Lake Tahoe Epidemic (1984 - 85)
Medical and Scientific Findings at the time which are still relevant today

 

Research papers

  • Buchwald, D., Cheney, P., Peterson, D., Henry, B., Wormsley, S., Geiger, A., Ablashi, D., Komaroff, D.etc. 1992. A chronic illness characterized by fatigue, neurologic and immunologic disorders, and active Human Herpesvirus Type 6 Infection. Annals of Internal Medicine 1116: 103-13. (The seminal scientific research paper on the Lake Tahoe epidemic in the USA in the mid 1980's and the origin of the term CFS)

    The Harvard-led research team found abnormal MRI brain scans, significant alterations in white blood cells counts and functioning, and signs of active infection with a recently discovered pathogen, HHV-6a. The illness was likely a “chronic, immunologically mediated inflammatory process of the central nervous system.”
  • Daugherty SA, Henry BE, Peterson DL, Swarts RL, Bastien S, Thomas RS. Rev Infect Dis. 1991 Jan-Feb;13 Suppl 1:S39-44. Chronic fatigue syndrome in northern Nevada.
  • Holmes GP, Kaplan JE, Stewart JA, Hunt B, Pinsky PF, Schonberger LB. A cluster of patients with a chronic mononucleosis-like syndrome. Is Epstein-Barr virus the cause? JAMA. 1987 May 1;257(17):2297-302.
  • Buchwald D, Ashley RL, Pearlman T, Kith P, Komaroff AL., J Med Virol. 1996 Sep;50(1):25-30.Viral serologies in patients with chronic fatigue and chronic fatigue syndrome.
  • The role of Molds and Mycotoxins in Immune Dysfunctions during the Lake Tahoe epidemic

    • Mold Warriors  By Dr Ritchie Shoemaker. Chapt.23. Mold at Ground Zero for CFS  "History doesn't remember the critics" page 447

      ' One of the researchers who was well represented at the CFS meetings was Dr Kenney De Meirleir from Belgium. He has published extensively on the different mechanisms that contribute to Chronic Fatigue Syndrome. Before I could talk to him, however, Dr.Robert Suhadolnik presented his data on the enzyme complexity involving RNase-L. He had been working with Drs Peterson and Cheney for some time.
      I asked him about mold and CFS. Making me fall to the floor, he said, "Oh yes, we know a lot about mold exposure in the original cohort in Incline Village. The source of activation of the endopeptidase that cleaves RNase L is increased response of a cytokine, alpha interferon."
      "Now wait," I said, "our data is very clear that alpha interferon levels are increased like crazy in mold patients compared to controls. Can we say that mold exposure doesn't change RNase L like you have reported in putative viral CFS patients?"
      Dr. De Meirleir chimed in, "We know that cytokine increases are important activators of the subsequent increased activity of these enzymes. Given your data, we need to look again at our data in which we clearly see changes in innate immune responses in CFS. Mold could be the common denominator. '

    • Simiilarities between the Lake Tahoe outbreak and Sick Building Syndrome (the role of molds and mycotoxins in damp buildings and defective air conditioning systems)

      Concurrent sick building syndrome and chronic fatigue syndrome: epidemic neuromyasthenia revisited
      Chester AC, Levine PH.Clin Infect Dis. 1994 Jan;18 Suppl 1:S43-8.

      Lake Tahoe Outbreak Truckee, California. Coincident with, and reported as part of an outbreak of CFS in northern Nevada and Califor-nia [13, 17, 24], nine of 10 high school teachers who used a single, small, poorly ventilated conference room became ill sequentially. All nine teachers required a leave of absence, and two retired. Eight teachers remain ill 5 years after the onset of the outbreak. The one unaffected teacher spent less time than the others in the conference room, often doing his work outdoors. The conference room was one of four rooms serviced by an all-water heating system installed in 1985. It functioned by using variable air flow over a coil filled with hot water. The fresh-airv ents were sealed with no other sourceo f fresh air available. There were no functioning windows or air con-ditioning. A spirit duplicator and two coffee machines were in the room. The onset of illness was generally sudden, evolving over 1 month, and fatigue was the predominant symptom. Headaches, myalgias, and dyspnea were other common com-plaints. Photophobia was often noted, with difficulty keeping the eyes open even in darkness. Many individuals experi-enced recurrent sinusitis. The prevalence of severe fatigue is noted in figure 1.

      Sick Building Syndrome
      Sick building syndrome (SBS) is usually characterized by upper respiratory complaints, headache, and mild fatigue. Chronic fatigue syndrome (CFS) is an illness with defined criteria including extreme fatigue, sore throat, headache, and neurological symptoms. We investigated three apparent outbreaks of SBS and observed another more serious illness (or illnesses), characterized predominantly by severe fatigue, that was noted by 9 (90%) of the 10 teachers who frequently used a single conference room at a high school in Truckee, California; 5 (23%) of the 22 responding teachers in the J wing of a high school in Elk Grove, California; and 9 (10%) of the 93 responding workers from an office building in Washington, D.C. In those individuals with severe fatigue, symptoms of mucous membrane irritation that are characteristic of SBS were noted but also noted were neurological complaints not typical of SBS but quite characteristic of CFS. We conclude that CFS is often associated with SBS.
      PMID: 8148452 [PubMed - indexed for MEDLINE]

      PROCEEDINGS of the International Conference Saratoga Springs, New York

      Oct 6-7, 1994

      FUNGI AND BACTERIA IN INDOOR AIR ENVIRONMENTS Health Effects, Detection and Remediation Editors Eckardt Johanning, M.D.,M.Sc. Chin S. Yang, Ph.D.

      Eastern New York Occupational Health Program

      MYCOTOXINS AND NEUROTOXICITY Page 161

      Pierre L. Auger, M.D. M.Sc., FRCPC(c)

      Abstract: Mycotoxins have been called "agents in search of a disease" (Schiefer, 1990). Medical literature contains little information concerning airborne mycotoxins. We would like to make the point that mycotoxins are potent neurotoxic agents. Chronic Fatigue Syndrome and psycho-organic syndrome comprise an array of symptoms which overlap. We considered both of these diseases as consequences of possible central nervous system injuries and hypothetically related to mycotoxin exposure.

      Key words. Mycotoxins, neurotoxicity, Stachybotrys atra, indoor air pollution, chronic fatigue syndrome, psycho-organic syndrome.

