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Tips and Techniques for Treating Chronic Fatigue Syndrome: CFS and the Post-Polio Connection

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By Dr. Richard L. Bruno • • May 24, 2002

by Dr. Richard L. Bruno

In the Summer of 1956, I had a fever and stiff neck. Our family doctor diagnosed me with rheumatic fever since I had been given the polio vaccine.

Over the past 10 years, I have developed muscle weakness and pain and have become very fatigued. I went to well-known polio doctors in Washington who said I couldn't have had polio in 1956 because it was cured in 1954 when the vaccine came out. I went to a rheumatologist who said I'd never had rheumatic fever but thought that I now have chronic fatigue syndrome. Is there any way I can know if I ever had polio? And what should I do about my symptoms?

It's impossible to know for sure what caused your illness in 1956, but polio is the most likely suspect. The polio vaccine was not 100% effective. And polio wasn't eliminated by the vaccine. There were over 15,000 reported cases of polio in the United States in 1956. So you very well could have had polio.

Last month I discussed the finding of our 2001 International Chronic Fatigue Survey that at least 20% of baby boomers diagnosed with CFS may have had an undiagnosed case of polio and actually have PPS -- not CFS or ME -- today. Since then I have had dozens of e-mails asking how someone can find out if they indeed did have polio way back when. This is a difficult proposition.

There are tests that may show if you had polio. For those rare individuals who never received the polio vaccine antibodies to the three types of polioviruses can be measured. An increase in one or more types would reflect the kind of poliovirus that had infected you. But if you had the vaccine, antibodies to all three types would be elevated.

A painful test is a biopsy, where a small chunk of muscle is removed to look for signs of motor neuron death which most likely would have been the result of a poliovirus attack. An even more painful test, and the one most readily available, is an electromyogram (EMG) where a needle is inserted into muscles to pick up electrical activity that can show if motor neurons have been killed. However, an EMG isn't always able to identify muscles whose motor neurons were damaged during the poliovirus attack. Physiatrist Mark Bromberg found that almost 10% of patients who had a history of paralytic polio, and who were reporting pain, fatigue or weakness in mid-life, had normal EMGs - that is there was no evidence that they ever had polio.

The EMG that your local doctor can perform isn't always sensitive enough to pick up damage done by the poliovirus, especially if you didn't have muscle weakness originally. Using a special EMG technique not available in doctor's offices, neurologist Carlos Luciano found evidence of poliovirus damage in 85% of muscles that were thought to not to have been affected in people who obviously had paralytic polio. This makes sense since research from the 1940’s by polio pioneer David Bodian, and a 1997 study by Canadian neurophysiologist Alan McComas, showed that polio survivors’ apparently unaffected muscles had lost 40% of their motor neurons.

So, polio survivors’ muscles can be ‘silently affected’ and develop weakness without any obvious evidence of poliovirus damage back when. Bodian came to the same conclusion about silent damage to the brain neurons responsible for keeping you awake and focusing attention - the brain activating system, that our and others’ research has found to be damaged in those with post-polio fatigue and CFS/ME. Bodian concluded that every case of polio, with our without muscle weakness, is ‘encephalitic’ and cases of brain inflammation – ‘whether symptoms are present or not.’

Whether or not you can prove you had polio, you need to make sure that nothing else is causing new symptoms, like a slow thyroid, anemia or the sleep disorders that are so common in those with CFS/ME (See March, 2002 Tips and Techniques). If you exclude all other problems, and whether you had polio or have CFS/ME, you need to take care of damaged neurons and treat your symptoms by following The Golden Rule: If anything causes fatigue, weakness or pain DON'T DO IT! (Or do much less of it.)

Dr. Richard Bruno is Director of Fatigue Management Programs and The Post-Polio Institute at Englewood (NJ) Hospital and Medical Center. His new book, THE POLIO PARADOX: UNCOVERING THE HIDDEN HISTORY OF POLIO TO UNDERSTAND TREAT “POST-POLIO SYNDROME” AND CHRONIC FATIGUE, will be published by Warner Books in June. (AOL Keyword POLIO PARADOX. E-mail for discount group orders.) E-mail questions to Dr. Bruno at

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