Viral, Lyme, Bacteria, Parasite and other Pathogen Infections and reactivated latent infections of the nervous system, brain, muscles, intestines, glands, blood, joints, heart and blood vessels


Scientific and Medical Evidence
- Listing of Research conducted worldwide section :
Viral infections
Mycoplasma infections

Serious Bacteria infections
Cryptostrongylus Pulmoni infection

The presence of crimson crescents in the mouth
Environmental Toxins, Molds & Mycotoxins, Heavy Metals, Organophosphates
Beta 2 microglobulin levels as a measure of the severity of the condition

Genetic markers


A recent scientrific and medical consensus review on Chronic Fatigue Syndrome (CFS) and Myalgic Encephalomyelitis (ME) concluded that CFS/ME is significantly underdiagnosed and that the condition is likely caused, in part, by viruses. (Smith MEB, et al. Diagnosis and Treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Evidence Report/Technology Assessment No. 219. Rockville, MD: Agency for Healthcare Research and Quality. December 2014.)

Top ME medical doctors A. Gilliam, Melvin Ramsay, Elizabeth Dowsett, John Richardson of Newcastle-upon-Tyne, W.H. Lyle, Elizabeth Bell, James Mowbray of St Mary’s, Peter Behan and Byron Hyde all believed that the majority of primary M.E. patients fell ill following exposure to an Enterovirus. Dr. John Richardson, a medical doctor based in Newcastle in England treated ME patients from many parts of Britain for over 40 years. He developed an expertise in diagnosing the illness, and became one of the world's foremost experts in ME. He even used autopsy results from dead patients to investigate the illness. He found that Enteroviruses and toxins played a major role in ME, and that this led to immune dysfunction, neurological abnormalities, endocrine dysfunction, and over time to increased risk of cardiac failure, cancers, carcinomas, and other organ failure. He wrote a book about his medical experiences called Enteroviral and Toxin Mediated Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. This book is a classic medical book on the illness, and provides an excellent introduction to ME. Historically, Enterovirus infections mainly target the nervous system, brain, muscles and intestines, all of which abnormal in ME patients.

The research and evidence cited above points convincingly to a number of viruses, bacteria and pathogens playing a key role in subgroups of ME patients. It is important to diagnose the infections present in ME patients, subgroup the patients, and administer appropriate medical treatments to the subgroups.

Read about Dr. Montoya's successful treatments of ME / CFS

'While I have not published my adult cases, a case series of adolescents was published last year. What has emerged from my work is that over 85% of patients with SEID (diagnosed by Fukuda criteria) respond to antiviral therapy. Among adolescents, the outcome is better with 92% responding.'
Dr. Theodore Henderson, http://www.psychiatryadvisor.com/opinion/the-role-of-antiviral-therapy-in-chronic-fatigue-treatment/article/405424/

Some studies show that 50% or more of ME (CFS) patients have Chronic Lyme infection (which cannot be picked up in standard Elisa and Western blot tests), others show 40% or more have Mycoplasma infection, while other studies show HHV6a infection in 35% or more patients. EBV infection is a factor in some patient cohorts. Other studies including epidemics and clusters point to 50% or more of patients being infected with Enteroviruses of the intestines, muscles and nervous system. Other studies show co-infections and multiple infections in ME patients. The scientific and medical evidence points to infections playing a major role in ME and the urgent need to diagnose them and identify infection & immune dysfunction subgroups.

A coroner's report of ME patient Sophia Mirza revealed that 4 out of 5 dorsal root ganglia were abnormal and showed disease. The coroner had not been able to find exactly what had caused this but the result was dorsal root ganglionitis – an inflammation. This suggests an infection of this area. An MRI scan or MRS scan or samples of this area would have revealed abnormalities, infections and inflammation while she was alive, but unfortunately this was never done. She was refused these tests by some doctors. Recent ME subgroup recoveries from use of the medical drug Rituximab which is used for autoimmune illnesses and Cancers, strongly suggests autoimmunity involving B-cells and / or infection of B cells or B cell generation mechanisms as the key component in the illness, in addition to other immune system dysfunctions.

Dr. Martin Lerner who has been diagnosing and treating the illness for over 20 years has consistently found viral infections and co-infections of viruses and bacteria in patients referred to his medical clinic. The infections were not identified by other doctors and GP's and patients had remained ill for several months and years as a result. Dr. Lerner's intensive diagnostics and treatments led to significant improvements and recoveries of patients. This underpins the need for very thorough diagnostics and treatments, with some treatments lasting for 12 months or more.

"Primary cell culture of lymphocytes showed active replication of HHV-6 in 79 of 113 patients (70%; CI, 61% to 78%)............., a finding confirmed by assays using monoclonal antibodies specific for HHV-6 proteins and by polymerase chain reaction assays specific for HHV-6 DNA."
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)

Dr. De Meirleir has had great success with Ampligen combined with anti-viral and anti-pathogen treatments in his clinic in Belgium. Firstly, all of the infections were identified, including co-infections, through several intensive diagnostic tests. Then Ampligen was combined with specific anti-viral and anti-pathogen treatments. Treatment was given for several months and up to a year. The results were impressive, and patients recovered from ME . Dr. De Meirlier has stated that an eight-year follow-up of patients found that 92% had not relapsed. This is highly significant. This strongly indicates that Ampligen by itself may not be enough, but combining it with anti-viral and anti-pathogen treatments may bring about better improvement and a high probability of full recovey. This was reported in the AACFS Conference of 2001, click here to view paper. This must be put in context, the importance of having infectious and immune system dysfunction sub-groups identified through comprehensive testing.

