Levine P H, Jacobson S, Pocinki A G, Cheney P, Peterson D, Connelly R R, Weil R, Robinson S M, Ablashi D V, Salahuddin S Z
Environmental Epidemiology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892.
Arch Intern Med. 1992 Aug;152(8):1611-6.
The purpose of this study is to provide a case definition of chronic fatigue syndrome in an outbreak occurring in the Nevada-California region to evaluate candidate etiologic agents and observe the natural history of the illness.
Patients diagnosed as having chronic fatigue syndrome were studied by repeated interviews, questionnaires, and blood collection over a 3-year period. Serum samples were tested for antibodies to Epstein-Barr virus, human herpesvirus-6, and human T-lymphotropic viruses I and II. Leukocytes from typical cases were also assayed for human T-lymphotropic viruses I and II.
Cases were defined as persons who had: (1) severe persistent fatigue following an acute illness appearing in an individual with no previous physical or psychological symptoms; (2) presenting signs and symptoms of an acute infection; (3) severe and persistent headache and/or myalgias; and (4) abrupt change in cognitive function or the appearance of a new mood disorder. After 3 years of follow-up, almost all study subjects were able to return to pre-illness activity. None of the viruses evaluated--human T-lymphotropic viruses I and II, Epstein-Barr virus, or human herpesvirus-6--could be etiologically linked to these outbreaks.
Clinical features of outbreaks of chronic fatigue syndrome differ sufficiently to suggest different etiologic agents. Giardiasis appears to have precipitated one of the four clusters in this study but the cause(s) of the other three outbreaks is as yet uncertain. The overall prognosis of chronic fatigue syndrome is usually favorable.
本研究的目的是为内华达 - 加利福尼亚地区爆发的慢性疲劳综合征提供病例定义，以评估候选病原体并观察该疾病的自然史。
对被诊断患有慢性疲劳综合征的患者进行了为期3年的反复访谈、问卷调查和血液采集研究。检测血清样本中针对EB病毒、人类疱疹病毒6型以及人类嗜T淋巴细胞病毒I型和II型的抗体。还对典型病例的白细胞进行了人类嗜T淋巴细胞病毒I型和II型检测。
病例定义为具有以下情况的人：（1）在之前无身体或心理症状的个体中，急性疾病后出现严重的持续性疲劳；（2）出现急性感染的体征和症状；（3）严重且持续性头痛和/或肌痛；（4）认知功能突然改变或出现新的情绪障碍。经过3年的随访，几乎所有研究对象都能够恢复到患病前的活动水平。所评估的病毒——人类嗜T淋巴细胞病毒I型和II型、EB病毒或人类疱疹病毒6型——均与这些疫情无病因学关联。
慢性疲劳综合征疫情的临床特征差异足以提示不同的病原体。贾第虫病似乎引发了本研究中的四组疫情之一，但其他三组疫情的病因尚不确定。慢性疲劳综合征的总体预后通常良好。
