Epidemic neuromyasthenia & Chronic Fatigue Syndrome (CFS) in west Otago, New Zealand. A 10-year follow-up

BACKGROUND: In 1984, an outbreak of an illness characterized by
prolonged unexplained fatigue was reported in West Otago, New
Zealand. This outbreak resembled other reported outbreaks of
epidemic neuromyasthenia in that affected individuals
presented with a spectrum of complaints ranging from transient
diarrhea and upper respiratory disorders to chronic fatigue
syndrome (CFS).

OBJECTIVE: To obtain a perspective on the
natural history of CFS not possible in clinic-based studies.

METHODS: Twenty-three of the 28 patients in the original
report were contacted and asked to complete written
questionnaires. Interviews were obtained in person or via
telephone.

RESULTS: Ten (48%) of the 21 patients with
satisfactory interviews appeared to meet the current Centers
for Disease Control and Prevention (CDC) case definition of
CFS, and 11 were classified as having prolonged or idiopathic
fatigue. A return to premorbid activity was seen in most (n =
16) patients, although some reported the need to modify their
lifestyle to prevent relapses. A female predominance was noted
in those meeting the CDC case definition for CFS, whereas
males predominated in patients diagnosed as having prolonged
or idiopathic fatigue.

CONCLUSIONS: The high proportion of
patients recovering from CFS in the West Otago cluster
suggests that epidemic-associated CFS has a better prognosis
than sporadic cases. Female sex was confirmed as an important
risk factor for CFS.

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