Polio-Chronic Fatigue Link Explored

Study to probe childhood 'grippe' connection to syndrome

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HealthDay Reporter

SATURDAY, July 14, 2001 (HealthDayNews) -- During the middle decades of the last century, thousands of American kids came down with "summer grippe," an illness that caused high fevers, flu symptoms and sore necks. They recovered and went on with their lives -- and few realized they had survived a mild form of polio.

Now, an expert in brain disorders is launching an international study to determine whether the grippe -- also known as non-paralytic polio -- may have left those children vulnerable to chronic fatigue syndrome, one of the modern era's most mysterious and controversial diseases.

Baby boomers as young as 40 could have been affected, says Richard L. Bruno, the director of a center for polio survivors who will be conducting the study.

"If we find out what we think we're going to, the bottom line is that half of the people being diagnosed with chronic fatigue syndrome could have had polio as kids, and they didn't even know it," he adds.

Chronic fatigue syndrome tends to come on suddenly and afflict its sufferers, mostly women, with weakness, tiredness, muscle aches, sore throat and fever. Some sufferers complain of memory loss and confusion.

Researchers at DePaul University estimate that 800,000 people nationwide suffer from chronic fatigue syndrome. A study found that most people with the syndrome knew they were sick but had no idea what was wrong, says DePaul psychology professor Leonard Jason.

The causes of chronic fatigue are anything but clear. Some researchers speculate it is closely related to mental illnesses like depression, while others suspect viruses and sleep disorders.

"We know a lot about anxiety and depression, but we know much less about fatigue," Jason says. "It's a very difficult entity for people to study and take seriously."

In fact, skeptics claim chronic fatigue is imaginary, a symptom of mental illness.

A decline in dopamine

Bruno, director of The Post-Polio Institute at New Jersey's Englewood Hospital and Medical Center, says the key to chronic fatigue may indeed rest in people's heads. But he suspects the culprit is in the brain itself, not the mind.

Before it was wiped out by vaccine, severe polio targeted the spinal cord and often caused paralysis. Mild polio -- the grippe, which was caused by the weakest of the three strains of the polio virus -- may have spared the spinal cord but left a time bomb behind in the brain, Bruno says.

The illness could have killed off neurons that produce dopamine, a chemical that helps the body stay alert and awake, he notes.

Humans naturally lose dopamine-producing neurons as they age, and Bruno thinks the neuron loss caused by aging and mild polio could combine to cause a "brownout" of alertness -- or never-ending tiredness.

Bruno works with people who suffer from post-polio syndrome, an energy-sapping illness that is similar to chronic fatigue syndrome. A year ago, he speculated in a published study about a link between polio and chronic fatigue.

A woman in San Diego who read about his work asked members of her chronic-fatigue support group whether any of them suffered from the grippe as children.

"A bunch of hands went up," Bruno recalls. "She said, 'My God, I had something like that when I was a kid. I think you're on to something.' "

Support groups to be polled

Other support groups had similar results, inspiring Bruno to draft a questionnaire that will soon be sent to every known chronic-fatigue support group in the United States, Canada and Great Britain. It will also be distributed to support groups for people who suffer from fibromylagia (FM) and myalgic encephalomyelitis (ME), disorders considered by some experts to be related to chronic fatigue or, possibly be even the same illness.

The study "looks extremely exciting," says Kate Andersen, a consultant with the National FM/ME Action Network of Canada.

Andersen came down with chronic fatigue in 1983 after her infant son was sickened by viral meningitis. It makes sense that viruses like meningitis and polio would cause problems, adds Andersen, who recovered in 1996.

Administering the survey to chronic fatigue sufferers won't be easy, Bruno notes, because some people won't remember being ill as children, even if they were.

Some chronic fatigue experts are intrigued by Bruno's work. "He's a very competent individual and very respected," says Fred Friedberg, a clinical assistant professor of psychiatry at the State University of New York at Stony Brook.

The theory of a link to polio "is consistent with the idea that if your body is physically challenged, that might lead you to be susceptible to illness," Friedberg notes.

Another expert, San Diego neurologist Dr. James Grisolia, says existing research supports the idea that the causes of chronic fatigue lie in the nervous system. Scientists have shown a connection between pressure on the brain stem and chronic fatigue.

"You take the pressure off and you don't have fatigue," he adds.

But it's equally possible that chronic fatigue could have been caused by an immune system disorder, such as an early case of mononucleosis, the highly contagious disease commonly known as "mono," he says.

Skeptics question the link

Not all experts, however, support Bruno's theories.

Dr. Jay Goldstein, director of a California chronic fatigue clinic and author of several books on the subject, doubts that Bruno's research will be helpful to patients.

"If chronic fatigue is a result of having polio when (patients) were children, and they don't have it any more, what difference does that make? And how would that explain the onset of new cases?" he says.

Goldstein supports using medicine to treat chronic fatigue.

For his part, Bruno doesn't support medical intervention in most cases of post-polio syndrome or chronic fatigue. He supports something much cheaper: common sense.

Sufferers should pace their activities, take breaks and stop before they get tired, he says.

"The idea is that if something happened to your brain, you need to listen to your body and you'll feel better," he adds. "This should at least be tried before people take drugs and herbs and God-knows-what-else."

Even if Bruno's research proves to be groundbreaking, experts agree that much more work needs to be done to find new treatments or a cure for chronic fatigue.

"It's a murky area," Grisolia says. "We're dealing with an illness that is fundamentally not understood."

What To Do

If you are always tired, consult your doctor. A variety of medical problems, from thyroid trouble to sleep disorders, could be responsible.

Be prepared to be treated with skepticism by some people if you do think you have chronic fatigue syndrome. There are many chronic fatigue support groups that can help you deal with your feelings.

To learn more, visit the Chronic Fatigue and ImmuneDysfunction Syndrome Association of America Web site, or see the National Institute of Allergy and Infectious Diseases' chronic fatigue fact sheet.

SOURCES: Interviews with Richard L. Bruno, Ph.D., director, The Post-Polio Institute, Englewood Hospital and Medical Center, Englewood, N.J.; Leonard Jason, Ph.D., professor of clinical and community psychology, DePaul University, Chicago; Fred Friedberg, Ph.D., assistant professor of clinical psychiatry, State University of New York at Stony Brook; Kate Andersen, M.Ed., youth consultant, National ME/FM Action Network of Canada, Vancouver; James Grisolia, M.D., chairman, neurology section, Scripps Mercy Hospital, San Diego; Jay A. Goldstein, M.D., director, Chronic Fatigue Syndrome Institute, Orange, Calif.

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