Journal of IiME Volume 1 Issue 1 ME/CFS: a research and clinical conundrum (continued) pain, tenderness and swelling; variable involvement of the central nervous system (ataxia and cranial nerve involvement); muscle weakness and/or sensory changes due to neuronal damage; impairment of memory; sleep disorders, etc.; vascular tachycardia, pallor); involvement (orthostatic reticulo-endothelial dysfunction; and recurrences of flu-like symptoms with myalgia. From 1934–90 there were at least sixtythree outbreaks of epidemic proportions, all well-documented, distributed geographically in North America (29 outbreaks), the UK (16), the rest of Europe (11), Australasia (4), Africa (2) and Asia (1). One of the most studied, and possibly the most controversial, of these outbreaks occurred at the Royal Free Hospital, London, in 1955, during which 292 people were affected. Indeed, outbreaks may still be occurring, and some of the patients who currently come under the CDC-1994 CFS definition have clinical features similar to the classical description of post-infectious ME patients defined above. The fact that we are still aware of these details is in no small measure due to Dr J. Gordon Parish who is attending this workshop today. Dr Parish has over many years collected reports of these outbreaks of ME (Parish, 1978; Shelokov & Parish, 1989), and has a complete archive of the relevant literature. A complete listing of these references can be found on the MERGE web site (www.meresearch.org.uk). Given the heterogeneous nature of the term CFS, and the different ways of defining it, it is probably no surprise that many of the biomedical studies conducted into the illness — a relatively small number given the scale of the problem — have had inconclusive results. Despite this, however, a range of abnormalities have been found by a number of different research groups, and these are summarised in the Figure 2 (previous page). Today’s workshop will concentrate on the vascular and biochemical aspects of ME/CFS, but MERUK intends to facilitate further workshops concentrating on other aspects of ME/CFS pathophysiology, such as muscle metabolism and function, and neuro-imaging and brain function. References A full list of the references mentioned can be obtained from Dr Neil Abbot, ME Research UK (Charity Number SC036942), The Gateway, North Methven St, Perth PH1 5PP; e-mail meruk@pkavs.org.uk; website www.meresearch.org.uk Invest in ME Charity Nr 1114035 www.investinme.org Facts About ME ME is estimated to cost the UK economy over £6 BILLION per year Dr Vance Spence and Kathleen McCall and Sue Waddle from Invest in ME – at a presentation for Invest in ME entitled Making the Breakthrough [http://tinyurl.com/yreh7a] ME Story At work I have been asked to go to see the company doctor as noone believes I'm unwell yet they see me struggling to walk on occasions! - Clare Dr Vance Spence and Dr Neil Abbot, ME Research UK, The Gateway, Perth, UK. Based on a presentation given at the Royal Society of Edinburgh Research Workshop on ME/CFS 18
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