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The history of chronic fatigue syndrome (CFS, also known by many other names) is thought to date back to the 19th century and before.


Timeline

Several descriptions of illness resembling those of chronic fatigue syndrome have been reported for at least 200 years. In the 19th century, neurologist George Miller Beard popularised the concept of
neurasthenia Neurasthenia (from the Ancient Greek νεῦρον ''neuron'' "nerve" and ἀσθενής ''asthenés'' "weak") is a term that was first used at least as early as 1829 for a mechanical weakness of the nerves and became a major diagnosis in North A ...
, with symptoms including fatigue, anxiety, headache, impotence, neuralgia and depression. This concept remained popular well into the 20th century, eventually coming to be seen as a behavioural rather than physical condition, with a diagnosis that excluded postviral syndromes. Neurasthenia has largely been abandoned as a medical diagnosis. The ICD-10 system of the
World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of ...
now categorizes neurasthenia under (F48 Other neurotic disorders) which specifically excludes chronic fatigue syndrome. A
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(USPHS) official, Alexander Gilliam, described an illness that resembled poliomyelitis, after interviewing patients and reviewing records of one of several clusters which had occurred in
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, during 1934. The
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outbreak included all or most of its nurses and doctors. Gilliam called the outbreak "atypical poliomyelitis" and described the symptoms as: rapid muscle weakness, vasomotor instability, clonic twitches and cramps, ataxia, severe pain (usually aggravated by exercise), neck and back stiffness, menstrual disturbance and dominant sensory involvement. There was a cluster of "encephalitis" cases in 1936, at a
convent A convent is a community of monks, nuns, religious brothers or, sisters or priests. Alternatively, ''convent'' means the building used by the community. The word is particularly used in the Catholic Church, Lutheran churches, and the Anglic ...
in
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, amongst novices and convent candidates. The following year two towns in Switzerland had outbreaks of "abortive poliomyelitis" , and 73 Swiss soldiers were given the same diagnosis in 1939. Outbreaks in
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were called " Akureyri disease" or "simulating poliomyelitis" and were later called "Iceland disease." 800 people in
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, Australia became ill during 1949–1951 with a disease "resembling poliomyelitis." Two smaller clusters in the United States during 1950 were diagnosed as "Epidemic neuromyasthenia" and "resembling Iceland disease simulating acute anterior poliomyelitis." Additional outbreaks of poliomyelitis-like "mystery diseases" occurred from the 1950s through the 1980s, in
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, the United States, South Africa, and Australia, among others. Several outbreaks of a polio-resembling illness occurred in Britain in the 1950s. A 1955 outbreak at the Royal Free Hospital Group was later called "Royal Free disease" or "benign myalgic encephalomyelitis". After the Royal Free Hospital outbreak, a disorder with similar symptoms was found among the general population and the epidemic form came to be considered the exception. Pathology findings, both in monkeys and in rare human
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, led to the conclusion that the disorder was caused by
inflammation Inflammation (from la, inflammatio) is part of the complex biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or irritants, and is a protective response involving immune cells, blood vessels, and molec ...
of the brain and the
spinal cord The spinal cord is a long, thin, tubular structure made up of nervous tissue, which extends from the medulla oblongata in the brainstem to the lumbar region of the vertebral column (backbone). The backbone encloses the central canal of the sp ...
, particularly the afferent nerve roots, perhaps with neuroimmune etiology. In the 1960s and 1970s, chronic fatigue symptoms were often attributed to chronic brucellosis, but typically people were seen as having psychiatric disorders, in particular depression. Epidemic cases of benign myalgic encephalomyelitis were called
mass hysteria Mass psychogenic illness (MPI), also called mass sociogenic illness, mass psychogenic disorder, epidemic hysteria, or mass hysteria, involves the spread of illness symptoms through a population where there is no infectious agent responsible for c ...
by psychiatrists McEvedy and Beard in 1970, provoking criticism in letters to the editor of the British Medical Journal by outbreak researchers, attending physicians, and physicians who fell ill. The psychiatrists were faulted for not adequately investigating the patients they described,
/ref> and their conclusions have been refuted. In 1978 a symposium held at the
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(RSM) concluded that "epidemic myalgic encephalomyelitis" was a distinct disease entity with a clear organic basis. The illness gained national attention in the United States when the popular magazine ''Hippocrates'' ran a cover story of an epidemic at Lake Tahoe,
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, in the mid-1980s. The designation Chronic Epstein-Barr Virus was in use in the U.S., but the magazine used the term "Raggedy Ann Syndrome" to note the fatigue and loss of muscle power patients felt. Researchers investigating the Lake Tahoe cluster did not find evidence that EBV was involved, and they proposed the name "chronic fatigue syndrome", describing the main symptom of the illness. They published the first working case definition for CFS in 1988. Research increased considerably, and more so after the criteria were relaxed in 1994. In 1990, researchers presented evidence they found DNA sequences very similar to the human HTLV-II retrovirus in some CFS patients, at a conference in
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. Their study was later published in the
Proceedings of the National Academy of Sciences ''Proceedings of the National Academy of Sciences of the United States of America'' (often abbreviated ''PNAS'' or ''PNAS USA'') is a peer-reviewed multidisciplinary scientific journal. It is the official journal of the National Academy of Sci ...
. A reporter on Prime Time Live stated the announcement made headlines all over the world. The CDC first ignored their findings, then later conducted a study and published a paper that refuted the hypothesis. In the United Kingdom, the Chief Medical Officer
Kenneth Calman Sir Kenneth Charles Calman, HonFAcadMEd (born 25 December 1941) is a doctor and academic who formerly worked as a surgeon, oncologist and cancer researcher and held the position of Chief Medical Officer of Scotland, and then England. He was Wa ...
requested a report from the medical Royal Colleges in 1996. This led to the publication of a joint report in which the term "chronic fatigue syndrome" was found to be most representative. This was followed in 2002 by a further report by the new CMO,
Liam Donaldson Sir Liam Joseph Donaldson (born 3 May 1949) is a British doctor. He was formerly the Chief Medical Officer for England, being the 15th occupant of the post since it was established in 1855. As such, he was principal advisor to the United King ...
. The U.S. Centers for Disease Control & Prevention (CDC) recognize CFS as a serious illness, and launched a campaign in June 2006 to raise public and medical awareness about it. A 2009 study published in the journal ''Science'' reported an association between a retrovirus
xenotropic murine leukemia virus-related virus {{Short pages monitorThe name Chronic Fatigue Syndrome has been attributed to the US
Centers for Disease Control The Centers for Disease Control and Prevention (CDC) is the national public health agency of the United States. It is a United States federal agency, under the Department of Health and Human Services, and is headquartered in Atlanta, Georgi ...
1988 research case definition for the illness, "Chronic fatigue syndrome: a working case definition". Chronic Fatigue Syndrome (CFS) was added to ICD-9 after 1988 and listed under code 780.71, Symptoms Signs and Ill-defined Conditions.


