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Epidemic neuromyasthenia & Chronic Fatigue Syndrome (CFS): epidemiological importance of a cluster definition

  [ 42 votes ]   [ Discuss This Article ] • January 3, 1994

Outbreaks of illness variously identified by a number of
terms, including epidemic neuromyasthenia, myalgic
encephalomyelitis, Iceland disease, and atypical
poliomyelitis, have been reported from many countries during
the past 45 years. Since the first well-described outbreak
occurring in 1934, > 60 outbreaks have been reported, but few
of these have been described in considerable detail. These
outbreaks are usually cited in historical reports of chronic
fatigue syndrome (CFS) since each of these outbreaks appears
to contain a number of cases meeting the current case
definition of CFS. There has been inadequate attention given
to the fact that epidemic neuromyasthenia and related clusters
characterized by various complaints, including fatigue, do not
have an accepted epidemiological or clinical definition, and
only rarely have descriptions of these clusters included a
specific case definition. When such case definitions have been
applied, the occurrence of cases meeting the current case
definition for CFS appears to be both variable and infrequent.
This report utilizes examples of several well-documented
outbreaks to emphasize specific aspects that should be
considered in the investigation of future clusters.

Levine PH

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