Baby Boom Bust: Could CFS/ME be PPS?

From The Polio Paradox
Richard L. Bruno, HD, PhD 
Director, International Centre for Polio Education
http://www.postpolioinfo.com

In a survey of nearly 20,000 Americans, researcher Leonard Jason found that half of everyone with CFS (Chronic Fatigue Syndrome) is over 40 year old and may be at greater risk for CFS. According to Lenny Jason's calculations, potentially half of people who have CFS today may have had an undiagnosed polio infection when they were children; in the years before the polio vaccines became available, and have brain activating system damage that is today causing their chronic fatigue symptoms. Could it be that as many as half of everyone diagnosed with Chronic Fatigue Syndrome actually had polio and have PPS, not CFS?

We developed a questionnaire and conducted the 2001 International Chronic Fatigue Survey. We asked Americans, Britons and Canadians with CFS or ME if they had had a childhood illness -- a fever that left them fatigued for several days, maybe a stiff neck or even muscle weakness -- in the years before the polio vaccine was distributed in 1955. Two-thirds of the 586 chronic fatigue patients who responded were born before 1955; they were on average 61 years old, 4 year younger than polio survivors' average age in our post-polio surveys, which dashed the notion of CFS being a 30- something "Yuppie Flu." Symptoms of brain fatigue were more frequent and more severe in CFS patients with and without a childhood illness, as compared to the polio survivors surveyed. Physical stress triggered symptoms in over 90% of both the 2001 Survey's CFS patients and polio survivors in our 1985 Post-Polio Survey. Over 90% of CFS patients surveyed reported emotional stress triggers symptoms as compared to almost 60% of polio survivors in the 1985 Survey. While nearly three- quarters of polio survivors in our Surveys were women, 90% of chronic fatigue patients surveyed were female, a percentage nearly identical to the number of women affected in the 1948 Iceland Disease outbreak.

Twenty percent of surveyed CFS patients born before 1955 remembered having had an illness with a fever, typically at age seven and in 1947, the same year as Cincinnati's Summer Grippe epidemic. Just over one-third recall having had a stiff neck -- the "red flag" symptom of a virus infecting the brain and spinal cord -- about over one-third were hospitalized and 70% remember having had muscle weakness. The distribution of childhood illness cases in the Survey is nearly identical to the distribution of reported polio cases in the US and UK between 1935 and 1955.

CFS patients who remember having had a childhood illness before 1955 were different from both those without a childhood illness and from polio survivors. Difficulty with concentration, thinking clearly, word finding and joint pain were reported to be about 15% more severe or more frequent in CFS patients surveyed who'd had a childhood illness as compared to those without.

While just over 60% of polio survivors in our 1985 Survey reported muscle twitching at night, almost three-quarters of CFS patients without a childhood illness reported nighttime twitching, as compared to 95% of childhood illness patients. Symptoms of abnormal breathing during sleep -- snoring, waking short of breath or with hearts pounding -- were reported by half of chronic fatigue patients without a childhood illness and by almost two-thirds of childhood illness patients. At least 60% of our PPS patients had abnormal breathing during sleep.

The similarities between the findings of our Post-Polio Surveys and the 2001 Chronic Fatigue Survey support the notion that a mild childhood illness occurring before polio vaccination began in 1955 -- possibly resulting from the Type II poliovirus responsible for Summer Grippe and Iceland Disease or a Type I poliovirus causing "non-paralytic" polio -- damaged the brain activating system, setting the stage for mid-life symptoms that are identical to post-polio brain fatigue.

So when baby boomers report symptoms of chronic fatigue, doctors need to ask if there is a history of childhood illness with a fever, stiff neck or muscle weakness that occurred during the polio epidemic years, even though it may be relatively rare for patients to remember such a mild illness. And whether or not chronic fatigue patients recall a childhood illness, the finding that over 50% of those surveyed had symptoms of abnormal nighttime breathing and that 80% had nighttime muscle twitching requires that a sleep history be taken as in polio survivors -- from both patients and their bed partners -- and that sleep studies be performed so that disturbed sleep as a cause of chronic fatigue can be ruled out or treated.