The following viruses and pathogens have been found in subgroups of ME patients

Viruses include: Reactivated (latent) EBV virus, particularly in nervous system, glands and organs, HHV6a virus, Herpes family viruses 1-8, Parvovirus B-19, CMV, Coxsackie viruses, Enteroviruses, Ross river virus, Q fever virus, Stealth virus, JHK virus,  Parainfluenza Virus-5 (PIV-5), Paramyxovirus and measles viruses of the  Paramyxoviridae family, Cryptovirus, Borna virus, HTLV family viruses, HGRV virus in spinal fluids, nerve tissues, blood, brain, intestines, and muscles. Retroviruses are important, as Retrovirus sequences were found in 85% of ME cases, and Anellovirus found in 75% of ME cases in research conducted by Dr. Hornig and Dr. Lipkin in Columbia University in September 2013. Most of these viruses listed here would include chronic, low level, sub-acute infections which inflict damage and immune activation, but which may not show up in standard or outdated tests.
Reactivated latent viruses include HERV-K18, Varicella-Zoster virus, Herpes family viruses 1-8, measles viruses of the  Paramyxoviridae family. Some viral infections can reactivate latent viruses and undermine immune system functions.
Mycoplasma: M. fermentans, M. penumoniae, M. hominis, M. penetrans, M. pirum,  M. incognito. in intestines, spinal fluids, blood, brain, nerve tissues, muscles. These mycoplasmas would include chronic, low level, sub-acute infections which inflict damage and immune activation, but which may not show up in standard or outdated tests.
Bacteria: Chronic Lyme disease, Ehrlichia, Bartonella, Brucella, Rickettsia, Chlamydia pneumonia, Staphylococcus spp. (live blood analysis), and Bacteria, including Microbiota of bacteria which include L-form, biofilm, and intracellular bacterial forms in spinal fluids, intestines, blood, brain, nerve tissues, muscles. Intestinal overgrowth of Gram positive D/L lactate-producing bacteria which are known to produce H2S (hydrogen sulfide) in the presence of certain heavy metals as a survival defense mechanism (Dr. Kenny De Meirleir). These bacteria would include chronic, low level, sub-acute infections which inflict damage and immune activation, but which may not show up in standard or outdated tests.
Parasite: Cryptostrongylus pulmoni, Babesia, Candida, Giardia lamblia, Aspergillus Niger
Molds, Bacteria and Mycotoxins in water damaged buildings: Stachybotrys family of molds, Cladosporium, Penicillium, Alternaria, Aspergillus, mycobacteria, Actinomycetes, Lipopolysaccharides (LPS), Microbial Volatile Organic Compounds (VOCs), Hemolysins. These can cause chronic inflammatory immune response and immune dysfunction over time.

These infections may be causative, opportunistic or a co-factor in the illness.

(a) Tests for Viruses and Pathogens

1. ME Primer for Healthcare Professionals: based on Myalgic encephalomyelitis: International Consensus Criteria, 2012


2. Tests for Viral, Bacteria, Lyme and Mycoplasma and other Pathogen infections of the nervous system, brain, intestines, blood, muscles, thyroid, liver, spleen, joints, organs, heart and blood vessels and immune system cells.

  • There are some tests which are very accurate and effective, and also cost effective and time effective.

    1. Virome Capture Sequencing platform develped by Dr. Lipkin of Columbia University in New York in the USA enables one to test for over 2,000,000 viruses in blood tests or spinal fluids tests or tissue tests. It is highly accurate, fast and inexpensive. It uses the genetic signatures of viruses, and is more accurate than PCR.
    MBio. 2015 Sep 22;6(5). pii: e01491-15. doi: 10.1128/mBio.01491-15. Virome Capture Sequencing Enables Sensitive Viral Diagnosis and Comprehensive Virome Analysis. Briese T, Kapoor A, Mishra N, Jain K, Kumar A, Jabado OJ, Lipkin WI.
    Article from Scientific American magazine - Trawling for Viruses

    2. Virscan Test developed by Howard Hughes Medical Institute. This tests for 250 viruses commonly found in humans.

    3. Test reverse transcriptase levels. These indicate retrovirus infections, including HTLV family, mlv's, gamma retroviruses, and jhk virus

    4. High Magnification Dark Field Microscopy. Live blood analysis and tissue analysis for viral, bacteria, parasite and other infections.

    5.
    Real time PCR, qPCR and Tacqman tests are highly accurate

    6. Sequencing By Synthesis (SBS) technology, high throughput sequencing and miRNA testing can also improve accuracy, while reducing time and cost.

    7. Newer tests under development
    • New genetic sequencing devices can rapidly identify the genetic signatures of viruses and other pathogens, these would be recommended as they improve accuracy, while reducing time and cost.
    • MRI signature, Spectroscopic signature and EMF signature scans may be able to detect localized infections, inflammation, damage and lesions of the nervous system.

    Test spinal fluids, inflamed or infected intestinal tissue, muscle tissue, virus incubation in the thyroid gland, liver tissues, spleen tissues and heart tissues, whole blood (including pmbc, plasma, red and white blood cells), blood vessels, immune system cells, B cells, NK cells, inflamed joints and synovial fluids, and inflamed samples from the vagus nerve, dorsal root ganglia, basal ganglia, brain stem, autonomic ganglia, peripheral ganglia, anterior and posterior horns of the spinal cord, cervical and lumbar nerve roots and peripheral nerves and sites of brain lesions for the following:

  • Epstein Barr virus and Reactivated (latent) Epstein Barr virus. This is the most important virus and after infection (such as chronic mono) can remain latent for years and decades in the human body, and reactivate many times causing immune system weaknesses, fevers, extreme fatigue, joint pains, catching other illnesses, and can migrate to other body organs, glands, and parts during an infectious period. There are many strains of EBV. For Autoimmune conditions test for active, incubated, latent and reactivated latent Epstein Barr infections.
  • All Herpes Family Viruses, 1-8, including HHV6a. The research shows a high prevalence of active and reactivated HHV6a virus in ME patients. This would be high priority as a result of the historical association between ME and Herpes viruses, particularly in North America and Europe.There are many strains of Herpes viruses. For Autoimmune conditions test for active, incubated, latent and reactivated latent Herpes family infections.
  • Enteroviruses (See work of Dr. Chia below). This would include ECHO viruses, Enterovirus 71, and Coxsackie viruses. This would be high priority as a result of the historical association between ME and Enteroviruses in North America and Europe. The intestines, muscles and nerves being major reservoirs of infection. Dr. Chia in California has developed highly accurate tests.
  • Retroviruses including HTLV-1, HTLV-2, HTLV-3, HTLV-4. Also test for HGRV and MLV's. And test for new and unknown Retroviruses, including Gamma Retroviruses. Retrovirus sequences found by Dr. Lipkin (Columbia University, New York) in 85% of ME cases
  • JHK virus. A gamma retrovirus similar to MLV's. First isolated by Dr. Sidney Grossberg in ME patients.
  • Spleen focus-forming virus (SFFV). 30% of patients.
  • Chronic Lyme, including systemic Lyme infection, Lyme Neuroborreliosis and Lyme carditis. (See Chronic Lyme Diagnostic Information below). Test for Borrelia burgdorferi, Borrelia garinii, Borrelia afzelii, Borrelia valaisiana, B. miyamotoi, B. lonestari, B. lusitaniae, B. andersonii, B. japonica, B. turdae, B. tanukii, B. bissettii.
  • Lyme co-infections - Babesia, Ehrlichia, Anaplasma phagocytophila, Bartonella, Yersenia
  • Mycoplasma. M. fermentans, M. penumoniae, M. hominis, M. penetrans, M. pirum,  M. incognito.
  • Chlamydia pneumonia
  •  SV40 virus
  • C. burnetti
  • Stealth virus (See work of Dr. Martin in research section)
  • Anellovirus found by Dr. Lipkin in 70% of cases
  • Brucella, including crystalline form of Brucella
  • Microbiota of bacteria which include L-form, biofilm, and intracellular bacterial forms
  • The Marshall Protocol for Chronic Infections and associated Immunological Defects
  • Cryptococcal meningitis
  • Measles Rubeola
  • Mumps
  • Varicella Zoster
  • Parvovirus B-19
  • Bethesda-Ballerup paracolon organisms
  • Ross river virus
  • Q fever virus
  • All reactivated latent viruses, including HERV-K18, Varicella-Zoster virus, Herpes family viruses 1-8, measles viruses of the Paramyxoviridae family
  • Flaviviridea family of viruses
  • Staphylococcus spp.
  • Parainfluenza Virus-5 (PIV-5)
  • Streptococcus
  • Borna virus
  • Paramyxovirus and measles viruses of the  Paramyxoviridae family
  • Adult and Child Rheumatic Fever
  • Rickettsia
  • Aspergillus
  • Candida
  • Giardia lamblia
  • California Encephalitis
  • St. Louis Encephalitis
  • Eastern and Western Encephalitis
  • LCM Virus
  • Cryptostrongylus pulmoni
  • Angiotensin Converting Enzyme (ACE)
  • acid fast bacilli
  • Test for Oligoclonal bands

  • For Autoimmune conditions test for active, incubated, latent and reactivated latent Herpes family (1-8) infections inside B cells, blood (pmbc, plasma, red and white blood cells), liver, spleen, thyroid and other organs and nerves. The EBV virus can reside in these cells and use the machinery of the cell to replicate. This is believed to create EBV-infected autoreactive B cells and autoimmune conditions in several ilnesses and ME. The following research paper by Dr. Pender investigates this phenomenon
    CD8+ T-Cell Deficiency, Epstein-Barr Virus Infection, Vitamin D Deficiency, and Steps to Autoimmunity: A Unifying Hypothesis. Pender MP. Autoimmune Dis. 2012;2012:189096.
    This is explored further in the following papers Could the Epstein-Barr Virus – Autoimmunity Hypothesis Help Explain Chronic Fatigue Syndrome ? and EBV I: A Deficient Immune Response, Increased Levels of Epstein-Barr Virus Opens Up EBV Question in Chronic Fatigue Syndrome Again
  • For Enteroviral infection, the severity of the symptoms correlated with the frequency of finding enteroviral RNA in the peripheral blood leucocytes. Enteroviral RNA in the tissues, including peripheral blood mononuclear cells, immune cells, bone marrow, and muscles of patients.  Among other immunostimulatory effects, double stranded RNA was found, and is is a potent inducer of interferon synthesis, which activates intracellular RNase, with resultant degradation of excessive single stranded RNA. Chronic immune system activation and chronic inflammatory state in the local tissues (J Chia and A Chia. Detection of double-stranded RNA in the peripheral blood leukocytes of patients with the chronic fatigue syndrome. Abstract T-101. In: Program of the 104th General Meeting for the American Society of Microbiology. New Orleans: Louisiana, 2004)
  • For HHV6a and other Herpes infections, IgM antibodies are not diagnostic in this disease, Dr. Henderson and others have found that primary cell cultures in combination with antibody or PCR tests indicate HHV-6 infection rates are very high in ME/CFS
  • For retroviruses : Partial molecular cloning of the JHK retrovirus using gammaretrovirus consensus PCR primers Brian D Halligan, Hai-Yuan Sun, Vladimir M Kushnaryov, and Sidney E Grossberg. Future Virol. 2013 May; 8(5): 507–520. doi: 10.2217/fvl.13.25
  • Reactivation of latent viruses and Methylation blockages and MTHFR gene mutations found in some ME and CFS patients
    The Human Genome Project found that this gene has been found to be mutated or abnormal in many people. Some ME and CFS patients have this genetic abnormality. This causes methylation cycle blockage, immune system abnormalities, including re-activation of latent viruses, thyroid and endocrine abnormalities, excess inflammation, antioxidant deficiencies, high homocysteine levels, arteriosclerosis and cardiac abnormalities, fatty liver, increased Cancer risk, neurotransmitter abnormalities and mood disorders, IBS, detoxification deficiency, multiple chemical sensitivity, cell growth and maintenance abnormalities. All of these are commonly found in ME and CFS patients.
    Testing Labs
    - DNA Methylation Pathway with Methylation Pathway Analysis

    Some more info
    http://www.stopthethyroidmadness.com/mthfr/
    Video Lecture by doctor
    MTHFR Awareness
  • Test for Protein M
    Bacteria and other pathogens have evolved to use a protein called 'Protein M' to block all antibodies produced by the human immune system. This remarkable discovery by scientists at the Scripps Research Institute in 2014 sheds new light on chronic bacteria infections in humans. As many ME patients have chronic infections, this information is important. Tests are being developed for Protein M. See paper below
    - http://www.scripps.edu/news/press/2014/20140206lerner.html
  • Biofilms and antibiotic resistant bacteria
    For info about Biofilms and antibiotic resistant bacteria, click on the following link - http://mpkb.org/home/pathogenesis/microbiota/biofilm
    Carry out diagnostic tests for Biofilms in areas of inflammation and pain.