      INTRODUCTION

      Fungi are one of the agents present in dust causing harm to human health. The lung and upper respiratory airways have been considered to be the historical targets for disease subsequent to mold exposure. Mycotoxins are metabolites produced by fungi in certain favorable environment. They are polysystemic poisons and many of them are neurotoxic and immunotoxic. Since 1984, we have been confronted with patients complaining of fatigue, cognitive difficulties, repetitive respiratory infectious diseases and a complex array of symptoms consistent with the diagnosis of psychoorganic syndrome (POS) and/or chronic fatigue syndrome with immunodysfunction (CFIDS). We think that neurotoxicity from mycotoxins are an important aspect of mycotoxicosis. This report is based on soft data, on circumstantial evidence. Epidemiological analysis is not yet possible.

      A few case reports are gleaned from the medical literature. They can let us suspect the importance of the neurotoxic effects of molds. Croft W. et al (1986), Johanning, et al (1993), and Recco P., et al (1986) described patients exposed to Stachybotrys Atra. These people all complained of neuropsychological problems accompanied by fatigue with concommitant irritative symptoms. Nexo, et al (1983) relate cases of extreme fatigue alleviated by the removal of dusty carpets possibly contaminated by known toxicogenic Fusarium fungi.

      Two other publications seem to entertain a similar hypothesis (Levine P.H., et al 1992, Chester A.C. et al, 1994). They described cases of chronic fatigue syndrome in buildings with indoor air problems. Also a few epidemiological studies of other symptoms than respiratory have shown significant relative risks of exposure to molds and humidity giving rise to symptoms like depression, aching joints, nausea, tiredness (Waegermaekers M., et al 1989, Platt, et al 1989). Finally Gordon et al (1993) reported a neurological syndrome in a young man consisting of dementia and tremor possibly related to the presence of different toxicogenic Aspergillus and Penicillium in a moldy silage.

      Some more Research papers on these similarities

    • Back from the Edge: How One Man's Discovery Brought Him From Desperately Sick with Chronic Fatigue Syndrome To the Top of Mt. Whitney in Six Months by Erik Johnson
  • Levine PH, Jacobson S, Pocinki AG, Cheney P, Peterson D, Connelly RR, Weil R, Robinson SM, Ablashi DV, Salahuddin SZ, et al. Arch Intern Med. 1993 Mar 8;153(5):661. Clinical, epidemiologic, and virologic studies in four clusters of the chronic fatigue syndrome.
  • Cheney PR, Dorman SE, Bell DS: Interleukin-2 and the chronic fatigue syndrome. Ann Intern Med 1989, 110:321.
  • T reg cell exhaustion
    • Jones JF, Straus SE: Chronic Epstein-Barr virus infection. Annu Rev Med 1987, 38:195-209.
    • Borysiewicz LK, Haworth SJ, Cohen J, Mundin J, Rickinson A, Sissons JG: Epstein-Barr virus - specific immune defects in patients with persistent symptoms following infectious mononucleosis. Q J Med 1986, 58:111-121.
    • Klimas N, Salvato F, Morgan R, Fletcher MA: Immunologic abnormalities in chronic fatigue syndrome. J Clin Microbiol 1990, 28:1403-1410.
    • Behan PO, Behan WHM, Bell EJ: The postviral fatigue syndrome - an analysis of the findings in 50 cases. J Infect 1985, 10:211-222.
    • Tobi M, Morag A, Ravid Z, Chowers I, Feldman-Weiss V, Michaeli Y, Ben-Chetrit E, Shalit M, Knobler H: Prolonged atypical illness associated with serological evidence of persistent Epstein-Barr infection. Lancet 1982, 1:61-64.
  • HHV-6a  virus which has been consistently found in high pecentages of ME / CFS patients has been found to be associated with Hodgkin's lymphoma, acute lymphocytic leukemia, African Burkitts lymphoma, and sarcoidosis, as well as AIDS and Chronic Fatigue Syndrome. Lusso, P. et al.; "In Vitro Cellular Tropism of Human B-Lymphotropic Virus(Human Herpesvirus-6)"; Journal of Experimental Medicine 167:1659, May 1988.
  • When HHV-6a's growth is stopped by the experimental drug Ampligen in Chronic Fatigue Syndrome patients, their symptoms resolve. (In a trial published in 1987, the same appeared to be true for "AIDS" patients treated with Ampligen.) Strayer, D.R. et al.; "A Controlled Clinical Trial
  • Gin W, Christiansen FT, Peter JB. Immune function and chronic fatigue syndrome. Med J Aust 1989:151:117-8.
  • Grufferman, S. et al.; "Epidemiologic Investigation of an Outbreak of Chronic Fatigue-Immune Dysfunction Syndrome in a Defined Population"; American Journal of Epidemiology 128(4), 1988.
  • Barnes, Deborah; "Mystery Disease at Lake Tahoe Challenges Virologists and Clinicians"; Science 234:541, 1986.

 

Medical and Clinical Findings of Dr. Cheney and Dr. Peterson and other doctors involved in the epidemic. And the findings of scientific researchers during and after the epidemic..

  • The illness had two phases - an acute illness phase and a chronic illness phase. The onset of the illness was acute. This progressed to the chronic phase over several weeks or months. Symptoms differed between the acute phase and the chronic phase. The Holmes CDC criteria (1988) and the Fukuda CDC criteria (1994) failed to distinguish the two phases and the differences in symptoms and biomarkers between the two phases. Gradual onset ME which is different to these aforementioned phases was also not mentioned by the CDC criteria.
  • It first occurred in children or students. Then it passed on to adults. This was the case in most ME epidemics and clusters. The reason fo this has not been clearly established.
  • Immune system abnormalities - Low natural killer cell numbers and lowered cytotoxicity, B cell abnormalities, high levels of inflammatory cytokines, particularly IL-2. Drs. Komarroff, Cheney and Peterson believed a pathogen was involved in natural killer cell depletion, most likely a virus. These findings were never fully followed up by CDC and NIH and other research bodies in other countries since 1986.
    In the book Osler's Web: Inside the Labyrinth of the Chronic Fatigue Syndrome Epidemic by Hillary Johnson medical doctors in the USA found an unusually high number of B cell lymphomas in ME / CFS patients. Special scientific tests showed that these B-cell Lymphomas in ME patients were unusual types, not seen before. The researchers found B-cell deficiency in all patients, and a positive result on the kappa/lambda assay for a majority of these patients. After studying samples from approximately fifty patients, Wormsley estimated that the rate of clonal excess abnormality in the CFS patients from Nevada was at least 25 percent ('Oslers Web, by Hillary Johnson, Penguin Books 1997, page 94). This is significant as kappa/lambda light chains are the result of abnormalities within the bone marrow B-cell lineage. This has direct on B-cells and overall immunity, and susceptibility to Cancers. Recent scientific studies show that the incidence rate of non-Hodgkin's lymphoma is 0.02% in the United States, yet nearly 5% of CFS patients develop the disease. This is a significant risk factor.
  • The medical findings presented by Dr. Cheney, Dr. Peterson, Dr. Holmes, Dr. Komaroff, and others to the CDC and Federal health bodies and scientific journals during and after the Lake Tahoe outbreak confirmed a rapidly spreading infectious disease with a short incubation period of one week or less which progressed to a chronic illness within 6 months. This incubation period narrows down the causative agent for the illness. High numbers of patients had HHV6a (then called HBLV), some had EBV, including reactivated EBV, some had CMV infection, some had serious Herpes simplex infections and some had measles infection. A significant number had several infections at the same time, including re-activated latent viruses.

