Chronic fatigue syndrome

A variety of studies have shown that millions of people worldwide suffer from chronic fatigue syndrome (CFS). They are seriously impaired, at least a quarter is unemployed or on disability benefit because of CFS, yet only about half has consulted a physician.

CFS is a debilitating and complex disorder characterised by profound fatigue that is not improved by bed rest and that may be worsened by physical or mental activity. People with CFS often function at a substantially lower level of activity than they were capable of before the onset of the illness.

Symptoms

CFS is marked by extreme fatigue that has lasted at least for a period of six months, is not the result of ongoing exertion, is not substantially relieved by rest, and causes a substantial reduction in daily activities.

In addition to fatigue, CFS includes the following eight characteristic symptoms:

• Post-exertion malaise (relapse of symptoms after physical or mental exertion)
• Un-refreshing sleep
• Substantial impairment in memory/concentration
• Muscle pain
• Pain in multiple joints
• Headaches of a new type, pattern or severity
• Sore throat
• Tender neck or armpit lymph nodes.

Symptoms and their consequences can be severe. CFS can be as disabling as multiple sclerosis, lupus, rheumatoid arthritis, congestive heart failure and similar chronic conditions. Symptom severity varies from person to person and may vary over time for an individual.

Treatment

The earlier a person with CFS receives medical treatment, the greater the likelihood that the illness will resolve. Equally important, about 40% of people in the general population who report symptoms of CFS have a serious, treatable, previously unrecognised medical or psychiatric condition (such as diabetes, thyroid disease, substance abuse). CFS is a serious illness and poses a dilemma for patients, their families and healthcare providers.

Depression must be treated if present, and recent research has demonstrated the effectiveness of cognitive therapy.

Causes

The cause of CFS remains unknown, but it is believed to have its origin in a combination of viral, social and psychological factors. Theories based on one specific cause (such as the Epstein-Barr virus) have been largely discredited.

The earlier term myalgic encephalomyelitis was replaced with the more accurate term CFS because sufferers do not have encephalomyelitis (inflammation of the muscle membranes) and many do not have myalgia (muscle pain). Stereotypes of the typical sufferer being a middle-class, middle-aged woman have also been found to be unjustified. CFS is not a new phenomenon and cases have been documented worldwide for more than 50 years.

Risk factors for CFS

• People of every age, gender, ethnicity and socio-economic group can suffer from CFSCFS affects women at four times the rate of men
• Research indicates that CFS is most common in people in their 40s and 50s
• Although CFS is much less common in children than in adults, children can also develop the illness, particularly during the teen years.

Diagnosis of CFS

• There are no physical signs that identify CFS.
• There are no diagnostic laboratory tests for CFS.
• People who suffer from the symptoms of CFS must be carefully evaluated by a physician because many treatable medical and psychiatric conditions are hard to distinguish from CFS. Common conditions that should be ruled out through a careful medical history and appropriate testing include mononucleosis, Lyme disease, thyroid conditions, diabetes, multiple sclerosis, various cancers, depression and bipolar disorder.

The first diagnosed cases of CFS in South Africa were reported as early as 1955 in Durban City at the Addington Hospital. It was then referred to as "The Durban Mystery Disease" with140 people infected. According to statistics the prevalence of CFS (the estimated population of people who are managing Chronic Fatigue Syndrome at any given time in South Africa) is relatively high compared to other Africa countries.

Our Employee Wellbeing Programme (EWP) is available 24 hours a day if you want to know more about CFS. Call us on the EWP number or email us at This e-mail address is being protected from spambots. You need JavaScript enabled to view it. .