cheeky bastard

The Carousel Network Chronic Neuroimmune Diseases
Information & Support Group for Sonoma County


Chronic Fatigue: A polio by another name
Research into Post-Polio syndrome and chronic fatigue has-made the
astounding discovery that the virus that most often triggers CFS is
closely related to the one that causes polio.
Jane Colby
ME: The New Plague
First and Best in Education Ltd.
24 Nene Valley Business Park, Oundle, Peterborough, PE 8 4HL, UK
Excerpt published in What Doctor's Don't Tell You, Vol. 6, No. 9
Just a few decades ago, hospital wards were full of children in iron
lungs as a result of polio. No longer. The horrific spectacle
appeared to abate with the advent of vaccination, but nothing is
without its price.

The public breathed a sigh of relief and even the medical profession
believed, and still seems to believe, that the dreaded scourge of
polio was at last being vanquished. We read predictions that it will
be wiped out by the year 2000.

But a body of evidence is growing linking Chronic Fatigue Syndrome
(CFS), also called myalgic encephalomyelitis (ME), to this terrible
disease, largely caused by attempts to eradicate polio. An
alternative polio seems to be upon us.

The proceedings of the first intemational scientific conference on
the Post-Polio Syndrome in the US have been collated in the Annals of


neurology.

In particular, papers by Dr Richard Bruno, assistant professor at the
New Jersey Medical School's department of physical medicine and
rehabilitation and director of Post-Polio Rehabilitation and Research
Service at the Kessler Institute for Rehabilitation in New Jersey,
and four other specialists compare Chronic Fatigue Syndrome and Post-
Polio Syndrome (Dalakas, et al, ed. The Post Polio Syndrome: Advances
in the Pathogenesis Treatment,Annals, NY Academy, Sciences, 1995:
273: 1-409). Post-Polio is developing in those who had polio 25-30
years previously. Clinically, it is indistinguishable from CFS.

Other researchers demonstrate that CFS is just another form of polio,
which has increased with the advent of polio vaccination. As one type
of gut virus has been eradicated, so other forms have had the space
to proliferate. Up to one in every 500 Americans may have CFS,
according to the Centers for Disease Control.

To understand the link one needs to understand the microbiological
habits of both polio and other enterovirus disease-that is, gut bugs.

A historical accident has led to various names being given to
viruses, all of which share physical , chemical and epidemiological
characteristics of what we consider the classic polio virus, which
science refers to as polio viruses 1, 2, and 3 (Dowsett: Journal of
Hospital Infection, 1988:11:103-15). ln l948, a polio-like illness in
New York state prompted scientists to culture the virus. But what
grew looked to them at that time like a new virus.

They called it "Coxsackie' after the small town up the Hudson River
where it was found. And they called the disease "Atypical Polio"
because its symptoms identified it as a kind of polio, despite the
virus being apparently different.

This kind of polio, "Atypical Polio,' has since been
renamed, 'Chronic Fatigue Syndrome,' or ME. But it remains a kind of
polio despite the change of name. and newer technology has shown up
the generic similarities of the most frequent agent that causes it.

These techniques place Coxsackie, the virus most often implicated in
CFS, in the polio family tree, along with so-called echo viruses.
Coxsackie has been further divided into Coxsackie type A (with 24
viruses) and Coxsackie type B (six viruses ). There are 34 echo
viruses. In total, there are at least 72 enteroviruses in all, with
new ones still being discovered.

All this has been unnecessarily confusing and complicated, even for
doctors. These days newly discovered enteroviruses are just given a
new number, not a new name, since their inter-relationship is
recognized.

Had the techniques been available that we now have at our disposal,
all these viruses might simply have been called "Polio 1 through 72."

There are several angles from which to investigate the hypothesis
that CFS is a type of polio. One is its clinical symptoms. Dr.
Elizabeth Dowsett, consultant microbiologist of the Southeast Es***
NHS Trust who is in the forefront of British CFS research, explains
that true CFS (as opposed to fatigue states with other etiologies)
strikes one clinically as being polio-like, and it has often been
diagnosed as a "non-paralytic polio." "These patients have weakness,
pain down their spines and are systemically ill," she says.

