Chronic fatigue caused by brain injury due to glandular fever: study

Those suffering from chronic fatigue syndrome might be experiencing temporary brain damage caused by glandular fever, a study, by University of New South Wales, has found. Glandular fever, which is caused by Epstein-Barr virus, is characterized by fever, sore throat and fatigue, whereas chronic fatigue has symptoms like muscular weakness, pain, cognitive and digestive disturbances, hypersensitivity, depression and most importantly, low stamina and energy.

Likening the action of the Epstein-Barr virus on the brain to a hit and run accident, Andrew Lloyd, lead author of the study, said, “It's an injury in the sense that it wasn't there – people were perfectly well – something in the acute phase of the illness went wrong and then it slowly recovers like a broken arm or a broken leg. It's just that in this case its taking weeks to months rather than days or quicker.”

Under the study, the researchers, led by Lloyd, tracked the long-term health of subjects who had contracted the Epstein-Barr virus (EBV), Ross River virus (RRV) or Q fever. Around 39 subjects were afflicted with acute glandular fever, of which eight developed a 'post-infective fatigue syndrome' that lingered for over six months. Thirty-one of the subjects recovered without any fatigue. The researchers also studied the activity of the EBV in the blood of the eight over a period of one year.

“Our findings reveal that neither the virus nor an abnormal immune response explain the post-infective fatigue syndrome. We now suspect it's more like a hit and run injury to the brain. We believe that the parts of the brain that control perception of fatigue and pain get damaged during the acute infection phase of glandular fever. If you're still sick several weeks after infection, it seems that the symptoms aren't being driven by the activity of the virus in body, it's happening in the brain,” Lloyd said while explaining the findings.

Chronic fatigue syndrome has baffled researchers and doctors worldwide, ever since it was recognized by the World Health Organization in 1969. However, a number of doctors have refused its diagnosis, leading to a stigma being attached with the mysterious disease. But lately, attitudes seem to be changing towards the disease, with many doctors and medical authorities emphasizing on the need to accept that the disease exists.

“I personally have never had a doubt that it's real because there are people who have got a set of symptoms that are unexplained. The real versus not real thing is often caught up in the mistaken notion about malingering or it's all depression but really there's no evidence to support that. So in a nutshell yes, it (the study) clearly supports the argument that it's real,” Lloyd said.

He added that the symptoms show that the problem is related to the brain rather than being physical. “It's not too big a leap of faith to say after that, it's in the brain, because of the nature of the symptoms – it's fatigue, it's pain, sleep disturbance, concentration and memory difficulties and mood disturbance. They're very much brain symptoms,” Lloyd said.

The findings of the study have been published in Journal of Infectious Diseases.

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