 

3. Other Important tests

Red Blood cells and ESR.
Test for Infection of red blood cells with mycoplasma, Lyme, chlamydia and viruses.  Abnormal red blood cell structure means blood cannot get through capillaries and thin blood vessels. This can lead to Oxygen starvation. When the blood is cut off from the brain, punctate lesions appear, because those parts of the brain die. Mycoplasma will get into portions of the heart muscle, especially the left ventricle, and those cells will die. This can cause carring of the left ventricle and heart dysfunction.

  • ESR
    • Test for Erythrocyte sedimentation rate. The rate is usually very low or zero in ME patients. This has been consistently found by Dr. Paul Cheney in the USA. Dr. Kommaroff of Harvard Medical School has also found this abnormality in patients. Canadian clinician Byron Hyde reported in the fall 1989 issue of his newsletter to sufferers, “To my knowledge, there are only five diseases that have a pathological low sedimentation level: myalgic encephalomyelitis (ME also called CFS), sickle-cell anemia, hereditary sperocytosis, hyper-gammaglobulinemia, hyper-fibrogenemia.”
  • Red Blood cell structure
    • L. O. Simpson, 'The Role of Nondisocytic Erythrocytes in the Pathogenesis of Myalgic Encephalomyelitis / Chronic Fatigue Syndrome', The Clinical and Scientific Basis of ME/ CFS [Ottawa, Ontario: The Nightingale Research Foundation, 1992], p. 597
    • Mukherjee TM, Smith K, Maros K. Abnormal red-blood-cell morphology in myalgic encephalomyelitis. Lancet 1987;2:328-329.20. Simpson LO. Nondiscocytic erythrocytes inmyalgic encephalomyelitis. N Z Med J 1989;102:126-127.21.
    • Simpson LO, Murdoch JC, Herbison GP. Red cell shape changes following trigger finger fatigue in subjects with chronic tiredness and healthy controls. N Z Med J 1993;106:104-107
    • MYCOPLASMA : The Linking Pathogen in Neurosystemic Diseases Donald W. Scott
      The linking pathogen in CFS, Parkinsons, MS, Alzheimers disease. Donald W. Scott

Physical examinations

  • Check for Lymphadenopathy. This will require a few tests and if necessary a biopsy of inflamed or swollen tissues. Also check for tenderness on palpation of enlarged lymph glands and over the liver and spleen.
  • Pathologically high levels of lactic dehydrogenase, and glutamic oxalo-acetic transaminaser. Dr. Melvin Ramsey
    Ramsay A. Epidemic neuromyasthenia: 1955-1978. Postgrad Med J 1978;54:718-21.
  • Check for raised urinary creatine excretion
  • Check for photophobia, severe headaches, neck pain or stiff neck, sore throat, paresis, muscle weakness and tenderness, pain in the limbs, urinary retention, diplopia, nystagmus, gastrointestinal pain and dysfunctions, vertigo type symptoms, respiratory infection, worsening of sinusitis and allergies, tinnitus and inner ear deafness, coldness in the extremities, cognitive dysfunctions, paresthesia and sleep disturbance
  • Damage to the Cranial Nerves
    "Symptoms or signs indicating damage to the cranial nerves or their central connections have occurred in nine outbreaks"
    The Clinical Syndrome Variously Called Benign Myalgic Encephalomyelitis, Iceland Disease and Epidemic Neuromyasthenia. Dr. Acheson, American Journal of Medicine, 1959.
  • Hyperacusis was a feature of five epidemics
    The Clinical Syndrome Variously Called Benign Myalgic Encephalomyelitis, Iceland Disease and Epidemic Neuromyasthenia. Dr. Acheson, American Journal of Medicine, 1959.
  • Check for red spots along the course of the sciatic nerves
  • Check for Ulnar and sciatic nerve lesions, and lower motor neurone lesions
  • Check for microscopically infiltration of nerve roots with lymphocytes and mononuclear cells and nerve fibres showing patchy damage to the myelin sheaths and axon swellings.
  • Check for perivascular collars of lymphocytes and plasma cells in the cerebral cortex, brain stem and cerebellum, spinal cord and around blood vessels to the nerve roots

 

4. Diagnostic Information about Chronic Lyme Disease & Co-infections - Babesia, Ehrlichia, Anaplasma phagocytophila, Bartonella

Click here to view Diagnostic information and Tests

5. Diagnostic Information about Enteroviruses
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. Acheson in 1955. Coxsackie viruses, other Enteroviruses and ECHO 7 virus appear to be infecting significant numbers of ill people, as evidenced from prior ME (CFS) epidemics dating back to the 1930's.

" 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

“Virological studies revealed that 76% of the patients with suspected myalgic encephalomyelitis had elevated Coxsackie B neutralising titres (and symptoms included) malaise, exhaustion on physical or mental effort, chest pain, palpitations, tachycardia, polyarthralgia, muscle pains, back pain, true vertigo, dizziness, tinnitus, nausea, diarrhoea, abdominal cramps, epigastric pain, headaches, paraesthesiae, dysuria)….The group described here are patients who have had this miserable illness.  Most have lost many weeks of employment or the enjoyment of their family (and) marriages have been threatened…”
(BD Keighley, EJ Bell. JRCP 1983:33:339-341).

