TO TABLE OF CONTENTS
latest information on research, treatment and diagnosis of CFIDS and related
Terms in bold type appear in the
CFIDS Glossary box.
Dual treatment shows no benefit
A new study from
that combining hydrocortisone and fludrocortisone therapy to treat CFS symptoms
was not effective in a six-month trial.
Urine samples from many CFS patients show lower-than-normal
levels of cortisol, a stress-related hormone also called hydrocortisone. It’s
not known whether low cortisol is a cause of CFS symptoms, or an effect
triggered by other abnormalities.
In the past, researchers have attempted to treat CFS symptoms
by supplementing the body with hydrocortisone. The results have been mixed, and
there have been reported side effects that include a suppression of natural
Fludrocortisone, a synthetic hormone known by the brand name
Florinef, is sometimes used to treat orthostatic intolerance. But at least two
previous studies have shown that Florinef does not significantly alleviate CFS
The latest research involved 80 CFS patients who met the 1994
Fukuda criteria for CFS. The patients were given a daily treatment that
included both fludrocortisone and hydrocortisone. The treatments were randomized
and double-blinded over six months, so that neither the patients nor the
researchers knew who was receiving the drugs and who was receiving a placebo
treatment. After the treatment period, researchers found no difference between
the treatment group and the placebo group in terms of patient-reported fatigue
or overall well-being.
The study appeared in the June 15 issue of the American
Journal of Medicine.
CFS-vaccine link probed
Collaboration has launched an initiative to develop assessment guidelines for
patients who have an onset of a CFS-like illness after being vaccinated.
An international working group of experts in CFS and vaccine
safety has been assembled; Association President & CEO Kim
Kenney is a member. The group will: conduct a literature
review; define various levels of diagnostic certainty for evaluating possible
CFS cases that follow vaccination; and write guidelines for data collection,
analysis and presentation to enhance comparability across research and clinical
settings. The process is expected to take about a year; all meetings are held by
The Brighton Collaboration was begun by the Centers for
Disease Control and Prevention in 2001. So far, nine case definitions with
guidelines have been written. CFS was selected as a topic based on sporadic
reports of CFS-like illness following Rubella and hepatitis B vaccines.
Brighton staff emphasize that the group’s interest in a
particular condition does not imply a causal link between vaccines and that
study reaches med journal
Research results from a large
population-based study of CFS patients in
Kansas have been published in an
international medical journal.
In July, Archives of Internal Medicine featured a paper called
“Prevalence and incidence of chronic fatigue syndrome in
Kan.” The multi-year study was conducted by
the Centers for Disease Control and Prevention (CDC) in conjunction with other
In the study, more than 30,000 households were contacted and
screened for people with CFS-like symptoms. Researchers gave questionnaires
and/or medical examinations to a group of 7,162 residents, then re-checked their
status after one year. The results showed that the overall rate of CFS in the
general population is about 235 per 100,000 residents (95% confidence
The prevalence of CFS was higher among women (373 per 100,000)
than men (83 per 100,000). These figures roughly correspond to earlier
prevalence studies done on smaller groups. The new report concludes that
“Chronic fatigue syndrome constitutes a major public health problem.”
The Wichita study
began in 1997 and took four years to complete. CDC teams have recently conducted
thorough medical examinations and numerous research tests on more than 400 city
residents who were tracked during this period, including those with and without
CFS. Results from these examinations are expected to be published over the next
several years. Wichita was chosen as
a test site because the makeup of its population is representative of the
“Intriguing” result from Lyndonville study
study related to the Lyndonville, N.Y., outbreak of CFS shows that environmental
and genetic factors may combine to cause the illness in susceptible
The study looks at aspects of the immune systems in 90 people
with CFS and 50 healthy controls. Included in the study were people from
Lyndonville, where scores of residents developed CFS in the mid-1980s. Other
subjects, who came from Buffalo,
N.Y., were used for comparison.
Study authors said they discovered an “intriguing outcome”
when looking at the cytotoxic T-cell levels in the patient groups. This type of
T-cell attacks body cells that are infected or have become malignant. The CFS
patients who lived in Lyndonville during the outbreak showed an increased level
of the T-cells, as did the CFS patients from
But the non-CFS controls from Lyndonville also showed higher
T-cell counts, while the non-CFS
Buffalo controls did not.
This could indicate that some agent was present in Lyndonville
that caused the residents’ immune systems to gear up for a fight. It’s possible,
the authors say, that residents who developed CFS were predisposed in some
unknown way to develop CFS, while those who remained healthy had the ability to
fight off the illness.
residents with CFS may have been exposed to the same agents as the people in
Lyndonville — although the whole city apparently did not receive the same
The study was published in the journal Cytometry Part B:
Clinical Cytometry (53B, 2003).
Terms You Need to Know
Confidence interval: In statistics, a range of figures
in which the true value being sought most likely resides. This is expressed in
terms of percentage. The term “95 percent confidence interval” means that the
true value will be within the given range 95 percent of the time.
For instance: A report says that 300 people out of 100,000
have CFS (95 percent confidence interval: 250-350). This means there’s a 95
percent chance that the figure is somewhere between 250 and 350 people.
Fukuda criteria: Another term for the 1994
International Research Case Definition of Chronic Fatigue Syndrome. This is the
most commonly used criteria for identifying CFS cases for use in research
studies. Although not originally intended for use by physicians to diagnose CFS
in individual patients, it is often used for this purpose. Keiji Fukuda of the
Centers for Disease Control and Prevention was the lead author of the
Population-based study: As the name implies, a
study that seeks information by looking at the residents of a particular
geographic region. These studies can be particularly useful in determining the
prevalence of a disease. By taking a representative sample of the population,
scientists can imply how many people are affected by a given condition. This
sampling method helps avoid conclusions that are biased by subjects’ differing
access to medical care, as often occurs with clinic-based studies.
If you have suggestions for terms to include in future
editions of the glossary, please send them to: email@example.com, or to
The CFIDS Association of America, P.O. Box
220398, Charlotte, NC 28222-0398, Attention: Chronicle.