She feels that it has been an unfortunate mistake to turn to the
label "Chronic Fatigue" because true CFS is a neurological condition
that usually originates with a gut virus infection like Coxsackie.

Apart from clinical examination, in some cases of CFS you can
actually demonstrate the presence of gut virus infection in the
patient. The requirement to put off diagnosing CFS for six months
after the patient falls ill has unwittingly militated against this.
If tests are not done very rapidly after the onset of infection, it
is too late to identify the virus.

A blood screening test called the IGM, which shows up recent
infection, can be positive up to three months after infection in
adults. As the enteroviruses are characterized by their relapsing
nature (on average, three-week intervals), it could also be
identified on relapse.

Apart from modern techniques, a research procedure called the acid
elution test can identify your antibody from a circulating virus and
can be applied to viruses multiplying in the bowel. Years ago it was
difficult to diagnose polio, and it was this very test which was used.

A third way to compare CFS with polio is by looking at studies of
actual outbreaks which identified the viruses causing it. Here the
evidence is particularly striking.

A recent paper by Richard T. Johnson, at the Department of Neurology,
John Hopkins University School of Medicine, in Baltimore, published
in the 1995 Annals of the New York Academy of Sciences mentioned
above, sets out evidence that has been available since the 1950s. "In
the spring of 1957," he wrote, "we investigated an epidemic of
poliomyelitis in Hawaii...of the 39 cases of nonparalytic
poliomyelitis, only four were related to type I poliovirus. There
were 16 cases of echovirus 9, seven cases of Coxsackie, and four to
five other enteroviruses."

The very enteroviruses known to be implicated in CFS were here
identified as causing "non-paralytic polio." CFS has often been
diagnosed as "non-paralytic polio." And even more interestingly, two
of the 38 cases of paralytic disease were not caused by the polio
virus at all, but by one of the Coxsackie viruses.

So we know that enteroviruses in general can cause varying forms of
the disease we call polio.

Other parallels between CFS and polio concern neurological damage.
In the November 1991 edition of Orthopedics, Dr. Bruno says that "all
the evidence available shows conclusively that every case of
poliomyelitis, human or experimental, exhibits lesions of the brain.
In the experimental animal this included non-paralytic and abortive
cases as well as paralytic cases." CFS has been diagnosed by both
italicized names. In fact, brain abnormalities can now be
demonstrated in the brains of people with CFS using SPECT and MRI
scans.

One would expect there to be differences in the diseases caused by
different viruses, but if these viruses are all of the same family
and use the same receptor sites in the body, one would also expect
there to be similarities. This is just what we find.

Dr. Bruno says: "Despite the differences between poliomyelitis and
CFS, an association with the polio virus was suggested by the fact
that, of the more than one dozen CFS outbreaks before the
introduction of the Salk vaccine, nine occurred during or immediately
after outbreaks of polio, and several involved hospital staff who
cared for polio patients" (Annals, NY Academy of Sciences, 1995).

There is also the case of a woman who fell ill with classical CFS
while nursing a lady friend with acute paralytic polio (Hyde et al:
Epidemiological Aspects of ME/CFS, Nightingale Research Foundation,
Ottawa, Canada, 1994).

But if CFS is a type of polio, why doesn't everyone exposed to the
relevant viruses develop ME just as they did polio?

It has been forgotten that, as Dr. Thomas Stuttaford of The London
Times explains, ". . only a small number of those infected with the
polio virus became paralyzed; about 90 percent didn't even realize
that they had anything more threatening than a cold." With polio and
CFS, the state of your immune system governs whether you will be
susceptible.

By altering the population's resistance to a particular organism, we
alter the balance of infectious agents in the environment. The
circulation of wild polio viruses 1-3 has declined through
vaccination. However, this has left us open to the other 69 polio-
related viruses, which have thrived (see How viruses compete with
each other).

It is therefore not surprising that since the late 1950s the
incidence of CFS has risen, and experts predict that it will be the
neurological disease of the 21st century. By suppressing the spread
of three enteroviruses we have opened the door to the rest.

The argument about whether enterovirus infection persists over many
years is still raging. In her 1995 review of the proceedings of the
1994 Post-Polio Conference, Dr. Dowsett draws attention to new
evidence of persistent enterovirus infection in the central nervous
system of Post-Polio patients.

