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Dr. Komaroff’s current view on infectious agents and CFS

Infectious agents, mostly viruses and sometimes bacteria, can probably trigger and perpetuate CFS. “There is enough evidence in the literature that this now is pretty well-established.” 

The agents all share a common property —they can’t be eradicated by the immune system. “…There is now solid evidence that CFS can follow a new infection— the Australian study nailed that to most everyone’s satisfaction.”

It’s possible in CFS that different infectious agents interact with each other to cause symptoms. For instance, it’s possible if XMRV is involved and is reawakened, that it then reawakens a second virus, and both are needed to cause the symptoms of the illness. Such a process “would be tough to study, but doable.”

Concluding Thoughts

If Dr. Komaroff thinks back over 20 years ago when he gave his first talk to the Massachusetts CFIDS/ME & FM Association, it was a time when many people were sick, and most of the world around them including the medical community, really did not necessarily believe that CFS patients were sick with a biologically-based illness. There were no diagnostic tests or treatments available.

Now 20 years and more than 5,000 research papers later, there are hundreds of laboratories around the world studying this illness. “We still don’t have a cure, there isn’t a really good diagnostic test, but looking at it from the trenches as a physician and researcher of the illness, I am very impressed at how much we have learned, and by how attitudes around me in the medical community have changed—although they haven’t fully changed to the degree I would like. There are still some skeptics.”

Dr. Komaroff cited current studies by the CDC of national doctor attitudes toward CFS that found that about 75%-80% of American physicians now believe that CFS is really a biologically-based disease.

“Doctors are very frustrated by CFS, and they’re not always happy to see patients with the illness, because a doctor wants to have a solution for the patient. And if the doctor doesn’t even have a diagnostic test, let alone a cure, a doctor feels like she or he is failing in his or her responsibility to the patient.”

Dr. Komaroff thinks attitudes towards CFS research will rapidly change in a positive way if there proves to be a diagnostic test or marker within the next couple of years.

He’s optimistic that in the next two years there will be more progress than has already occurred in the last 20 years, because of the existing 5000 research studies that now provide the foundation for that progress.

The Massachusetts CFIDS/ME & FM Association is grateful to the pioneer and current CFS researchers and clinicians who have given of themselves over the last 20 years to discover and build the knowledge toward an understanding and treatment of CFS/ME.