Sierra Sun – May 7, 1987


Study on Fatigue Illness Determined “Inconclusive”

By Jean Lamming

Federal medical researchers who studied the chronic fatigue outbreak in Incline Village in 1985 published a report on their work in a national professional journal May 1.

The Centers for Disease Control (CDC) epidemiologists wrote that their study of 134 of North Shore and Truckee patients revealed that Epstein-Barr virus is not necessarily the culprit in the fatigue syndrome.

The report, however, falls far short of providing any conclusive answers for victims of the fatigue illness. Doctors Gary Holmes and Jon Kaplan report in a five page lead story in The Journal of the American Medical Association today, that other known and unknown viruses should be suspected.

The CDC investigators also report that the tests used to diagnose the syndrome in the practices of Incline internists Paul Cheney and Daniel Peterson yield inconclusive information.

However, the journal report, which circulates to 300,000 physicians, does not pioneer any new information, according to one of the doctors who asked the investigators to come to Lake Tahoe.

“It’s not very useful to me,” Peterson said Wednesday. “It’s two years old. It doesn’t say anything,” he said.

Epstein-Barr virus, (EBV) was the first agent the Incline Village internists suspected when cases of the mysterious fatigue started to mount in their practice in 1985. EBV, a virus in the herpes family that causes mononucleosis, had been linked to cases characterized by chronic-fatigue, sore throats, aches, and other cold-like symptoms by a national researcher that year.

Today it is implicated in new reports across the country as the root of an illness that has emerged as a nationwide phenomenon in the last year. But by 1986, Peterson and Cheney had decided that a new virus or bacterial agent was probably involved or totally to blame.

In October of 1986 they joined forces with the National Cancer Institute (NCI) to prove that a new virus in the herpes family, HBLV, was the cause. AIDS co-discoverer Dr. Robert Gallo and his NCS lab had isolated a new herpesvirus HBLV, in 1986.

Lake Tahoe patients had tested positive for it.

Peterson said he expects a more provocative report on the Lake Tahoe and Truckee cases and the illness to be published this month, with his name on the list of authors.

Packaged with the CDC report in The Journal of the American Medical Association today was a report on chronic fatigue by Harvard researchers who have been working with Cheney, Peterson, the NCI and others on cases from Lake Tahoe and other areas. That article also reports that EBV cannot be said to cause the chronic fatigue.

But results of the Harvard study, which was set at Brigham and Women’s Hospital in Boston, show that a mild fatigue syndrome could be common in medical practices. The goal of the study was to determine the number of patients in a large practice that complained of chronic fatigue.

Doctors Dedra Buchwald, John Sullivan and Anthony Komaroff found 21% of the 500 unselected patients they studied suffered from an illness similar to what has been labeled chronic EBV or CEBV. However, they, like Holmes and Kaplan, found that there was no evidence to implicate EBV as the cause and that tests that measure the immune reaction to EBV infection had to be carefully interpreted.

In fact the Harvard article reports that the test results could point to an infection by another virus that also reactivated a latent EBV infection. Most people carry EBV in their immune system by the time they are teenagers.

The CDC also reports that Holmes and Kaplan tried to define the scope of the North Shore outbreak.

Because there was a high proportion of patients who lived outside of Incline, the total number of patients treated reflected an epidemic in Incline Village when in reality the patient profile entailed a much larger geographic area.

Copyright 1987, Sierra Sun