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module menu icon Post-viral syndromes

Long COVID is the latest example of a condition where symptoms linger for weeks or months after an acute illness.

Ongoing fatigue, cognitive difficulties, pain and sometimes gastric or cardiac problems following an infection or illness are core symptoms of CSF/ME, glandular fever (Epstein-Barr virus), severe acute respiratory syndrome (SARS – a coronavirus), and fibromyalgia.11-18

SARS emerged in 2003. WHO noted there was a “persistent and significant impairment of exercise capacity and health status in survivors of SARS over 24 months.” In addition, 40% of people recovering from SARS still had chronic fatigue symptoms 3.5 years after being diagnosed.17

In 2006, Australian scientists investigated post-infective and chronic fatigue syndrome symptoms associated with glandular fever, chronic Q fever (bacterial infection by Coxiella burnetii), and epidemic polyarthritis (Ross River virus). They concluded: “A relatively uniform post-infective fatigue syndrome persists in a significant minority of patients for six months or more after clinical infection with several different viral and non-viral micro-organisms.”19

However, fluctuating symptoms and subjectivity of reporting has often made it difficult for such syndromes to be recognised or accepted by the medical profession. There has been a tendency to put ongoing symptoms down to psychogenic causes, or to disregard what the patient reports.20,21

Fibromyalgia syndrome (FMS) consist of a broad range of symptoms including muscle pain, fatigue, sleep disturbance, bladder and bowel abnormalities and reduced pain threshold. It accounts for 20% of referrals to rheumatology clinics yet there is still an ongoing clinical debate among rheumatologists as to its nature.22

Chronic Lyme disease (CLD, following infection by bacterial Borrelia species after a tick bite) is an example where there is less professional recognition. This multi-system illness is characterised by symptoms, such as tiredness, aches and loss of energy, that can last for years, but some dismiss it as a “fictitious entity”.18,23,24

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