Dr. John Chia, is a world renowned doctor who has successfully treated ME patients. He has found that Enteroviruses are present in some subgroups of ME patients and that treating these Enterovirus infections can lead to significant improvement and recovery.

His research paper provides some important insights - Chronic fatigue syndrome is associated with chronic enterovirus infection of the stomach. Chia JK, Chia AY. J Clin Pathol. 2008 Jan;61(1):43-8. Epub 2007 Sep 1. See diagram below:

Dr. John Chia presents his research findings up to the year 2011 to the National Institutes of Health (NIH) in the USA below:

Dr. Chia's work and findings are similar to those of John Richardson, a medical doctor who was based in Newcastle in England who treated ME patients from many parts of Britain for over 40 years. He developed an expertise in diagnosing the illness, and became one of the world's foremost experts in ME. He even used autopsy results from dead patients to investigate the illness. He found that Enteroviruses and toxins played a major role in ME, and that this led to immune dysfunction, neurological abnormalities, endocrine dysfunction, and over time to increased risk of cardiac failure, cancers, carcinomas, and other organ failure. He wrote a book about his medical experiences called Enteroviral and Toxin Mediated Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. The John Richardson Research Group has released its own diagnostic and treatment guidelines.

The outbreak in Iceland was important, and provided some vital clues about the illness and the role of Enteroviruses.
"However, children in epidemic Neuromyasthenia areas responded to poliomyelitis vaccination with higher antibody titres than in other areas not affected by the poliomyelitis epidemic, as if these children had already been exposed to an agent immunologically similar to poliomyelitis virus (Sigurdsson, Gudnad6ttir Petursson, 1958). Thus, the agent responsible for epidemic Neuromyasthenia would appear to be able to inhibit the pathological effects of poliomyelitis infection. When an American airman was affected in the 1955 epidemic and returned home, a similar secondary epidemic occurred in Pittsfield, Massachusetts, U.S.A. (Hart, 1969: Henderson and Shelokov, 1959)."
Many outbreaks of ME or epidemic Neuromyasthenia worldwide followed an outbreak of polio virus.
Parish JG (1978), Early outbreaks of 'epidemic neuromyasthenia', Postgraduate Medical Journal, Nov;54(637):711-7, PMID: 370810.

He also presents his medical experiences in the videos below:

 

 


  • Chronic Pelvic Pain (CPP) in Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is Associated with Chronic Enterovirus Infection of Ovarian Tubes
    John Chia, M.D., David Wang, Rabiha El-habbal and Andrew Chia, EV Med Research, Lomita California

    IACFS/ME Conference. Translating Science into Clinical Care. March 20-23, 2014 • San Francisco, California, USA

Tests

Laboratories

 

6. EBV infection in B cells. Also test for other infections in B cells.
Test for the presence of EBV in B cells. The EBV virus can reside in these cells and use the machinery of the cell to replicate. This is believed to create EBV-infected autoreactive B cells and autoimmune conditions in several ilnesses and ME. The following research paper by Dr. Pender investigates this phenomenon
CD8+ T-Cell Deficiency, Epstein-Barr Virus Infection, Vitamin D Deficiency, and Steps to Autoimmunity: A Unifying Hypothesis. Pender MP. Autoimmune Dis. 2012;2012:189096.
Many cases of ME/CFS began with an EBV infection. Chronic EBV infection is a factor in some cases of ME/CFS.
- Characterization and treatment of chronic active Epstein-Barr virus disease: a 28-year experience in the United States
- Optimal Treatment for Chronic Active Epstein-Barr Virus Disease

Also test B-cells for viruses, myocplasmas, bacteria, lyme and co-infections, fungii, and for toxins.


7. Dr. Martin Lerner has developed some useful diagnostic criteria for doctors based on his 20 years experience with the illness.
ME/CFS Treatment Resource Guide for Practitioners by Dr. Martin Lerner

 

8. Abortive lytic replication (EBV, CMV, HHV-6a)
Dr. Martin Lerner has found that some of these viruses have special characteristics:
- abortive lytic replication (EBV, CMV, HHV-6a) producing host cell apoptosis as described by Dr. Martin Lerner. 
- IgM antibody to non-structural gene products (resulting from abortive lytic replication) as described by Dr. Martin Lerner
- coexisting infection by bacteria, mycoplasma, babesia, chalmydia, Lymes disease.
- this type of infection causes an increase in a protein called dUTPase, a biomarker
- this type of infection causes an increase in a protein called DNA polymerase, a biomarker
Treating and eliminating these infections (over many months) has resulted in recoveries from ME . The above markers are a very important scientific discovery and could be one of the main bio-markers for ME .

Important lecture by Dr. Martin Lerner on ME diagnosis and treatment. Click on links to view videos.

Lecture part 1. Dr. A Martin Lerner presenting at William Beaumont Hospital in Royal Oak, MI USA. August 2011

Lecture part 2. Dr. A Martin Lerner presenting at William Beaumont Hospital in Royal Oak, MI USA. August 2011

- Slides of Dr. Martin Lerner's lecture

Dr. Lerner has developed some useful diagnostic criteria for doctors based on his 20 years experience.
ME/CFS Treatment Resource Guide for Practitioners by Dr. Martin Lerner

Research Papers
Abortive lytic Epstein–Barr virus replication in tonsil-B lymphocytes in infectious mononucleosis and a subset of the chronic fatigue syndrome. A Martin Lerner, Safedin Beqaj. Virus Adaptation and Treatment November 2012 Volume 2012:4 Pages 85 - 91.