    All of these particular infections have an incubation period of greater than one week. The exception to this being latent versions of these viruses which can be reactivated within a day or a few days, and certainly less than one week. Some Enteroviruses have an incubation period of 1 week or less. Infection by bacteria, including brucella and other pathogens were also found in some patients, these typically have incubation periods of less than one week. Certain unusual immune system abnormalities and dysfunctions were found which undermined the body's ability to fight viruses and pathogens ; these may have been caused by the causative infectious agent.
  • The diagnosis of HHV6a was undermined by the fact that it was newly discovered and most doctors did not test for it and by outdated diagnostic technologies at the time which could not test for it.

  • Enteroviruses, indicated in most ME epidemics throughout history, were not tested for in the Lake Tahoe epidemic.

    Enteroviruses have been associated with ME since the 1930's. Names such as 'Epidemic  Neuromyasthenia’,  ‘Encephalitis’,  ‘Akureyri Disease’, ‘atypical poliomyelitis’, 'Iceland disease',  ‘poliomyelitis-like epidemic neuromyasthenia’  ‘Abortive Poliomyelitis’ were used to describe the illness prior to the term ‘Myalgic Encephalomyelitis’ being created by Dr. Melvin Ramsey in 1956. Enteroviruses were implicated in most epidemics from the 1930's to the present day.

    " Primary M.E. is always an acute onset illness. Doctors A. Gilliam, A. Melvin Ramsay and Elizabeth Dowsett (who assisted in much of his later work,) John Richardson of Newcastle-upon-Tyne, W.H. Lyle, Elizabeth Bell of Ruckhill Hospital, James Mowbray of St Mary's, and Peter Behan all believed that the majority of primary M.E. patients fell ill following exposure to an enterovirus. (Poliovirus, ECHO, Coxsackie and the numbered viruses are the significant viruses in this group, but there are other enteroviruses that exist that have been discovered in the past few decades that do not appear in any textbook that I have perused.) I share this belief that enteroviruses are a major cause. "
    Source: http://www.nightingale.ca/documents/Nightingale_ME_Definition_en.pdf

    Dr. John Richardson, was a brilliant British doctor who spent over 30 years diagnosing and treating ME patients in Britain. He advised and mentored Dr. Byron Hyde. Dr. Melvin Ramsey is world famous for his contributions to ME research. Dr. Byron Hyde also has a good international reputation.

  • Chronic Lyme disease, including Lyme infection of the brain and nervous system and accompanying co-infections were not tested. Mycoplasma infections were not tested as the diagnostic technologies at the time could not identify such chronic infections. In recent years both Lyme and Mycoplasma infections have been found in high percentages of ME patients.
  • flu like fatigue
  • diffuse brain injury. Brain lesions confirmed by MRI scans. Lesions were similar to AIDS patients and MS patients
  • brain hypoperfusion confirmed by brain scans
  • areas of abnormal signal intensity in the white matter of the central nervous system similar to multiple sclerosis, Alzheimers, metastatic disease, post-chemotherapy, trauma, viral infection.
  • diffuse CNS and PNS injuries
  • inflammation of the nervous system
  • unusual fever, high temperature (acute phase, but may occur in chronic phase during opportunistic infections)
  • night sweats
  • cough
  • diarrhea
  • Pain. (a) severe headaches of a type never previously experienced, (b) often associated with neck rigidity and occipital pain, (c) retro-orbital eye pain, (d) migratory muscle and arthralgia pain, (e) cutaneous hypersensitivity and (f) fibromyalgia type pain
  • earache
  • Non-exudative pharyngitis (acute phase, but may occur in chronic phase during opportunistic infections)
  • Swollen Lymph nodes. Palpable or tender anterior or posterior cervical or axillary lymph nodes (acute phase, but may occur in chronic phase during opportunistic infections)
  • myalgia, muscle aches
  • sore throat / dry throat
  • light sensitivity, photophobia
  • dyspnea
  • encephalitis-like symptoms including confusion, gait problems, paralysis and seizures
  • classical radiculopathy in some cases
  • neurological dysfunctions
  • cognitive dysfunction, short term memory loss, confusion, and perceptual difficulties, irritability.
  • some symptoms of Guillain-Barré Syndrome
  • joint pains
  • weakness
  • recurrent sinusitis. Allergies prior to getting the illness. Continuation of these and worsening of them after getting the illness. These findings may be linked to overactive inflammatory cytokines in the illness.
  • Unrefreshing sleep. Some sleep dysfunctions.
  • digestive abnormalities, bowel dysfunction, stomach pain
  • Vasculitis
  • coldness in hands and feet, poor circulation, some symptoms of Raynaud's syndrome
  • Cardiac irregularities. Orhtostatic intolerance, POTS, dizziness
  • muscle dysfunction, including weakening of the muscles
  • vision difficulties
  • post exercise malaise, often accompanied by a worsening of cognitive dysfunctions
  • HPA axis dysfunction. Hormone deficiencies and abnormalities.
  • The role of Molds and Myocotoxins in immune system dysfunctions in subsets of patients.
  • some patients developed multiple chemical sensitivities
  • The epidemic started with children or students and then on to adults. This was similar to other ME epidemics.
  • Increased Cancer risk In the book Osler's Web: Inside the Labyrinth of the Chronic Fatigue Syndrome Epidemic by Hillary Johnson medical doctors in the USA found an unusually high number of B cell lymphomas in ME / CFS patients. Special scientific tests showed that these B-cell Lymphomas in ME patients were unusual types, not seen before. The researchers found B-cell deficiency in all patients, and a positive result on the kappa/lambda assay for a majority of these patients. After studying samples from approximately fifty patients, Wormsley estimated that the rate of clonal excess abnormality in the CFS patients from Nevada was at least 25 percent ('Oslers Web, by Hillary Johnson, Penguin Books 1997, page 94). This is significant as kappa/lambda light chains are the result of abnormalities within the bone marrow B-cell lineage. This has direct on B-cells and overall immunity, and susceptibility to Cancers. Recent scientific studies show that the incidence rate of non-Hodgkin's lymphoma is 0.02% in the United States, yet nearly 5% of CFS patients develop the disease. This is a significant risk factor.

