Erich D. Ryll, M.D., Assistant Clinical Professor of Medicine:
INFECTIOUS VENULITIS CHRONIC FATIGUE SYNDROME MYALGIC ENCEPHALOMYELITIS Erich D. Ryll, M.D. Assistant Clinical Professor of Medicine Division of Infectious & Immunologic Diseases University of California, Davis
In the spring and summer of 1975 there occurred a major, severe epidemic of a communicable, apparent viral disease at the Mercy San Juan Hospital in Carmichael, a suburb of Sacramento, California.
The first two cases became ill in February; the bulk of the cases fell ill between July and November of 1975. Several cases tailed out to 1978. The epidemic spread to all departments of the Hospital. It was equally severe in all departments. I was appointed chairman of a committee to investigate the outbreak. Fearing that some people might die, I asked that the CDC (Communicable Disease Center of Atlanta, Georgia) to become involved.
An epidemic intelligence officer of the CDC spent one week in residence, and an epidemiologist from the California State Department of Health, Berkeley, came for a day. Cultures were obtained for all known viruses, bacteria, mycoplasma, and rickettsiae, and all were found to be negative.
The disease was apparently due to an unknown agent, presumably a virus.
At the time we did a literature search and found three reports of outbreaks that were called EPIDEMIC PHLEBODYNIA (EP), meaning painful veins. While the disease at the Mercy San Juan Hospital (MSJ) was somewhat similar, it included many more features than were described in EP and so at the time I did not believe it was the same disease.
Additional literature search showed that the disease was very similar to EPIDEMIC NEUROMYASTHENIA/MYALGIC ENCEPHALOMYELITIS (ENM/ME). But troublingly, very few vascular features were mentioned. I have followed these patients on a daily basis since 1975. This is the longest continual study of this type of disease that has ever been made. Because of this, I have learned all the nuances, all the signs and symptoms of the disease.
Because the complaints of patients are so many and often seemingly bizarre, I often attempted to disclaim them as being real. But I learned that you patients were always right and I was always wrong. In studying this disease, one must always have an open mind. This disease teaches the physician to be humble.
One must remember what a famous French physician, Jean Martin Charcot, said many years ago; "DISEASE IS VERY OLD AND NOTHING ABOUT IT HAS CHANGED. IT IS WE WHO CHANGE AS WE LEARN TO RECOGNIZE WHAT FORMERLY HAS BEEN IMPERCEPTIBLE." Read more>>