"There is prolonged elevated antibody level against the encoded proteins EBV dUTPase and EBV DNA polymerase in a subset of CFS patients, suggesting that this antibody panel could be used to identify these patients." Antibody to Epstein-Barr Virus Deoxyuridine Triphosphate Nucleotidohydrolase and Deoxyribonucleotide Polymerase in a Chronic Fatigue Syndrome Subset. A. Martin Lerner, Maria E. Ariza, Marshall Williams, Leonard Jason, Safedin Beqaj, James T. Fitzgerald, Stanley Lemeshow, Ronald Glaser

CFS LLC has a US patent application pending entitled Methods for Diagnosis and Treatment of Chronic Fatigue Syndrome. Inventor Lerner, Albert Martin. Agents Barry, Thomas F. et al: Venable LLP, P.O. Box 3485 Washington, DC 20043 - 9998 (US). This patent differentiates Group A and Group B CFS. 

Chonic Epstein Barr Infection over many years

- Characterization and treatment of chronic active Epstein-Barr virus disease: a 28-year experience in the United States

- Optimal Treatment for Chronic Active Epstein-Barr Virus Disease

Laboratories
Make enquiries to Dr. Martin Lerner's Clinic for information about testing methods and technologies and reputable laboratories.
 The Treatment Center for Chronic Fatigue Syndrome set up by Dr. Martin Lerner . Some are listed in the following document
ME/CFS Treatment Resource Guide for Practitioners by Dr. Martin Lerner

- New genetic sequencing devices can rapidly identify the genetic signatures of viruses, these would be recommended as they improve accuracy, while reducing time and cost.
- Sequencing By Synthesis (SBS) technology, PCR, high throughput sequencing, miRNA testing can also improve accuracy, while reducing time and cost.


9.
Diagnostic Information about Viruses

(i) HHV6a and b Viruses
- active and latent forms and chromosomally integrated HHV-6 form (CIHHV-6)
Found in many ME and CFS patients.

Laboratories


(ii) Diagnostic Information about Herpes family viruses 1-8, Parvovirus B-19, CMV, Coxsackie virus, JHK virus, Ross river virus, Q fever virus
. Including reactivated latent forms of these viruses. Re-activated latent viruses are playing a major role in many ME and CFS patients.

For CMV the IgG test is most accurate blood test. It may not pick up infections of the nervous system.
For EBV the EBV serum IgM viral capsid antibodies (VCA) and EBV early antigen diffuse (EA) are quite accurate blood tests. They may not pick up infections of the nervous system.

  • Reactivation of latent viruses and Methylation blockages and MTHFR gene mutations found in some ME and CFS patients
    The Human Genome Project found that this gene has been found to be mutated or abnormal in many people. Some ME and CFS patients have this genetic abnormality. This causes methylation cycle blockage, immune system abnormalities, including re-activation of latent viruses, thyroid and endocrine abnormalities, excess inflammation, antioxidant deficiencies, high homocysteine levels, arteriosclerosis and cardiac abnormalities, fatty liver, increased Cancer risk, neurotransmitter abnormalities and mood disorders, IBS, detoxification deficiency, multiple chemical sensitivity, cell growth and maintenance abnormalities. All of these are commonly found in ME and CFS patients.
    Testing Labs
    - DNA Methylation Pathway with Methylation Pathway Analysis

    Some more info
    http://www.stopthethyroidmadness.com/mthfr/
    Video Lecture by doctor
    MTHFR Awareness

Laboratories

 

(iii) Diagnostic Information about Retroviruses

 

(iv) Diagnostic Information about Borna virus infection

This virus has been found in subsets of ME/CFS patients. Borna virus is rarely tested for and thus not many ill people are diagnosed with it. Infection may be more prevalent than commonly thought. Important diagnostic and treatment information included in the following link.
Borna Disease Virus and Human Disease. Kathryn M. Carbone. Clin Microbiol Rev. Jul 2001; 14(3): 513–527

Tests

  • Anti-BDV antibody (IgM and IgG)
    Immunologically based tests for BDV proteins
    Immunofluorescence assay Immunoblot assay
    cDNA clones for BDV
    RT-PCR assays for BDV RNA, and in vitro or in vivo assays for infectious BDV
    Infectious-virus isolation (the best method)

    A highly sensitive and specific determination of the BDV infection status is required. Two or more tests required. Elisa test is not reliable.

(v) Diagnostic Information about Latent Viral Infections of Immune cells, Nerve cells, Intestinal cells, Muscle cells and viral transmission of chemicals containing RNA. Reactivation of dormant endogenous viruses, HERV's including HERV-K18 in ME patients

HERV infection in the intestines and is detailed in the following paper Plasmacytoid Dendritic Cells in the Duodenum of Individuals Diagnosed with Myalgic Encephalomyelitis Are Uniquely Immunoreactive to Antibodies to Human Endogenous Retroviral Proteins. De Meirleir et al. in vivo 27: 177-188 (2013). Research at Tufts University also corroborates these findings.

This is a new scientific finding relating to MS which may have implications for ME as both are neurological illnesses, both involve lesions in the brain and nervous system and both involve immune system dysfunctions and inflammation in the nervous system. The research paper and report are included below:

Association of innate immune activation with latent Epstein-Barr virus in active MS lesions.
Tzartos JS, Khan G, Vossenkamper A, Cruz-Sadaba M, Lonardi S, Sefia E, Meager A, Elia A, Middeldorp JM, Clemens M, Farrell PJ, Giovannoni G, Meier UC. Neurology. 2012 Jan 3;78(1):15-23.

Link between MS and latent viruses and inflammation (2012).Queen Mary University of London.