News reports



Documentary about CFS which includes the Lake Tahoe epidemic

 


Books about the Lake Tahoe outbreak

 

Press and Media Articles


June 7, 1986
Los Angeles Times
160 Victims at Lake Tahoe: Chronic Flu-Like Illness a Medical Mystery Story
By Robert Steinbrook
http://articles.latimes.com/1986-06-07/news/mn-9956_1_lake-tahoe

July 28, 1987
The New York Times
Fatigue "Virus" Has Experts More Baffled and Skeptical Than Ever
By Philip M. Boffey
http://www.nytimes.com/1987/07/28/science/fatigue-virus-has-experts-more-baffled-and-skeptical-than-ever.html

July 28, 1988
The New York Times
Health
Personal Health
By Jane E. Brody
http://www.nytimes.com/1988/07/28/us/health-personal-health.html

November 12, 1990
Newsweek
Chronic Fatigue Syndrome
http://www.newsweek.com/1990/11/11/chronic-fatigue-syndrome.html

November 19, 1990
The Baltimore Sun
"Yuppie Flu" Tied To Immune System: Blood Test May Identify Chronic Fatigue
Syndrome
http://articles.baltimoresun.com/1990-11-19/news/1990323120_1_chronic-fatigue-syndrome-immune-system-cfs-patients


North Lake Tahoe Bonanza

Friday october 10 1986

Could explain fatigue illnesses- patients tested for new virus

by Jean Lamming NLTB Staff Writer

An Incline Village resident stricken with Chronic Epstein-Barr Virus said Wednesday that national medical researchers believe a new virus they have discovered is partly to blame for his syndrome. Bill Rulle said researchers from the National Institutes of Health in Bethesda, Md. interviewed him last week in Incline and took samples of his blood. They will test it for a virus they discovered a year ago and think might be a partial culprit in the fatigue syndrome that struck some 200 North Shore and Truckee residents in the last two years. "They think there might be a new virus and that what it is doing is triggering the Epstein-Barr Virus reaction on a constant basis." Rulle said of the National Institutes of Health (NIH) researchers. The researchers are calling the new virus HBLT and B-cell lymphoma, Rulle said. New tests for the virus are inconclusive. Its symptoms include a positive test for Chronic EBV and the fatigue syndrome that accompanies it, said Rulle, who calls himself an "interested patient." Doctors, including Incline internist Paul Cheney who treated many area fatigue patients, and officials at the NIH have been vague on the subject of a new virus. Cheney said in September that news of a new medical discovery that might eventually be linked to Lake Tahoe would be announced in a prestigious medical journal this year. A spokesman for Science magazine, a definitive professional research journal, said Monday that the magazine would carry two research articles from the NIH's cancer research division in its Oct. 24 edition. The Science spokesman declined to comment on the content of the articles and said rsearchers involved are bound not to release information on articles before they are published. The NIH researchers, who have reportedly tested about 72 blood samples from area residents for the presence of the new virus, took another 90 samples from residents during a visit last week, Rulle said. As many as 90% of he 70-some Lake Tahoe CEBV patients tested for the new virus showed positive signs of carrying it under the new test, Rulle said. Results of blood tests from people who are not infected with CEBV showed none were affected with the new virus either, he said.

"They are relatively sure that the new virus is in fact activating the EBV and not the other way around." -Bill Rulle Incline Village fatigue illness victim

The test is too new to be conclusive, but supports the hypothesis that CEBV, which most adults carry latently, was activated in many area victims by the new virus, Rulle said. "That was a scientific basis that what we have here is a new virus and all we can see as a symptom is CEBV, said Rulle. "They are relatively sure that the new virus is in fact activating the EBV and not the other way around." he said of researchers. The symptoms of the new virus fall under the umbrella of symptoms CEBV victims suffer from in varying combinations and degrees. Rulle said. These include chronic fatigue, upper respiratory-tract infections, headaches, tingling and loss of feeling in extremeties, dizziness, memory loss, sleep disturbances and more. Rulle, who has been sick with CEBV for about two years, said if people at Lake Tahoe have the new virus, they might be among the first to develop antibodies to it. "That is why we have two groups from the NIH very interested - the scientific group that discovered it (new virus) and the people who recently visited who study viral groups in populations;


North Lake Tahoe Bonanza

Nov 16 1987

Incline Victims Show Cell Abnormalities"

Tests Reveal New Clue in Fatiguing Illness

by Chris Fotheringham
NLTB Managing Editor

Laboratory results published this week in a prestigious medical journal confirm that over 50% of Incline Village chronic fatigue patients tested have suffered "dramatic" abnormalities in their immune systems.

Calling it the "most significant finding yet" in efforts to unravel the mystery of the widespread fatigue illness, Harvard researcher Dr. Anthony Komaroff said Monday the report published Sunday in the Journal of Immunology is the first scientific study that confirms "something is wrong with these people."

"it is really dramatic." said Komaroff, who is chief of general medicine at a Harvard teaching hospital in Boston.

The article, which underwent nearly 11 months of peer review before being published, was authored by Komaroff, Incline Village internist Dr.Daniel Peterson, and former Incline internist Dr Paul Cheney.
Dr Michael Caligiuri, an immunologist with the Dana-Farber Cancer institute of the Harvard Medical Center, was the lead author for the article which was originally submitted for review in January.

Komaroff says test results reveal an attack on the immune system's "natural killer cell" which is the body's primary means of killing virus-infected cells or cells that become cancerous.
Komaroff said "There is a substantial reduction in the number of natural killer cells in patients tested." He said the study has determined that this "major defense against virus infection and cancer" is damaged in over half of the test cases involving Incline Village patients.

Komaroff first broght his team of researchers to Incline Village in February of 1986 after Incline doctors Cheney and Peterson had documented an outbreak of approximately 200 cases of mononucleosis-type illnesses in the North Tahoe and Truckee area beginning in the fall of 1985.
While the Incline Village cluster of fatigue cases has drawn primary attention in the national media, researchers have found widespread occurrence of the illness throughout the country.

