Myalgic Encephalomyelitis / Chronic Fatigue Syndrome Information (2018)

Centers for Disease Control and Prevention

Reviewed and summarized by Medscape editors

August 09, 2018

The information about myalgic encephalomyelitis / chronic fatigue syndrome was released on July 12, 2018, by the CDC.[1,2]

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex, chronic, debilitating disease with systemic effects. ME/CFS is characterized by reduced ability to perform pre-illness activities that lasts for more than 6 months and is accompanied by profound fatigue, which is not improved by rest.

A hallmark of ME/CFS is that symptoms can worsen after physical, mental, or emotional effort, a manifestation known as postexertional malaise (PEM). Patients with ME/CFS also have unrefreshing sleep.

Other common manifestations are orthostatic intolerance, cognitive impairment, and pain. As can be observed in people with other long-term chronic illnesses, secondary psychological symptoms such as depression and anxiety may also be present in some patients with ME/CFS.

Onset of illness can be either acute or gradual. Acute onset may follow an infectious-like syndrome (eg, fever, malaise, aching muscles, respiratory or gastrointestinal symptoms) or a specific acute infection (eg, acute infectious mononucleosis from a new infection with Epstein-Barr virus). The illness also may follow other trauma such as car accidents or surgery. Gradual onset can occur over months or years.

Patients frequently experience a substantial impairment in both physical and mental function at some point in their illnesses.

There are no confirmatory tests, cures, or drugs approved by the FDA specifically for ME/CFS. While some patients and healthcare providers have reported improvement in ME/CFS after use of off-label or unlicensed medications, the efficacy of these medicines has not been tested in multiple, large, well-controlled clinical trials.

While many biological abnormalities have been reported in patients with the illness, none of these “biomarkers” have a sufficiently low false negative and false positive rate to constitute a diagnostic test. A healthcare provider can make the diagnosis of ME/CFS based on a thorough medical history and physical examination, laboratory test results, and evaluating for other fatiguing illnesses with a targeted work-up.

Comorbid conditions are often present and may include sleep disorders, irritable bowel syndrome, fibromyalgia, depression, or anxiety. The presence of these conditions does not exclude the diagnosis of ME/CFS.

Helping patients get relief from symptoms and achieve improvement in quality of life are the main goals of treatment.

Each patient’s program typically includes a combination of therapies to address symptoms, techniques to help patients cope, and strategies to manage daily activities.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.