suffered from the postviral fatigue syndrome myalgic encephalomyelitis for up to 20 years. Biopsy specimens from 20 patients were positive for the presence of virus-specific RNA with hybridization signals more than three standard deviations greater than the mean of the normal muscle controls. Biopsies from the remaining 76 patients were indistinguishable from the controls. These data show that enterovirus RNA is present in skeletal muscle of some patients with postviral fatigue syndrome up to 20 years after onset of disease and suggest that a persistent virus infection has an aetiological role.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (804K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Calder BD, Warnock PJ. Coxsackie B infection in a Scottish general practice. J R Coll Gen Pract. 1984 Jan;34(258):15–19. [PMC free article] [PubMed]
  • Calder BD, Warnock PJ, McCartney RA, Bell EJ. Coxsackie B viruses and the post-viral syndrome: a prospective study in general practice. J R Coll Gen Pract. 1987 Jan;37(294):11–14. [PMC free article] [PubMed]
  • McEvedy CP, Beard AW. Royal Free epidemic of 1955: a reconsideration. Br Med J. 1970 Jan 3;1(5687):7–11. [PMC free article] [PubMed]
  • Behan PO, Behan WM, Bell EJ. The postviral fatigue syndrome--an analysis of the findings in 50 cases. J Infect. 1985 May;10(3):211–222. [PubMed]
  • Jamal GA, Hansen S. Electrophysiological studies in the post-viral fatigue syndrome. J Neurol Neurosurg Psychiatry. 1985 Jul;48(7):691–694. [PMC free article] [PubMed]
  • Friman G, Schiller HH, Schwartz M. Distubed neuromuscular transmission in viral infections. Scand J Infect Dis. 1977;9(2):99–103. [PubMed]
  • Arnold DL, Bore PJ, Radda GK, Styles P, Taylor DJ. Excessive intracellular acidosis of skeletal muscle on exercise in a patient with a post-viral exhaustion/fatigue syndrome. A 31P nuclear magnetic resonance study. Lancet. 1984 Jun 23;1(8391):1367–1369. [PubMed]
  • Hamblin TJ, Hussain J, Akbar AN, Tang YC, Smith JL, Jones DB. Immunological reason for chronic ill health after infectious mononucleosis. Br Med J (Clin Res Ed) 1983 Jul 9;287(6385):85–88. [PMC free article] [PubMed]
  • McCartney RA, Banatvala JE, Bell EJ. Routine use of mu-antibody-capture ELISA for the serological diagnosis of Coxsackie B virus infections. J Med Virol. 1986 Jul;19(3):205–212. [PubMed]
  • Bowles NE, Richardson PJ, Olsen EG, Archard LC. Detection of Coxsackie-B-virus-specific RNA sequences in myocardial biopsy samples from patients with myocarditis and dilated cardiomyopathy. Lancet. 1986 May 17;1(8490):1120–1123. [PubMed]
  • Bowles NE, Dubowitz V, Sewry CA, Archard LC. Dermatomyositis, polymyositis, and Coxsackie-B-virus infection. Lancet. 1987 May 2;1(8540):1004–1007. [PubMed]
  • Hall JL, Dudley L, Dobner PR, Lewis SA, Cowan NJ. Identification of two human beta-tubulin isotypes. Mol Cell Biol. 1983 May;3(5):854–862. [PMC free article] [PubMed]
  • Feinberg AP, Vogelstein B. "A technique for radiolabeling DNA restriction endonuclease fragments to high specific activity". Addendum. Anal Biochem. 1984 Feb;137(1):266–267. [PubMed]
  • Schwartz MS, Swash M, Gross M. Benign postinfection polymyositis. Br Med J. 1978 Nov 4;2(6147):1256–1257. [PMC free article] [PubMed]
  • Southern P, Oldstone MB. Medical consequences of persistent viral infection. N Engl J Med. 1986 Feb 6;314(6):359–367. [PubMed]
  • Tobi M, Morag A, Ravid Z, Chowers I, Feldman-Weiss V, Michaeli Y, Ben-Chetrit E, Shalit M, Knobler H. Prolonged atypical illness associated with serological evidence of persistent Epstein-Barr virus infection. Lancet. 1982 Jan 9;1(8263):61–64. [PubMed]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press