 

The Spokesman Review (Spokane, WA)

King Features Syndicate

Epstein-Barr: Myth and Reality By Sandra Gurvis

Charlene, a 35-year-old married mother of two, wept with relief when she learned she had chronic Epstein-Barr virus (CEBV). "Iʼd been sick off and on for over two years and no one could tell me what was wrong. One doctor thought I had hepatitis, another sent me for an eye test, still another prescribed tranquilizers and suggested counseling. At last what had been plaguing me had a name." Yet her diagnosis, like that of thousands who claim to suffer from CEBV, has generated a tremendous amount of controversy within the medical community. Some doctors believe CEBV is a genuine ailment, while others regard it as a buzz word for hypochondria. Still othrs consider it a catch-all diagnosis for symptoms that canʼt be explained, as had been the case with low blood sugar, iron-poor blood, and thyroid disorders in the past. According to medical definitions, Epstein-Barr is a herpes virus, similar to chicken pox, genital lesions and cold sores. It is closely related to infectious mononucleosis in the United States and Western Europe, Burkittʼs lymphoma (a tumor of the jaw) in Africa, and cancer of the nose and mouth in Asia. "The Epstein-Barr virus is present in the white blood cells in over 90 percent of the American population," explains Dr. Ronald Glaser, chairman of the Ohio State University Department of Medical Microbiology and Immunology in Columbus. The virus is believed to be transmitted by saliva. "Usually it remains dormant until the immune system weakens, causing it to proliferate." And unlike mono, which strikes during adolescence and college years, CEBV affects adults. "During the first three to six weeks of incubation, patients show few or no symptoms," states Dr. James Jones of the National Jewish Center for Immunology and

Respiratory Medicine in Denver. "The illness takes hold, may worsen, then reaches a plateau, waxing and waning at seemingly unpredictable intervals." Victims of the disease, dubbed the "yuppie flu," are primarily women, health professionals and high-level executives in their 30s and 40s. The symptoms, they say, range from partially to completely disabling, cutting them off from their jobs, recreational activities and loved ones. "The disease took over my life," Charlene asserts. "I ran a counseling program for 13 years and had to quit. Whenever I have had spells, Iʼm forced to hire a babysitter to help care for my kids. I love my career and my family, but Iʼm too sick to handle them fulltime." Also nicknamed the "Raggedy Ann Syndrome" because sufferers feel as if theyʼve had the stuffing knocked out of them, CEBV first received national attention in 1985 after an outbreak of a mysterious illness in Incline Village, near Lake Tahoe. According to an account in HIppocrates magazine, two local doctors, Paul Cheney and Dan Peterson, began seeing an uncommonly large number of patients with persistent, flu-like symptoms. The patients tested negatively for mono, so Cheney and Peterson did some research, coming upon articles on CEBV in a medical journal. They then ordered a recently developed diagnostic test from a commercial laboratory. The results showed high levels of antibodies to the virus in sufferers. Thus, a syndrome was born -- or perhaps reborn. Because the outbreak appeared to be clustered in the Lake Tahoe area, the Centers for Disease Control (CDC) sent two researchers to investigate. Their highly publicized report in May 1986 questioned not only the validity of the lab test but pointed out that healthy people also had high antibody counts. The findings led many physicians to assume that CEBV was a fraud, even though more and more cases kept surfacing. "Thereʼs a large element of ʻme, tooʼ in this," says Ohio Stateʼs Glaser. "Once news of a disease reaches the media, people start thinking they have it if theyʼre tired or depressed." However, "not everyone who is sick is imagining this," he insists. "Many are truly ill.

They have clinical symptoms to prove it. And well-adjusted people who lead vigorous, active lives donʼt suddenly become too ill to lift their heads. Something is out there. We just donʼt know exactly what." The CDC is currently compiling a standard clinical diagnosis for Chronic Fatigue Syndrome for use by all doctors. "Weʼve had similar outbreaks since the 1930s," explains Carlos Lopez, chief of the Herpes-Virus Division there. "The scientific literature has described something like it for the past 50 years." It has also been known as Royal Free disease, epidemic neuromyasthema and myalgic encephalomyelitis. Lopez hopes the definition will serve as a unifying force in identifying the syndrome. "Our investigators were looking at one specific virus, Epstein-Barr (in Incline Village). What weʼre now dealing with is a series of symptoms, possibly resulting from a number of viruses." Other causes might be infectious agents, or the bodyʼs inability to respond to infection, toxic materials, stress or other psychological reactions, or a combination of these factors. And research is beginning to uncover a few things. Dr. Robert Gallo of the National Institutes of Health, who also first identified the AIDS virus, recently discovered a new herpes virus (HBLV) which may be involved in Chronic Fatigue. Researchers are currently trying to isolate HBLV in patients who already have the syndrome. Preliminary results of a study by David Purtilo of the University of Nebraska Medical Center link Chronic Fatigue with viruses known to cause sore throat (adenoviruses). And Ohio Stateʼs Glaser is studying diagnostic "markers" associated with the Epstein- Barr virus and nasopharygeal (nasal) carcinoma. He hopes to find an antibody that will serve as a common denominator in diagnosing some cases of the syndrome. Copyright 1987 King Features Syndicate *

 

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


Sierra Sun

March 6, 1986

Doctors Admit to Mystery of Malady.

No new answers were revealed concerning the so-called Tahoe malady during a February 27 panel discussion at Sierra Nevada College, Incline Village. Drs. Paul Cheney and Anthony Komaroff presented a synopsis of the disease and the results of the week-long studies by three doctors from Harvard University. Komaroff and his colleagues, Drs. Dedra Buchwald and Nick Fiebach, spent the past week in Incline Village poring over patients files in an attempt to locate correlating factors. What has been most noticeable about the disease is that it seems to occur within certain circles of people, although many individuals have it who do not associate with other people affected by it. The clusters have been detected in two groups of teachers, one group from Tahoe- Truckee High school and the other from North Tahoe High School, a local girls basketball team; and a group of Hyatt casino employees. Cheney said that the people contracted the disease at least a year ago, and that no new clusters have been found. For whatever reasons Incline High School has been relatively unaffected by it; there have been few complaints from the teachers there. Cheney said he thinks reasons Incline Village High has not been affected as much as the other schools are its circulating air system, large windows and overall good ventilation and airiness, as compared to internal circulation. The conditions of the buildings with poor ventilation is referred to by the doctors as the sick building syndrome. Although no one can confirm why some contract the Epstein-Barr virus and others don't, the doctors agree on a few points. First, they believe it is not really a new disease but one reactivated after lying dormant for years. Both believe that 90 per cent of all people come in contact with this disease at some point of their lives, usually before the age of 10. When the virus is first contracted it may or may not affect a person. The effects could show up as acute mononucleosis or a cold or remain latent for the duration.

