Polio and Chronic Fatigue Link Explored

A Bruno Byte
Posted by Richard L. Bruno, HD, PhD
Director, International Centre for Polio Education
From USA TODAY - By Randy Dotinga

Dr. Bruno’s Original Post:

"The bottom line is that half of the people being diagnosed with Chronic Fatigue Syndrome could have had polio as kids and didn't even know it."

During the middle decades of the last century, thousands of American kids came down with "summer grippe," an illness that caused high fevers, flu symptoms and sore necks. They recovered and went on with their lives -- and few realized they had survived a mild form of polio. Now, an expert in brain disorders is launching an international study to determine whether the grippe -- also known as non-paralytic polio -- may have left those children vulnerable to chronic fatigue syndrome, one of the modern era's most mysterious and controversial diseases.

“Baby boomers as young as 40 could have been affected” said Dr. Richard L. Bruno, the Director of the International Centre for Polio Education (who will be conducting the study). "The bottom line is that half of the people being diagnosed with chronic fatigue syndrome could have had polio as kids and didn't even know it," he said.

Chronic fatigue syndrome tends to come on suddenly and afflict its sufferers, mostly women, with weakness, tiredness, muscle aches, sore throat and fever. Some complain of memory loss and confusion. Researchers at DePaul University estimate that 800,000 people nationwide suffer from chronic fatigue syndrome. A study found that most people with the syndrome knew they were sick but had no idea what was wrong, says DePaul psychology professor Leonard Jason.

The causes of chronic fatigue are anything but clear. Some researchers speculate it is closely related to mental illnesses like depression, while others suspect viruses and sleep disorders. "We know a lot about anxiety and depression, but we know much less about fatigue," Jason says. "It's a very difficult entity for people to study and take seriously." In fact, skeptics claim chronic fatigue is imaginary, a symptom of mental illness.

A Decline in Dopamine. Bruno, also Director of the International Post-Polio Task Force, says the key to chronic fatigue may indeed be in people's heads. But he suspects the culprit is in the brain itself, not the mind. Before it was wiped out by vaccine, severe polio targeted the brain and spinal cord and caused paralysis. Mild polio - the Sumer Grippe, which Dr. Albert Sabin found was caused by the Type II poliovirus - may have spared the spinal cord but left a time bomb behind in the brain, Bruno says. The virus could have killed off neurons that produce dopamine, a chemical that activates the brain, keeping you alert and awake. Humans naturally lose dopamine-producing neurons as they age and Bruno thinks the dopamine neuron loss caused by aging and mild polio could combine to cause a "brownout" of alertness -- or never-ending fatigue.

Bruno treats and studies polio survivors having Post-Polio Sequelae, an energy-sapping condition that causes chronic fatigue. He speculated in a published study about a link between polio and chronic fatigue syndrome, that link being damage in both conditions to dopamine-producing neurons in the brain stem’s “fatigue generator.” Dr. Oliver Sachs, author of Awakenings who used dopamine replacement to “wake up” patients whose dopamine neurons had been killed by the 1918 flu epidemic), supports Bruno’s theory, saying that he “has made a very powerful case for the role of dopamine” in causing chronic fatigue.

Support Groups Polled - A woman in San Diego who read about Bruno’s work asked members of her chronic fatigue support group whether any of them suffered from the “grippe” as children. "A bunch of hands went up," Bruno was told. "She said, 'My God, even I had something like that when I was a kid. I think you're on to something.' "

Other support groups had similar results, inspiring Bruno to draft a questionnaire that will soon be sent to every known chronic fatigue support group in the United States, Canada and Great Britain. It will also be distributed to support groups for people who suffer from Fibromyalgia (FM) and Myalgia Encephalomyelitis (ME), disorders considered by some experts to be related to chronic fatigue or, possibly be even the same illness.

“Administering the survey to chronic fatigue sufferers won't be easy, Bruno notes, because some people won't remember being ill as children, even if they were”.

Some Chronic Fatigue experts are intrigued by Bruno's work. "He's a very competent individual and very respected," says Fred Friedberg, a clinical assistant professor of psychiatry at the State University of New York at Stony Brook.
Another expert, San Diego neurologist Dr. James Grisolia, says existing research supports the idea that the causes of Chronic Fatigue lie in the nervous system.

Skeptics Question the Link - Not all experts, however, support Bruno's theories. Dr. Jay Goldstein, director of a California Chronic Fatigue clinic and author of several books on the subject, doubts that Bruno's research will be helpful to patients. "If Chronic Fatigue is a result of having polio when (patients) were children, and they don't have it any more, what difference does that make? And how would that explain the onset of new cases?" he says.

Bruno responded saying, “The finding will help not only polio survivors and baby boomers with CFS to understand that their symptoms are ‘real’ but also will, in the same way, help young CFS patients.” As to the onset of new cases of CFS in younger people Bruno says, “I don't know why doctors forget that, although polio isn't an issue in the western hemisphere, there are still 100 polio-like viruses in the US that could damage the “brain fatigue generator” and brain dopamine-producing neurons -- just as the polioviruses did -- and could cause chronic fatigue.

For his part, Bruno doesn't support medication in cases of Post-Polio Syndrome or Chronic Fatigue. He supports something much cheaper: Common sense. Sufferers should pace their activities, take breaks and stop before they get tired, he says, a treatment that reduces fatigue in his Post-Polio Sequelae patients.

"The idea is that if something happened to your brain, you need to listen to your brain and body, stop before you get fatigued and you'll feel better," he adds. "This should at least be tried before people take drugs and herbs and God-knows-what-else."

What To Do - If you are always tired, consult your doctor. A variety of medical problems, from thyroid trouble to sleep disorders, could be responsible. Be prepared to be treated with skepticism by some people if you do think you have Chronic Fatigue Syndrome.

There is a lot of information in the Encyclopedia for polio survivors and those with CFS that can help you deal with your feelings, both physical and emotional.