ICD-9-CM

Since 1979 the U.S. has used a clinical modification of WHO's ICD 9th revision (ICD-9-CM), and ME is under index: "Encephalomyelitis (chronic) (granulomatous) (hemorrhagic necrotizing, acute) (''myalgic, benign'') (see also Encephalitis) 323.9." Index to Diseases ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Publications/ICD9-CM/2006/Dindex07.zip For CFS, a modification to the alphabetic index was made, effective on October 1, 1991, to direct users to code 780.7, Malaise and fatigue, the same code used to identify cases of postviral syndrome. In 1998, a new five-digit code included 780.71, Chronic fatigue syndrome, consistent with the WHO version of ICD-9. Chronic fatigue syndrome is classified in tabular list: "Symptoms, Signs and Ill-Defined Conditions," under the sub-heading of "General Symptoms". Tabular List ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Publications/ICD9-CM/2006/Dtab07.zip


ICD-10

CFS is not included as a coded term in the 1992 ICD-10, WHO created a new category G93, Other disorders of brain, in Chapter VI, Diseases of the Nervous System, and created a new code G93.3, post-viral fatigue syndrome (PVFS), a condition which was previously in the symptom chapter of ICD-9. WHO also moved benign myalgic encephalomyelitis to G93.3, subordinate to PVFS. The alphabetic index contains other terms, such as chronic fatigue syndrome, to which WHO assigned the same code.


ICD-10-CM

The proposed U.S. classification ICD-10-CM (2010 Update replaces July 2009 version) separates CFS and Postviral fatigue syndrome into mutually exclusive categories. "Chronic fatigue, unspecified , Chronic fatigue syndrome not otherwise specified" appears in Chapter XVIII under R53.82. "Postviral fatigue syndrome , benign myalgic encephalomyelitis" appears in Chapter VI under G93.3.https://www.cdc.gov/nchs/icd/icd10cm.htm International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), 2010 Update. Retrieved 2010-05-21. The
Chronic Fatigue Syndrome Advisory Committee The Chronic Fatigue Syndrome Advisory Committee (CFSAC) was formed in response to the use of funds by the United States Centers for Disease Control and Prevention in the study of chronic fatigue syndrome (CFS). The CFSAC was charted under the ...
(CFSAC) had previously recommended CFS to be placed under the same neurological code as ME and PVFS, G93.3.


References

{{DEFAULTSORT:History Of Chronic Fatigue Syndrome Chronic fatigue syndrome Immune system disorders Syndromes