The biggest question facing the doctors is what reactivates the disease. Komaroff said the thinks the activator is some other virus that has passed through a community of people. Other possibilities mentioned include household items such as tung oil,which is used in a variety of glues and varnishes, and certain foods such as vinegar from China that has been contaminated with tung oil. Basically, both doctors believe another virus triggers the EBV and environmental conditions may only amplify the situation rather than cause it. As far as the degree of contagion is concerned, although it is contagious in some capacity, Cheney said he didn't think it was highly communicable or otherwise he would have it by now. Despite the length of the illness and the despair that goes with being ill for a long period, there seems to be some hope. Very few new cases have been recorded in Dr Cheney's and Dr Dan Peterson's offices. And some people seem to have recovered from it, although, as Komaroff warned, it might seem to have gone away and then come back again. Both doctors agreed that the best way to treat the disease is to keep an optimistic attitude in spite of its antagonistic nature, and that those who have tended to be overstressed and therefore ill should pace themselves better. Although no one can safely say that a typical patient exists, Komaroff said, most of the patients are women between 25 and 40, have been athletic or in good health in the past, and seem to be in higher economic standing. But the Tahoe malady doesn't seem to follow this pattern, as the highest number of people affected by it have been the basketball team, teachers and casino workers. Cheney said that the degree of infection is much higher that the number of people sick with it because the spread of it appears to but the spread of it appears to be over. "The threat to public health has been diminished to almost near zero." Cheney said during a telephone interview later.

Cheney said that through the three types of tests that have been conducted there is strong evidence of the presence of Epstein-Barr virus. The EBV infection is not necessarily mono itself, although it can be a contributor to the common strain of mononucleosis. "The question of this virus is the primary problem or the secondary problem." Cheney said. "If it's primary then maybe it's because it's a new strain. If it's secondary the maybe we can find out what the primary problem is." he said. "If it's secondary we have to be more cautious. That's why Dr. Komaroff is here." Cheney said the tests used to detect the Epstein-Barr virus include sample tissues of patients and serologies. Also a new test has found antibodies that are directed toward EBV in a patients blood. Komaroff and his colleagues returned to Boston this week with samples, which they intend to study using the new test. Their findings will be released in a few months. Until then all doctors involved will be searching for the answer to whether the EBV is a new virus or a reactivated virus, yet Cheney believes the patients who already have the disease are not facing any new complications. Copyright 1986, Sierra Sun

North Lake Tahoe Bonanza

December 20, 1985

Basic Symptoms May Be Sign of Epstein-Barr Virus

SUMMARY: Headaches, Muscle spasms, Swollen glands, Slight fever, Dizziness. The symptoms of one of the least diagnosed but still widespread illnesses begin here and add up to chronic Epstein-Barr virus.

Most people are exposed when they are children to this herpesvirus that hides in the white blood cells. The symptoms are similar to those of mononucleosis, but the diagnosis is psychologically important to its sufferers. Though research is being done and doctors are hopeful of a cure, the victims turn for now to self-medication. Fifteen years ago, W.H. thought she was coming down with something going around. Her throat was sore, her arms felt bruised and she was tired. Really, really tired. But then, she had been working 12-hour days as a social worker, and she knew she was run-down. After about a month of a growing list of symptoms - headaches, muscle spasms, swollen glands, slight fever, dizziness - she went to her first doctor. He told her it was just the flu, and she should take it easy. She went back to see him, a month later, still complaining. "But they (the symptoms) were worse, you know, I was unable to get out of bed because my muscles were so weak." she says. And she had some numbness around her face and in her fingers. This time the doctor said it was probably stress. She asked him to run tests. He ran tests, and he said she was as healthy as an ox. And she went to another doctor. And another doctor, and another. She couldn't concentrate well, and she was so tired. "I was getting real depressed." she says. Generally she felt like leftover pizza. She quit her job and stayed in bed. "There wasn't one doctor that whole time who did anything more than pat me on the head, inferring it was psychosomatic." Finally, two years ago, W.H. was diagnosed as having chronic Epstein-Barr virus. There are stories of sufferers who have been placed in mental institutions or who have tried suicide. One young woman was diagnosed by psychiatrists as "a manipulative child" after she told her parents she was too tired to leave her bed. On the psychiatristʼs advice, the girl was forced to go to school. She was found in the street, asleep in the pouring rain. Even if Epstein-Barr virus is diagnosed, there is no cure, and currently no medically accepted treatment. Ninety percent of those who get it have it for life. Epstein-Barr is a herpesvirus that hides in the white blood cells of the body, suppressing the immune system when activated. Although there is "no evidence that this disease leads to a more serious illness." says Dr. James Brodsky of Chevy Chase, Md. it is associated with Burkitt's lymphoma, nasopharyngeal carcinoma, lupus and rheumatological arthritis. To date, most doctors are not knowledgeable enough to look for it, and most laboratories are not sophisticated enough to detect it. Because the disease is seldom diagnosed, it is considered extremely rare, although some researchers believe there may be as many Epstein-Barr sufferers as there are people with multiple sclerosis. "The patter we connect with this virus is that of mono." says Dr. James Jones of the National Jewish Center for Immunology and Respiratory Disease in Denver. The disease's symptoms have been misdiagnosed as infectious mononucleosis, except that mono is considered a short-term, nonrecurring illness.

When fatigue, swollen glands and muscle aches persist in the Epstein-Barr virus patients, the physicians treating these persons for mono either are dumbfounded by the symptomsʼ longevity or consider the disease psychosomatic. As early as 1948, Dr. Raphael Issacs of New York wrote that 25 of his patients had symptoms for infectious mononucleosis for more than a year. Not until 20 years later was the virus re-examined by Drs Werner and Gertrude Henle of Philadelphia. The mono connection was not gratuitous. Many of the people with the virus have had mono. The antibody test that finally was developed, thanks to the Henles, measures the active Epstein-Barr virus in the blood. Most people are infected with the virus - which mimics a case of the flu or a cold - as children and recover from it. The virus then lies in the body, held in check by the immune system. Most standard blood samples will contain a measure of the virus. But for those whose immune system for unknown reasons has proved to be less than efficient in checking the virus, these antibody levels increase. But the antibody test is not foolproof for identifying all persons with the disease. "I'm pretty sure we don't have a good test for all people," says Dr. Irena Brus of Beth Israel Hospital in New York. For some, the disease comes and goes. For other, like W.H., it remains constant. There is some evidence that it gets less severe with time. Many of the symptoms may disappear. "I'm much better than I was," says W.H. "but, my God, I wouldn't wish what I went through on anybody." The fatigue "a pronounced, an unusual and nauseating fatigue," says Brus.