  • MTHFR gene mutation found in some ME and CFS patients
    The Human Genome Project found that this gene has been found to be mutated or abnormal in many people. Some ME and CFS patients have this genetic abnormality. This causes methylation cycle blockage, immune system abnormalities, including re-activation of latent viruses, thyroid and endocrine abnormalities, excess inflammation, antioxidant deficiencies, high homocysteine levels, arteriosclerosis and cardiac abnormalities, fatty liver, increased Cancer risk, neurotransmitter abnormalities and mood disorders, IBS, detoxification deficiency, multiple chemical sensitivity, cell growth and maintenance abnormalities. All of these are commonly found in ME and CFS patients.
    Testing Labs
    - DNA Methylation Pathway with Methylation Pathway Analysis

    Some more info
    http://www.stopthethyroidmadness.com/mthfr/
    Video Lecture by doctor
    MTHFR Awaren

Laboratories

  • The scientific papers mentioned above mention diagnostic technologies for this
  • New genetic sequencing devices can rapidly identify the genetic signatures of viruses, these would be recommended as they improve accuracy, while reducing time and cost.
  • Sequencing By Synthesis (SBS) technology, PCR, high throughput sequencing, miRNA testing can also improve accuracy, while reducing time and cost.


(vi) Diagnostic Information about Parainfluenza Virus-5 (PIV-5), Paramyxovirus, Cryptovirus
These are new discoveries in ME patients. Commercial tests are being developed by labs and companes. More information about these viruses and diagnosis and treatments can be found by clicking here.

Laboratories

 

(vii) Diagnostic Information about Ramsey Hunt Syndrome
This condition involves reactivation of the varicella-zoster virus and damage to the nervous system and other body organs. This condition can co-exist with ME / CFS in some cases, due to the immune system dysfunctions and deficiencies and other (trigger) infections involved in ME / CFS. The following web site has some excellent information about this illness - http://ramsayhunt.org/info

 

(viii) Diagnostic Information about Stealth Virus infection: 

Click here to view diagnostic and treatment protocols for stealth virus infection - www.ccid.org.

.Laboratories

Click here to view diagnostic and treatment protocols for stealth virus infection - www.ccid.org.

 

10. Diagnostic Information about Mycoplasma

Mycoplasma: 
MYCOPLASMA : The Linking Pathogen in Neurosystemic Diseases Donald W. Scott
The linking pathogen in CFS, Parkinsons, MS, Alzheimers disease. Donald W. Scott
Salem News article on Mycoplasmas and neurological illnesses
Some Notes on Brucella and Mycoplasmas



Laboratories

 

11. Diagnostic Information about Chlamydia, Babesia, Ehrlichia, Bartonella, Adult and Child Rheumatic Fever, Brucella, Aspergillus, Giardia lamblia


(i) Diagnostic Information about Chlamydia pneumoniae

The following web site contains some important medical information http://cpnhelp.org/

Laboratories.


(ii)
Diagnostic Information about Adult and Child Rheumatic Fever

Test Anti - streptolysin O (ASO) titer. Many labs can carry out this test. Streptococcus pyogenes or group A streptococcus is the culprit.
Dr. Martin Lerner uses the following diagnostics
- Diffuse, multi - joint pain
- Antistreptolysin O titer = 400 (critical to diagnosis)
- Abnormal 24 hour Holter monitor with tachycardia and oscillating T - wave flattening, with or without T - wave inversions
- A thickened mitral valve at echocardiogram.
Source: ME/CFS Treatment Resource Guide for Practitioners by Dr. Martin Lerner


(iii) Diagnostic Information about Brucella species:
Some Notes on Brucella and Mycoplasmas

Laboratories


(iv) Diagnostic Information about Staphylococcus spp. in blood

Test blood for Staphylococcus spp.. These appear as Micrococci-like organisms in the blood. Your medical doctor or specialist should be able to arrange this type of test. Several private labs should offer this test.

Chronic fatigue syndrome (CFS) associated with Staphylococcus spp. bacteremia, responsive to potassium arsenite 0.5% in a veterinary surgeon and his coworking wife, handling with CFS animal cases. Arsenic Tarello W . Comp Immunol Microbiol Infect Dis. 2001 Oct;24(4):233-46. PMID: 11561958 

Chronic Fatigue Syndrome (CFS) in 15 dogs and cats with specific biochemical and microbiological anomalies. Tarello W .Comp Immunol Microbiol Infect Dis. 2001 Jul;24(3):165-85. PMID: 11440190 

 

(v) Diagnostic Information about Aspergillus Niger:
Test stool and urine, blood IgM and IgG and other blood subsets for Aspergillus Niger. New genetic sequencing devices can rapidly identify the genetic signatures of viruses and other pathogens, these would be recommended as they improve accuracy, while reducing time and cost.

Laboratories

 

(vi) Diagnostic Information about Giardia lamblia:

Laboratories


12. Tests for Molds, Mycobacteria and Mycotoxins

Myoctoxins have been found in high percentages of ME patients. One study found that 93% of ME patients had mycotoxin exposure, with many having multiple mycotoxin exposures, while none of the healthy controls had evidence of mycotoxin exposure. Mycotoxin exposure has been proven to lead to immune activation, in particular a chronic inflammatory state, and to endocrine system and nervous system abnormalities all which are consistently found in ME patients. Dr. Paul Cheney, Dr. De Meirleir and Dr. Peterson are now using tests for mycotoxins as part of their diagnostics protocol for ME / CFS.

  • Test spinal fluids, inflamed or infected intestinal tissue and muscle tissue, blood markers (IgG and IgM), B-cells, and inflamed samples from dorsal root ganglia, basal ganglia, brain stem, vagus nerve, peripheral ganglia, autonomic ganglia, spinal cord, cervical and lumbar nerve roots and peripheral nerves and sites of brain lesions for Molds, Mycobacteria and Mycotoxins
  • MRI scans and Spectroscopic signature and EMF signature scans may be able to detect localized infections of the nervous system.
  • New genetic sequencing devices can rapidly identify the genetic signatures of viruses and other pathogens, these would be recommended as they improve accuracy, while reducing time and cost.
  • Sequencing By Synthesis (SBS) technology, PCR, high throughput sequencing, miRNA testing can also improve accuracy, while reducing time and cost.
  • Test for Protein M
    Bacteria and other pathogens have evolved to use a protein called 'Protein M' to block all antibodies produced by the human immune system. This remarkable discovery by scientists at the Scripps Research Institute in 2014 sheds new light on chronic bacteria infections in humans. As many ME patients have chronic infections, this information is important. Tests are being developed for Protein M. See paper below
    - http://www.scripps.edu/news/press/2014/20140206lerner.html

See Section - Tests for chronic inflammatory immune response to molds and mycotoxins


13. Test for harmful Bacteria overgrowth in intestines. Dr. Kenny De Meirleir.

Specific Breath test and Urine test recommended by Dr. Kenny De Meirleir, Belgium.