She concluded: "Three separate groups of Virologists from the US, UK
and France have found fragments of enteroviral RNA in the spinal
cord, cerebrospinal fluid and blood of some patients with Post-Polio
syndrome. The fragments are identified as polio virus by some and as
seeing "Post-CFS" as well. The Nightingale Research Foundation in
Ottawa proposes that in fact they are one and the same condition-
others believe they may be variations of each other.

What has arisen is "two new diseases with different names, with
different degrees of acceptance and exactly the same set of symptoms
at exactly the same time. It is unrealistic to believe that we are
dealing with two different disease processes and two different
causes," the researchers concluded.

A paper investigating the epidemiological aspects of CFS has revealed
further convincing parallels between the behavior of this disease and
polio. It describes the onset of CFS as mainly being ushered in by
a "minor illness" which has "recently been described as a flu-like
illness. . .", The researchers continue: ". . in reality it is
identical to and has all of the features and variability of
the 'minor illness' of missed or abortive poliomyelitis."

In comparisons with epidemic polio going back to 1916, they note
that "we see the same two typical features" in a typical year with an
epidemic of CFS: "a decreasing incidence from January to reach a
summer low; then ... the strong late summer increased incidence,
peaking in the August to October period." (Hyde et al: Nightingale
Research Foundation. Ottawa, 1994).

CFS, or Atypical Polio, is such a serious and devastatingly
debilitating multisystem malfunction leading to such profound
form of therapy?

The treatment of choice for those with Post-Polio is "adequate rest,
energy conservation, the pacing of activities, and reducing physical
and emotional stress" (Bruno: Annals NY Academy of Sciences, 1995).

What on earth will happen in 30 years' time to children now getting
CFS in a climate where they are disbelieved and told to push
themselves through the pain barrier? The condition 'Post-CFS,' which
we are already seeing in adults, may well await them with a vengeance.

We have to ask ourselves the disturbing question: if polio victims
had been able to breathe, would we ever have taken that disease
seriously?

CB

cheeky bastard

The Carousel Network Chronic Neuroimmune Diseases
Information & Support Group for Sonoma County


Chronic Fatigue: A polio by another name
Research into Post-Polio syndrome and chronic fatigue has-made the
astounding discovery that the virus that most often triggers CFS is
closely related to the one that causes polio.
Jane Colby
ME: The New Plague
First and Best in Education Ltd.
24 Nene Valley Business Park, Oundle, Peterborough, PE 8 4HL, UK
Excerpt published in What Doctor's Don't Tell You, Vol. 6, No. 9
Just a few decades ago, hospital wards were full of children in iron
lungs as a result of polio. No longer. The horrific spectacle
appeared to abate with the advent of vaccination, but nothing is
without its price.

The public breathed a sigh of relief and even the medical profession
believed, and still seems to believe, that the dreaded scourge of
polio was at last being vanquished. We read predictions that it will
be wiped out by the year 2000.

But a body of evidence is growing linking Chronic Fatigue Syndrome
(CFS), also called myalgic encephalomyelitis (ME), to this terrible
disease, largely caused by attempts to eradicate polio. An
alternative polio seems to be upon us.

The proceedings of the first intemational scientific conference on
the Post-Polio Syndrome in the US have been collated in the Annals of


neurology.

In particular, papers by Dr Richard Bruno, assistant professor at the
New Jersey Medical School's department of physical medicine and
rehabilitation and director of Post-Polio Rehabilitation and Research
Service at the Kessler Institute for Rehabilitation in New Jersey,
and four other specialists compare Chronic Fatigue Syndrome and Post-
Polio Syndrome (Dalakas, et al, ed. The Post Polio Syndrome: Advances
in the Pathogenesis Treatment,Annals, NY Academy, Sciences, 1995:
273: 1-409). Post-Polio is developing in those who had polio 25-30
years previously. Clinically, it is indistinguishable from CFS.

Other researchers demonstrate that CFS is just another form of polio,
which has increased with the advent of polio vaccination. As one type
of gut virus has been eradicated, so other forms have had the space
to proliferate. Up to one in every 500 Americans may have CFS,
according to the Centers for Disease Control.

To understand the link one needs to understand the microbiological
habits of both polio and other enterovirus disease-that is, gut bugs.

