Date sent: Mon, 20 May 2002 Looking for baby boomers with CFS and childhood illness Dr. Bruno would like to correspond with baby boomers born before 1955 who have been diagnosed with CFS/ME who had a childhood illness that caused fever, fatigue -- maybe a stiff neck and muscle weakness -- in the years before the polio vaccine was administered (please see below). Please e-mail polioparadox@aol.com Thank you! -------------------------------------------------------------- Englewood Hospital and Medical Center Fatigue Management Programs The Post-Polio Institute International Centre for Post-Polio Education and Research UNDIAGNOSED CHILDHOOD POLIO CAUSES CHRONIC FATIGUE SYNDROME IN WOMEN BABY BOOMERS. Englewood, NJ. May 20, 2002 -- Undiagnosed childhood polio infection is a cause of chronic fatigue syndrome in women baby-boomers. This is the conclusion of the 2001 International Chronic Fatigue Survey conducted by Dr. Richard L. Bruno, chairperson of the International Post-Polio Task Force and director of The Post-Polio Institute, The International Centre for Post-Polio Education and Research and Fatigue Management Programs at New Jersey's Englewood Hospital and Medical Center. Bruno wondered if polio might be related to CFS in baby boomers after a 1999 study by Leonard Jason found that half of the estimated 836,000 Americans with CFS are at least 40 years old. Jason concluded that baby-boomers may be at greater risk for CFS. Bruno thought that baby boomers' greater risk might be related to their having had an undiagnosed poliovirus infection in childhood, since they would not have been vaccinated against polio until at least 1955 when the Salk vaccine was distributed. Bruno suspected the poliovirus as a cause of chronic fatigue because of his twenty years of studying and treating polio survivors with Post-Polio Sequelae (PPS), the unexpected and often disabling symptoms -- overwhelming and chronic fatigue, muscle weakness, muscle and joint pain, sleep disorders, heightened sensitivity to anesthesia, cold and pain, and difficulty swallowing and breathing -- that occur in paralytic and of "non-paralytic" polio survivors about 35 years after the poliovirus attack. "It has been known since 1947 that the poliovirus damages brain stem neurons that activate the brain E28093 the 'brain activating system' that keeps the brain awake and focuses attention E28093 whether or not poliovirus damages spinal cord neurons that move the muscles," says Bruno. "Some diagnosed with so called 'non-paralytic' polio were found to have severe damage to the brain activating system, and have severe fatigue today, even though they had no muscle paralysis." Fifteen years of Post-Polio Institute research has found evidence of brain activating system damage in polio survivors with brain fatigue, including lesions on MRI of the brain, attention deficits on neuropsychologic testing, reduced levels of brain activating hormones, and brain wave slowing. "These abnormalities are identical to those in CFS patients," says Bruno. "We believed that the poliovirus damaged brain activating neurons and causes the signs and symptoms of fatigue in both polio survivors and some baby boomers with CFS." To test this hypothesis Americans, Britons and Canadians diagnosed with CFS or ME (myalgic encephalomyelitis, as CFS is called outside the US) were surveyed and asked if they'd had a childhood illness -- a fever that left them fatigued for several days, a stiff neck or muscle weakness -- in the years before the polio vaccine was distributed in 1955. Two-thirds of the 586 chronic fatigue patients who responded were born before 1955. They were on average 61 years old, just 4 year younger than polio survivors' average age in Bruno's previous International Surveys of over 3,000 polio survivors. Twenty percent of chronic fatigue patients born before 1955 were able to remember an illness with a fever, typically in 1947 when they were seven, which was the average age of a polio patient in 1947. "Just over one-third recall having had a stiff neck -- the 'red flag' symptom of polio -- about one-third were hospitalized and almost two-thirds remember having had muscle weakness," says Bruno. Remarkably the distribution of childhood illness cases in the baby boomers was nearly identical to the distribution of reported polio cases in the US and UK between 1935 and 1955. "What's more 90% of baby boomers with CFS/ME are women," says Bruno. "This is exactly the same percentage of women affected in the 1948 chronic fatigue epidemic in Iceland that was found to be caused by the Type II poliovirus." And CFS/ME patients who do remember a childhood illness are more affected than CFS/ME patients who did not remember an illness: baby boomers report more difficulty with concentration, thinking clearly, word finding and joint pain, have had more episodes of fainting, and are more likely to have sleep disturbed by abnormal breathing and muscle twitching. "Our findings suggests that a relatively mild childhood illness occurring before polio vaccination began in 1955 -- likely caused by the poliovirus damaging the brain activating system -- sets the stage for mid-life symptoms that are identical to the 'brain fatigue' reported by polio survivors and patients with CFS/ME," says Bruno. Says Bruno's collaborator on the Survey, Dr. Elizabeth Dowsett, creator of the CFS Diagnostic and Management Service in Essex, England, "Dr. Bruno's research shows that there is very little, if any, difference between CFS, ME and PPS." "There is no question that neither the naturally occurring poliovirus nor the Sabin oral polio vaccine causes CFS today," says Bruno. "But the possibility of a non-paralytic poliovirus infection in childhood causing chronic fatigue in middle-aged baby-boomers is a reason for hope." The Post-Polio Institute's research has found that conserving energy, daytime rests breaks, stopping activities before fatigue starts, and a higher-protein diet significantly reduce symptoms of fatigue in polio survivors and CFS/ME patients. Bruno describes his research on PPS, the baby boomer study and the fatigue treatment program in detail in his new book, THE POLIO PARADOX: UNCOVERING THE HIDDEN HISTORY OF POLIO TO UNDERSTAND TREAT "POST-POLIO SYNDROME" AND CHRONIC FATIGUE, to be published by Warner Books on June 4, 2002. "When baby boomers report symptoms of chronic fatigue, doctors need to ask if they had a childhood illness with a fever, stiff neck or muscle weakness that occurred during the polio epidemic years," says Bruno. And whether or not chronic fatigue patients recall a childhood illness, the finding that over 50% of those surveyed had symptoms of abnormal nighttime breathing and that 80% had nighttime muscle twitching requires that a sleep history be taken in anyone reporting chronic fatigue and that sleep studies be performed so that disturbed sleep as a cause of fatigue -- in polio survivors and chronic fatigue patients -- can be ruled out or treated.