 

14. Tests for chronic focal infections. Including dental infections, jawbone infections, nasal and sinus infections and tonsil infections.

In many cases these focal infections are ignored or forgotten about, and there may be flare up of symptoms once or a few times a year. These infections are chronic and can persist for many years and lead to chronic immune system activation and inflammation. This includes inflammation and pain in different parts of the body, similar to Rheumatism. This can deplete and weaken the immune system over time making it more susceptible to more serious infections and significant damage to various body systems. These focal infections can also can cause abnormal tirnedness and exhaustion.

Test for
(i) dental infections and jawbone infections. This will require x-rays and scans. It many also require tissue biopsies. Kirilian Imaging Analysis may be useful in some cases.
(ii) nasal and sinus infections. This will require tissue and cartilage biopsies. Kirilian Imaging Analysis may be useful in some cases.
(iii) tonsil infections. This will require tissue biopsies
. Kirilian Imaging Analysis may be useful in some cases.
(iv) Biofilms and antibiotic resistant bacteria
For info about Biofilms and antibiotic resistant bacteria, click on the followig link - http://mpkb.org/home/pathogenesis/microbiota/biofilm
Carry out diagnostic tests for Biofilms in areas of inflammation and pain.
(v) The Marshall Protocol for Immunological Defects and Chronic Infections

 

13. Infectious Venulitis
Dr. Erich Ryll who is a medical doctor and Professor of Medicine at the University of California, Davis, closely studied Infectious Venulitis since the 1970's and he found many similarities between this illness and ME and CFS. He also studied and examined cases in other ocuntries and found similar results. He believes that a virus is responsible for systemic damage to the body and in particular the vascular system and veins.

Diagnostics - Inflammation of veins, including deep veins. Small haemorrhages around blood vessels in the cerebral cortex extending into the mid-brain, and other areas of the brain. Signs of slight vein breakages, minor haemmorhages in different body areas. Easy bruising. Some minor dy-myelination in the brain. Brain hypo-perfusion. Excess pro-inflammatory TH2 cytokines. Difficulty sleeping, unrefreshing sleep. Diffuse pain, headaches, dizziness, brain fog every day or most days. Poor circulation.

The following articles provide information about this condition

.- Infectious Venulitis, Dr. Erich Ryll

- Simialrities between ME and Infectious Venulitis

- Numerous small haemorrhages around blood vessels in the cerebral cortex extending into the mid-brain (post-mortem of English ME patient Andrew Wallis in 1955)

- Vasculitis involving the skin was recorded during outbreaks in Cumberland, Durham and North West London in 1955. A maculopapular rash may appear during the return of features of the initial illness such as flu-like symptoms and enlargement of lymph glands and liver.

 

15. Diagnostic Information about Candida:

Laboratories
New genetic sequencing devices can rapidly identify the genetic signatures of viruses and other pathogens, these would be recommended as they improve accuracy, while reducing time and cost.

 

16. Diagnostic Information about Chronic Rickettsia

Chronic Ricketssia infections have been found in significant numbers of ME and CFS patients. Click here to view medical diagnostic and treatment protocols for this particular infection. Information on web site http://drcjadin.com/

Where can these special tests be performed ?
Check with specialists / consultants at your regional hospital or top state hospital or private labs to see if they do these special tests. If not, then consult the following labs:

 

17. Diagnostic Information about Cryptostrongylus pulmoni

One study shows an infecton rate of 66% in ME. Clinical findings show over 80% infection. This infection may be causative, a co-factor or an opportunistic.

You will need to get the permission of the Patent owner to use the following test:

  • US Patent. 'Methods of diagnosing and treating an intestinal and lung roundworm infection.' Klapow, Lawrence A. Application No. 403278 filed on 03/13/1995. US Classes: 424/45, 424/405. Examiners Primary: Bawa, Raj Attorney, Agent or Firm Medlen & Carroll. International Class A61K 009/12. http://www.patentstorm.us/patents/5645819/description.html
  • New genetic sequencing devices can rapidly identify the genetic signatures of viruses and other pathogens, these would be recommended as they improve accuracy, while reducing time and cost.
  • Sequencing By Synthesis (SBS) technology, PCR, high throughput sequencing, miRNA testing can also improve accuracy, while reducing time and cost.
  • Test for Protein M
    Bacteria and other pathogens have evolved to use a protein called 'Protein M' to block all antibodies produced by the human immune system. This remarkable discovery by scientists at the Scripps Research Institute in 2014 sheds new light on chronic bacteria infections in humans. As many ME patients have chronic infections, this information is important. Tests are being developed for Protein M. See paper below
    - http://www.scripps.edu/news/press/2014/20140206lerner.html

 

18. Multiple Infections

Establish if there are multiple infections with viruses, bacteria, mycoplasmas, etc.. Some studies suggest that ME patients have multiple infections.

Laboratories
New genetic sequencing devices can rapidly identify the genetic signatures of viruses and other pathogens, these would be recommended as they improve accuracy, while reducing time and cost. MRI scans and Spectroscopic signature and EMF signature scans may be able to detect localized infections of the nervous system.

Test for Protein M
Bacteria and other pathogens have evolved to use a protein called 'Protein M' to block all antibodies produced by the human immune system. This remarkable discovery by scientists at the Scripps Research Institute in 2014 sheds new light on chronic bacteria infections in humans. As many ME patients have chronic infections, this information is important. Tests are being developed for Protein M. See paper below
- http://www.scripps.edu/news/press/2014/20140206lerner.html

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