A historical accident has led to various names being given to
viruses, all of which share physical , chemical and epidemiological
characteristics of what we consider the classic polio virus, which
science refers to as polio viruses 1, 2, and 3 (Dowsett: Journal of
Hospital Infection, 1988:11:103-15). ln l948, a polio-like illness in
New York state prompted scientists to culture the virus. But what
grew looked to them at that time like a new virus.

They called it "Coxsackie' after the small town up the Hudson River
where it was found. And they called the disease "Atypical Polio"
because its symptoms identified it as a kind of polio, despite the
virus being apparently different.

This kind of polio, "Atypical Polio,' has since been
renamed, 'Chronic Fatigue Syndrome,' or ME. But it remains a kind of
polio despite the change of name. and newer technology has shown up
the generic similarities of the most frequent agent that causes it.

These techniques place Coxsackie, the virus most often implicated in
CFS, in the polio family tree, along with so-called echo viruses.
Coxsackie has been further divided into Coxsackie type A (with 24
viruses) and Coxsackie type B (six viruses ). There are 34 echo
viruses. In total, there are at least 72 enteroviruses in all, with
new ones still being discovered.

All this has been unnecessarily confusing and complicated, even for
doctors. These days newly discovered enteroviruses are just given a
new number, not a new name, since their inter-relationship is
recognized.

Had the techniques been available that we now have at our disposal,
all these viruses might simply have been called "Polio 1 through 72."

There are several angles from which to investigate the hypothesis
that CFS is a type of polio. One is its clinical symptoms. Dr.
Elizabeth Dowsett, consultant microbiologist of the Southeast Es***
NHS Trust who is in the forefront of British CFS research, explains
that true CFS (as opposed to fatigue states with other etiologies)
strikes one clinically as being polio-like, and it has often been
diagnosed as a "non-paralytic polio." "These patients have weakness,
pain down their spines and are systemically ill," she says.

She feels that it has been an unfortunate mistake to turn to the
label "Chronic Fatigue" because true CFS is a neurological condition
that usually originates with a gut virus infection like Coxsackie.

Apart from clinical examination, in some cases of CFS you can
actually demonstrate the presence of gut virus infection in the
patient. The requirement to put off diagnosing CFS for six months
after the patient falls ill has unwittingly militated against this.
If tests are not done very rapidly after the onset of infection, it
is too late to identify the virus.

A blood screening test called the IGM, which shows up recent
infection, can be positive up to three months after infection in
adults. As the enteroviruses are characterized by their relapsing
nature (on average, three-week intervals), it could also be
identified on relapse.

Apart from modern techniques, a research procedure called the acid
elution test can identify your antibody from a circulating virus and
can be applied to viruses multiplying in the bowel. Years ago it was
difficult to diagnose polio, and it was this very test which was used.

A third way to compare CFS with polio is by looking at studies of
actual outbreaks which identified the viruses causing it. Here the
evidence is particularly striking.

A recent paper by Richard T. Johnson, at the Department of Neurology,
John Hopkins University School of Medicine, in Baltimore, published
in the 1995 Annals of the New York Academy of Sciences mentioned
above, sets out evidence that has been available since the 1950s. "In
the spring of 1957," he wrote, "we investigated an epidemic of
poliomyelitis in Hawaii...of the 39 cases of nonparalytic
poliomyelitis, only four were related to type I poliovirus. There
were 16 cases of echovirus 9, seven cases of Coxsackie, and four to
five other enteroviruses."

The very enteroviruses known to be implicated in CFS were here
identified as causing "non-paralytic polio." CFS has often been
diagnosed as "non-paralytic polio." And even more interestingly, two
of the 38 cases of paralytic disease were not caused by the polio
virus at all, but by one of the Coxsackie viruses.

So we know that enteroviruses in general can cause varying forms of
the disease we call polio.

Other parallels between CFS and polio concern neurological damage.
In the November 1991 edition of Orthopedics, Dr. Bruno says that "all
the evidence available shows conclusively that every case of
poliomyelitis, human or experimental, exhibits lesions of the brain.
In the experimental animal this included non-paralytic and abortive
cases as well as paralytic cases." CFS has been diagnosed by both
italicized names. In fact, brain abnormalities can now be
demonstrated in the brains of people with CFS using SPECT and MRI
scans.