In some persons, lasts a lifetime. Epstein-Barr disease has been called the "yuppie flu" because it tends to afflict urban professionals older than 30, especially women. It is thought that this demographic profile exists because of the rash of infectious mononucleosis that has occurred in the past 20 years. In reality, "It's an extraordinary, ubiquitous disease," says Jones, one of the principal researchers into its treatment and possible cure. Some victims get mono and just never get better. When these people go back to their doctors, their blood tests for mononucleosis are negative. But nothing else in their disease has changed. For those who have had mono years before an then get Epstein- Barr virus, the symptoms are similar. "Looking back on it now, " says W.H. whose spleen had been removed before the virus was diagnosed, "I practically gave the doctor the answer. I told him, ʻThe only time I ever felt this bad was when I had mononucleosis in 1968.ʼ" The diagnosis is psychologically important to the sufferers, especially those who have been undiagnosed for years. "Every doctor I went to in the last 10 years just rolled their eyes," says C.J., whose symptoms of sore throat, swollen glands and fatigue were cyclic, coming every fall. The disease varies greatly from individual to individual. When E.A. became sick with hepatitis five years ago, it seemed to trigger the disease. "But I've gone through every possible symptom of it you can. I've had it all." For five months of it, she says, "I couldn't talk, couldn't breathe, couldn't walk." Several sufferers had to quit their jobs, find part-time work or go on welfare. W.H went back to work part-time two years ago, when she began feeling better. "But I brought on my own relapse by doing too much," she says. Jones says he believes "the depression is a primary part of the illness." Considering the chronic nature of the disease, the difficulty in ever getting diagnosed and its debilitation, that depression is a symptom is not surprising. "It isn't my own depression," says C.J. "You know how you can tell about your own body after you reach a certain age? I'll tell you what's depressing, though: feeling like I'm older than my grandmother. And she's dead."

Like infectious mononucleosis, the "kissing disease," the Epstein-Barr virus is carried in the saliva. But it's considered only moderately infectious. Theories on what triggers it range from genetic susceptibility to immunological abnormality. One of the more interesting theories implicating tung oil, a furniture sealant. Tung oil, a rat poison in the Orient, is an active ingredient in paints, waxes, polyurethane, putty and caulk. In laboratory experiments, tung oil, a known carcinogen, has reactivated the latent virus. D.E, who has had the virus chronically for two years, says, "I restored an old house, and somewhere in there I got mono and then this. I like the tung oil idea. I like it a lot better than thinking I'm genetically faulty." Sherwyn Williams has agreed to look into the removal of tung oil from its products. Research to locate an effective treatment for the disease is being done at several institutions. At the National Institutes of Health in Bethesda Md, Dr. Stephen Straus is conducting a double-blind study using acyclovir, a drug proved effective against herpes simplex. Subjects in the study are given either the drug or a placebo and then monitored for improvement. Another double-blind study using intrasmuscular doses of gamma globulin was done by Dr. Richard DuBois of Atlanta, who says the blood protein indicated the therapy was more effective than placebo. By next spring, results on acyclovir and intravenous gamma globulin should be available. With no remedy in sight, many of the virus sufferers become self-medicators. W.H. calls herself "the home-remedy quack person," having read nearly everything in the years that she's had the disease. In the beginning, she says, bee pollen gave her some energy back. She tried megadoses of Vitamin C intravenously. Then she took the adrenal glands of baby pigs a couple of times a week. "That didn't help me, but it helped some people." There's also something called the transfer factor, which is a blood product made of centrifuge-spun blood. W.H. has had the mercury removed from her teeth and replaced with gold on the chance that mercury poisoning has something to do with chronic Epstein-Barr virus. There is optimism in the medical community about someday finding a vaccine for Epstein-Barr. "One of the crucial problems of finding a cure," says Brus, "is, Why do some people have chronic Epstein-Barr virus? What makes the latency? Is it a change in the immune system? Is this virus an innocent virus? Until these questions are answered, we cannot find a cure unless by serendipity." Copyright 1985, North Lake Tahoe Bonanza


Tahoe World

Page 14A

Thursday, October 24, 1985

At Least Six Were Affected: Truckee Teachers Recount "Malady" By Barbara Barte

Irene Baker, one of about a dozen local teachers who have been diagnosed as having chronic mononucleosis, is exasperated with doctors who dispute the findings of the two Incline Village doctors who have diagnosed 90 local cases. "I know that I'm sick and I think it's more than coincidence that five teachers who share the same prep period have the same symptoms," Baker said Tuesday. She spent most of the summer in bed and has not been able to return to her teaching job at Tahoe-Truckee High School this year. Her daughter, Laura, was also sick but has gotten better, she said. Baker said at least six other Truckee teachers -- Andy Antonucci, Gerry and Janice Kennedy, Karen and Michael Cosgriff, and Jan Showalter -- have similar symptoms and the same diagnosis, as do three North Tahoe High School teachers. Symptoms are "fatigue and killer headaches, sore throat, swollen lymph nodes, pain in the spleen area and the inability to stand up for more than a short period of time," she said. While she has all the above symptoms and most share the fatigue and bad headaches, not all have the other symptoms. Most were sick all summer, some have returned to teaching full- or only half-time, and some are still not able to work. "Eventually, everyone ended up at Peterson and Cheney's office," she said, referring to Incline Village doctors Daniel Peterson and Paul Cheney, who have been criticized by other doctors for their chronic-mono diagnoses.

"I don't think Peterson and Cheney are off-base," said Baker, "and what bothers me is that these doctors who are being so critical haven't seen patients with these symptoms, or, if they have, they haven't listened to them. "One teacher was told she just had an allergy, and she was so sick. Others are told they're depressed. I had gone to Peterson and recommended him to other teachers. "Peterson and Cheney believed we were sick. That's why they got all these patients. All of us showed negative on a mono spot test, but not on an E-B panel." (See other story for a description of the controversial Epstein-Barr test ) Since becoming ill, Baker has been finding out what she can about chronic mononucleosis and has learned that there isn't much research on the disease. She has learned, however, that she is not alone, as someone sent her a list of 200 names from a national support group. Since reading a paper by a Wisconsin doctor who believes he had a latent mono virus reactivated by the toner in his copy machine, she wonders if two copy machines in the teachers room could be at fault. Cheney says that certain drugs and chemicals can cause latent mono infection to become active again. So can other illnesses, such as cancer and rheumatoid arthritis. In fact, he says, the tiredness associated with these diseases my be due to reactivated mono. "Phorbol esters used in copy machine toner, the tung oil in many furniture polishes and in certain glues and varnishes and even in some houseplants may reactivate the mono virus that is latent in 90-percent of adults," says Cheney. While this may be the cause of a few local cases, however, he says he is more inclined to believe a reactivation was triggered by another virus last winter. "I wouldn't want people to go around unplugging their copy machines," he says. "If it is a common chemical, how come it caused problems this year and not last year? It was more likely a virus."

