Special problems of children with myalgic encephalomyelitis/chronic fatigue syndrome and the enteroviral link

Abstract

Since 1997, it has been known that myalgic encephalomyelitis/chronic fatigue syndrome constitutes the biggest cause of long-term sickness leading to absence from school, in both staff and pupils. The scale of the problem in children is substantial, and the pattern of illness in schools suggests a prominent role for viral infection—for example, the clustering of cases. The Dowsett–Colby study of 1997, researching long-term sickness, reported on a school roll of 333 024 pupils and 27 327 staff, and found a prevalence of long-term sickness in 70 of 100 000 pupils and 500 of 100 000 staff; 39% of cases were in clusters of three or more. The peak age was 14–16 years. The illness is known to be potentially severe and chronic. In addition, the Tymes Trust has reported that many affected children struggle for recognition of their needs, and are bullied by medical and educational professionals. Children should have time to recover sufficiently before returning to school; sustainable, energy-efficient and often home-based education is important here to fulfil legal obligations. Research is needed on viruses that trigger childhood myalgic encephalomyelitis—for example, enteroviruses—and on the neurocognitive defects caused by myalgic encephalomyelitis. We should recognise the value of previous biological research and records of outbreaks, and I recommend that myalgic encephalomyelitis be made notifiable owing to the encephalitic nature of the effects commonly reported in this illness.