One would expect there to be differences in the diseases caused by
different viruses, but if these viruses are all of the same family
and use the same receptor sites in the body, one would also expect
there to be similarities. This is just what we find.

Dr. Bruno says: "Despite the differences between poliomyelitis and
CFS, an association with the polio virus was suggested by the fact
that, of the more than one dozen CFS outbreaks before the
introduction of the Salk vaccine, nine occurred during or immediately
after outbreaks of polio, and several involved hospital staff who
cared for polio patients" (Annals, NY Academy of Sciences, 1995).

There is also the case of a woman who fell ill with classical CFS
while nursing a lady friend with acute paralytic polio (Hyde et al:
Epidemiological Aspects of ME/CFS, Nightingale Research Foundation,
Ottawa, Canada, 1994).

But if CFS is a type of polio, why doesn't everyone exposed to the
relevant viruses develop ME just as they did polio?

It has been forgotten that, as Dr. Thomas Stuttaford of The London
Times explains, ". . only a small number of those infected with the
polio virus became paralyzed; about 90 percent didn't even realize
that they had anything more threatening than a cold." With polio and
CFS, the state of your immune system governs whether you will be
susceptible.

By altering the population's resistance to a particular organism, we
alter the balance of infectious agents in the environment. The
circulation of wild polio viruses 1-3 has declined through
vaccination. However, this has left us open to the other 69 polio-
related viruses, which have thrived (see How viruses compete with
each other).

It is therefore not surprising that since the late 1950s the
incidence of CFS has risen, and experts predict that it will be the
neurological disease of the 21st century. By suppressing the spread
of three enteroviruses we have opened the door to the rest.

The argument about whether enterovirus infection persists over many
years is still raging. In her 1995 review of the proceedings of the
1994 Post-Polio Conference, Dr. Dowsett draws attention to new
evidence of persistent enterovirus infection in the central nervous
system of Post-Polio patients.

She concluded: "Three separate groups of Virologists from the US, UK
and France have found fragments of enteroviral RNA in the spinal
cord, cerebrospinal fluid and blood of some patients with Post-Polio
syndrome. The fragments are identified as polio virus by some and as
Coxsackie virus by others," she said.

It is thought that the emergence of late-onset Post-Polio fatigue may
result from age-related changes in brain cells that survived the
original polio infection (Bruno, Annals, NY Academy of Sciences,
1995).

But it can be observed through case histories that just as we see
Post-Polio Syndrome 30 years after initial infection, so we are
seeing "Post-CFS" as well. The Nightingale Research Foundation in
Ottawa proposes that in fact they are one and the same condition-
others believe they may be variations of each other.

What has arisen is "two new diseases with different names, with
different degrees of acceptance and exactly the same set of symptoms
at exactly the same time. It is unrealistic to believe that we are
dealing with two different disease processes and two different
causes," the researchers concluded.

A paper investigating the epidemiological aspects of CFS has revealed
further convincing parallels between the behavior of this disease and
polio. It describes the onset of CFS as mainly being ushered in by
a "minor illness" which has "recently been described as a flu-like
illness. . .", The researchers continue: ". . in reality it is
identical to and has all of the features and variability of
the 'minor illness' of missed or abortive poliomyelitis."

In comparisons with epidemic polio going back to 1916, they note
that "we see the same two typical features" in a typical year with an
Now. up to a half of survivors have gone on to develop Post-Polio. It
has been predicted that this will eventually rise to 100 percent.

What are we doing to our ****age CFS sufferers when we force them
back to school, deny home tutoring and tell them to exercise as a
form of therapy?

The treatment of choice for those with Post-Polio is "adequate rest,
energy conservation, the pacing of activities, and reducing physical
and emotional stress" (Bruno: Annals NY Academy of Sciences, 1995).

What on earth will happen in 30 years' time to children now getting
CFS in a climate where they are disbelieved and told to push
themselves through the pain barrier? The condition 'Post-CFS,' which
we are already seeing in adults, may well await them with a vengeance.

We have to ask ourselves the disturbing question: if polio victims
had been able to breathe, would we ever have taken that disease
seriously?

CB