If reactivation is caused by a chemical, he said, "a lot would depend on the concentration, ventilation, and a lot of other variables." Cheney agrees with Dr Gary Holmes, a viral-disease researcher from the Center for Disease Control in Atlanta who is investigating the Tahoe-Truckee cases, that chronic mono is not easily transmitted from person to person. "Ninety percent of all adults are immune to it because we already have the latent virus," says Cheney, "but I believe that something happened last winter to reactivate the virus in many people." He says that, because the virus that causes mono is a member of the same family as the herpes virus, a mono treatment is being studied using a new drug for herpes. "Results are still pending but may be in by mid-winter," says Cheney. Although the CDC researcher who investigated Cheney and Peterson's findings says he doesn't believe there is an outbreak of chronic mono in the area (see story) and other local doctors also dispute the claims, Cheney says he is convinced at least 90 local people had a mono virus reactivated last winter. He has seen no new cases since late summer and says "This thing has a beginning, a middle, and an end." Irene Baker and some other locals are still waiting for an end to their illness, though. "It's all I can do to go to the doctor, maybe stop at the store, and get back to bed." she said Tuesday. "I just talked to Karen Cosgriff (who is back teaching half-time) and she was going to go lie down." Copyright 1985, Tahoe World

 

Excerpts from the observations of doctors and scientists

Excerpt from 'A Brief History of Myalgic Encephalomyelitis and an Irreverent History of Chronic Fatigue Syndrome' as presented at the London Conference of May 12, 2006 by Byron Hyde

" The Lake Tahoe epidemic that started in August 1984 also started among students. In this case the epidemic began in a high school girls basketball team that was travelling in a bus to play various other teams. The epidemic spread rapidly with an incubation period of approximately a week. As in many of the other epidemics, it then spread to the general community. After the epidemic started it then involved three high schools, both students and teachers and ultimately spread to the community. For some reason it was considered to be an epidemic of infectious mononucleosis. This is an illness caused by a virus Epstein Barr Syndrome. Associating the Lake Tahoe epidemic with Epstein Barr Syndrome was frankly ridiculous and you will see why almost immediately. Dr Paul Cheney and Dr Daniel Peterson were inundated by the number of rapidly developing cases of seriously ill patients and called for the Centre for Disease Control (CDC) in Atlanta for back up. Initially CDC did not appear to (be) very interested. Members of Congress were then called and CDC jumped to investigate. According to one of the principals who related the story to me, a crew headed by Dr Gary Holmes from CDC came out ot Incline Village from Atlanta, drew blood samples from the ill patients and spent much of the short remaining time in Lake Tahoe playing golf.

It is possible that the CDC crew would have done a much more thorough investigation but they did not and this may have been due to the political forces that gathered steam. Business Comes First Reputedly, members of the business community whose commercial interests depended upon tourist trade and the seasonal ski business did not want news hitting television and other media that there was a devastating infectious disease running around Lake Tahoe. It would have cost the business community millions of dollars. Accordingly, I was told that pressure was then placed upon the congressmen to stop CDC from investigating this epidemic further or they would lose their jobs. And apparently, so it came to pass. There was little further investigation except for the sustained efforts of Dr Paul Cheney and Dr Daniel Peterson. Reputedly, increasing negative pressure and threats were placed upon both of these physicians, sufficiently so that Dr Cheney eventually moved his family to South Carolina. First International Symposium on Immunology and Pathogenesis of Persistent Virus Infections. Fast-forward to April 1987 and the First International Symposium on Immunology of Persistent Virus Infections held in Atlanta Georgia. This was a symposium hosted by the CDC and Dr Carlos Lopez. At this meeting Dr Gary Holmes gave out his new paper, "A cluster of patients with a chronic mononucleosis like syndrome," that had just been published in JAMA. (See Holmes, Kaplan, Stewart et al: JAMA 1987: 287:2297-2302) "

 

Donald W. Scott Myalgic Encephalomyelitis As New Variant Brucellosis Journal Of Degenerative Diseases Vol: 2 No: 3, 3 February 2001, p13-19. Lake Tahoe Epidemic

" In the summer of 1984 the Tahoe-Truckee High School in northeast California was visited by a group of workmen who removed the heating/ air-conditioning system and replaced it with a unique new system. The new system had ducts to and from each room to the heater/ air conditioner which were designed in such a way that the air from each room was individually removed, heated or cooled, and then returned to the room it had come from. Except for incidental air exchange in the hallways, there was no effective mixture of air between the other rooms of the school. Thus, occupants of one room re-breathed the same air all day long. In addition, the windows, which previously could be opened, were shut and bolted and sealed. Teachers were strongly directed not to open the windows. One of the rooms was a teacher work room to which eight teachers were assigned. Within days of their return to school, these teachers were discussing the poor quality of the air in their work room. One of the eight refused to use the room and parked a camper trailer near the school to use as his work room. Within the next few months seven of the teachers in that room had become ill with one of the major epidemics of myalgic encephalomyelitis.

The only teacher not taken ill was the one who had refused to use the room. However, there were other teachers and some students in the school who became ill with the new 'mystery' disease which had so many features in common with chronic brucellosis. There were also student family members and baby-sitters who became ill. Two local doctors soon became the medical professionals of choice for the person's ill with the new disease: Drs. Paul Cheney and Dan Peterson who had located in the outlying community just months before the High School heating system had been replaced. Also, both doctors had been to medical school at the expense of the U.S. Government and were obliged by their contracts to serve a period of time at a place designated by the Department of Defense. The circumstantial evidence is very compelling that the Department of Defense had remodelled the school heating system so that eight teachers would be exposed to primary aerosol, while the remainder of teachers and the students would be exposed only to secondary aerosol.

According to Dr. MacAthur's theory, which had been challenged by Congressman Rood, those exposed to the primary aerosol would be disabled, while those exposed to secondary aerosol would be spared. Congressman Flood was apparently proven to be right. The new disease agent, quite likely based upon the brucella bacterial exotoxin, was contagious by secondary aerosol. The disease spread to the community and then to travellers. It was a 'mystery' to those who encountered it, since no. bacteria could be recovered from victims. They were ill with a bacterial disease, but without any bacteria detectable. This new disease drew the interest of Dr. Holmes of the CDC and of Dr. Straus of the NIH and it was they who came up with the suggestion that it was a variant of chronic mononucleosis. Step Eight: By 1987 there had been several outbreaks of the 'mystery' disease. "

 

 

 

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