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Chronic fatigue syndrome (CFS)

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Viral Illnesses

Chronic fatigue syndrome (CFS) is a complicated disorder characterized by profound fatigue that doesn't improve with bed rest and may worsen with physical or mental activity. Of all chronic illnesses, CFS is one of the most mysterious. Unlike infections, it has no clear cause. Unlike conditions such as diabetes or anemia, there's essentially nothing to measure. And unlike conditions such as heart disease, there are relatively few treatment options.

CFS may occur after an infection such as a cold, bronchitis, mononucleosis, hepatitis or intestinal illness. It can start during or shortly after a period of high stress or come on gradually without any clear starting point and any obvious cause. CFS is a flu-like condition that can drain your energy and sometimes last for years. People previously healthy and full of energy may experience extreme fatigue, weakness and headaches as well as painful joints, muscles and lymph nodes.

Women are diagnosed with CFS two to four times as often as men are. However, it's unclear whether CFS affects women more frequently or if women report it to their doctors more often than men do.

Signs and symptoms

CFS exhibits signs and symptoms similar to those of most common viral infections. Unlike flu (influenza) symptoms, which usually subside in a few days or weeks, the signs and symptoms of CFS can last for months or years. They may come and go frequently with no identifiable pattern.

In addition to persistent fatigue not caused by other known medical conditions, CFS has eight possible primary symptoms. These include:

  • Loss of memory or concentration

  • Sore throat

  • Painful and mildly enlarged lymph nodes in your neck or armpits (axillae)

  • Unexplained muscle soreness

  • Pain that moves from one joint to another without swelling or redness

  • Headache of a new type, pattern or severity

  • Sleep disturbance

  • Extreme exhaustion after normal exercise or exertion

According to the International Chronic Fatigue Syndrome Study Group — a group of scientists, researchers and doctors brought together by the Centers for Disease Control and Prevention (CDC) to determine a standard method for defining and diagnosing CFS — a person meets the diagnostic criteria of CFS when unexplained persistent fatigue occurs for six months or more with at least four of the eight primary symptoms also present.

In addition, people with CFS have reported other various signs and symptoms that aren't part of the official definition of CFS determined by the International Chronic Fatigue Study Group. These include:

People with CFS usually experience the most severe symptoms within the first one to two months of illness. After that, a small number of those affected recover completely while a small percentage of others become incapacitated by their symptoms. However, for most people a gradual improvement occurs, although those affected by CFS often don't regain their normal level of energy.

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