Myalgic Encephalomyelitis/Chronic Fatigue Syndrome is an idiopathic disabling disorder characterized by persistent, unexplained fatigue in association with impaired memory or cognition, muscle or joint pain, headache, sore throat, tender lymphadenopathy and night sweats. The prevalence in the US is estimated at over 200 cases/100,000 population with annual medical care costs of $24 billion. There is no specific diagnostic test or treatment. Although the majority of cases are sporadic, there are reports of geographic and temporal clusters of CFS and many subjects report a viral prodrome and symptoms consistent with an infection. Efforts to identify causative agents have yielded inconsistent results and in some instances culminated in false leads that polarized the patient advocate and biomedical research communities, led to inappropriate allocation of resources and placed patients at risk for inappropriate therapeutic interventions. This project will test the hypothesis that CFS cases and controls differ with respect to bacterial, fungal or viral microflora in the oropharynx, lower gastrointestinal tract and blood in a well-powered study, using rigorously characterized cases and controls and state-of-the-art methods for microbial surveillance and discovery. Our proposal builds on the foundation established during the NIAID CFS multicenter study of XMRV/pMLV. It includes the expert clinicians who led work at the original six sites, thereby ensuring credibility within the scientific and CFS patient and advocacy communities and access to a network within which follow-up studies and translational research can be readily pursued. The laboratory team has extensive experience in infectious disease epidemiology, microbial discovery and de-discovery, as well as in the development of serological assays and animal models needed to test for causal relationships and investigate pathogenetic mechanisms.

Public Health Relevance

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, is a disorder characterized by persistent, unexplained fatigue and impacts more than 600,000 people and their families with annual medical costs as high as $24 billion in the US alone. Many patients report symptoms suggestive of infection; however, the cause is unknown and there is no diagnostic test or specific treatment. We will use state-of-the-art methods to search for associations between infectious agents and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome that have the potential to lead to new strategies for diagnosis, prevention and treatment of disease.

National Institute of Health (NIH)
National Institute of Allergy and Infectious Diseases (NIAID)
High Priority, Short Term Project Award (R56)
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Special Emphasis Panel (ZRG1-CFS-M (80))
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Dugan, Vivien G
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Columbia University (N.Y.)
Public Health & Prev Medicine
Schools of Public Health
New York
United States
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Nagy-Szakal, Dorottya; Barupal, Dinesh K; Lee, Bohyun et al. (2018) Insights into myalgic encephalomyelitis/chronic fatigue syndrome phenotypes through comprehensive metabolomics. Sci Rep 8:10056