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BACKGROUND

Chronic Fatigue Syndrome (CFS) is a chronic illness of unknown aetiology characterised by debilitating fatigue and associated symptoms (Komaroff 1993). Typically, the symptoms develop after a flu-like illness which is markedly exacerbated by exercise (Hamre 1995). These symptoms include severe fatigue, muscle and joint pain, headache, sore throat, dizziness, fever, depression, anxiety and difficulties with concentration and memory (Farrar et al 1995; Holmes et al 1988). In a population based study Pawlikowska et al (1994) found that women are more likely to complain of fatigue than men even after adjustment for psychological distress. However, Buchwald et al (1994) found that demographic, clinical and psychological factors do not distinguish men from women CFS patients. In a study on life events and CFS Ray et al (1995) found that positive life events were associated with lower scores for fatigue, anxiety and depression and negative life events were associated with higher anxiety. Results from an Australian study revealed that CFS subjects had significantly impaired quality of life, especially in areas of social functioning (Schweitzer et al 1995).

Various theories have been proposed to explain the aetiology of CFS but none has been proven. Currently the two major medical explanations of the aetiology of CFS are viral infection and immune dysregulation (McCully et al 1996). A variety of virusese have been put forward as explanations for the symptoms of CFS, including chronic Epstein-Barr virus infection (Straus et al 1985), Coxsackie virus (Yousef et al 1988), HHV-6 infection or HTLV 11 infection (Buchwald et al 1992 …