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Postgrad Med J. 1990 July; 66(777): 526–530.
PMCID: PMC2429637

Myalgic encephalomyelitis--a persistent enteroviral infection?


Myalgic encephalomyelitis is a common disability but frequently misinterpreted. Amongst 6,000 patients referred for general microbiological diagnosis between 1975 and 1987, 420 cases were recognized. Coxsackie B neutralization tests, in 205 of these, demonstrated significant titres in 103/205 (50%), while of 124 additionally investigated for enteroviral IgM, 38/124 (31%) were positive. This illness is distinguished from a variety of other post-viral states by an unique clinical and epidemiological pattern characteristic of enteroviral infection. Prompt recognition and advice to avoid over-exertion is mandatory. Routine diagnosis, specific therapy and prevention, await further technical advances.

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Selected References

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  • ACHESON ED. The clinical syndrome variously called benign myalgic encephalomyelitis, Iceland disease and epidemic neuromyasthenia. Am J Med. 1959 Apr;26(4):569–595. [PubMed]
  • Behan PO, Behan WM. Postviral fatigue syndrome. Crit Rev Neurobiol. 1988;4(2):157–178. [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]
  • Bell EJ, McCartney RA. A study of Coxsackie B virus infections, 1972-1983. J Hyg (Lond) 1984 Oct;93(2):197–203. [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]
  • Yousef GE, Bell EJ, Mann GF, Murugesan V, Smith DG, McCartney RA, Mowbray JF. Chronic enterovirus infection in patients with postviral fatigue syndrome. Lancet. 1988 Jan 23;1(8578):146–150. [PubMed]
  • David AS, Wessely S, Pelosi AJ. Postviral fatigue syndrome: time for a new approach. Br Med J (Clin Res Ed) 1988 Mar 5;296(6623):696–699. [PMC free article] [PubMed]
  • Hotchin NA, Read R, Smith DG, Crawford DH. Active Epstein-Barr virus infection in post-viral fatigue syndrome. J Infect. 1989 Mar;18(2):143–150. [PubMed]
  • LYLE WH. An outbreak of disease believed to have been caused by ECHO 9 virus. Ann Intern Med. 1959 Aug;51:248–269. [PubMed]
  • Keighley BD, Bell EJ. Sporadic myalgic encephalomyelitis in a rural practice. J R Coll Gen Pract. 1983 Jun;33(251):339–341. [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]
  • Bell EJ, Irvine KG, Gardiner AJ, Rodger JC. Coxsackie B infection in a general medical unit. Scott Med J. 1983 Apr;28(2):157–159. [PubMed]
  • Muir P, Nicholson F, Tilzey AJ, Signy M, English TA, Banatvala JE. Chronic relapsing pericarditis and dilated cardiomyopathy: serological evidence of persistent enterovirus infection. Lancet. 1989 Apr 15;1(8642):804–807. [PubMed]
  • Prasher D, Smith A, Findley L. Sensory and cognitive event-related potentials in myalgic encephalomyelitis. J Neurol Neurosurg Psychiatry. 1990 Mar;53(3):247–253. [PMC free article] [PubMed]
  • Archard LC, Bowles NE, Behan PO, Bell EJ, Doyle D. Postviral fatigue syndrome: persistence of enterovirus RNA in muscle and elevated creatine kinase. J R Soc Med. 1988 Jun;81(6):326–329. [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]
  • 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]
  • Matteucci D, Paglianti M, Giangregorio AM, Capobianchi MR, Dianzani F, Bendinelli M. Group B coxsackieviruses readily establish persistent infections in human lymphoid cell lines. J Virol. 1985 Nov;56(2):651–654. [PMC free article] [PubMed]
  • Miller JR. Prolonged intracerebral infection with poliovirus in asymptomatic mice. Ann Neurol. 1981 Jun;9(6):590–596. [PubMed]
  • McKinlay MA, Frank JA, Jr, Benziger DP, Steinberg BA. Use of WIN 51711 to prevent echovirus type 9-induced paralysis in suckling mice. J Infect Dis. 1986 Oct;154(4):676–681. [PubMed]
  • Dowsett EG. Human enteroviral infections. J Hosp Infect. 1988 Feb;11(2):103–115. [PubMed]

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