The Question
The question of "What are ME and CFS?" can be approached from a number of perspectives, but within the context of this website, the question refers to the term ME CFS and not medical issues.
What is CFS?
CFS is an acronym for Chronic Fatigue Syndrome. The name arose from the US following outbreaks of an unknown condition in various places throughout the United States, including the most famous at Incline Villiage at Lake Tahoe:(HOLMES, G. P., KAPLAN, J. E., STEWART, J. A., HUNT, B., PINSKY, P. F. & SCHONBERGER, L. B. (1987) A Cluster of Patients With a Chronic Mononucleosis-like Syndrome - is Epstein-Barr-Virus the Cause? Journal of American Medical Association, 257, 2297-2302)
The name appears to have been first coined in 1986 by Stephen Straus in a grant application: (STRAUS, S. (1986) A Study of Sporadic Neuroasthenia Associated with Epstein-Barr Virus - Grant No. 1Z01AI000470-01)
In 1988 the CDC arranged a meeting to forumate a criteria for the newly created entity to be known as CFS: (HOLMES, G. P., KAPLAN, J. E., GANTZ, N. M., KOMAROFF, A. L., SCHONBERGER, L. B., STRAUS, S. E., JONES, J. F., DUBOIS, R. E., PURTILO, D. T., BROWN, N., SCHOOLEY, R. T. & BRUS, I. (1988) Chronic Fatigue Syndrome: A Working Case Definition. Annals of Internals Medicine, 108, 387-9) In 1994 the criteria was altered to open up the criteria (allowing those affected by mental illness to be included):(FUKUDA, K., STRAUSS, S. E., HICKIE, I., SHARPE, M. C., DOBBINS, J. & KOMAROFF, A. (1994) The Chronic Fatigue Syndrome: A Comprehensive Approach to its Definition and Study. International Chronic Fatigue Syndrome Study Group. Annals of Internal Medicine . 121, 953-959)
Alterations to the application of the criteria were made by the CDC in 2005 and this increased the prevalence figures on CFS tenfold: (REEVES, W. C., WAGNER, D., NISENBAUM, R., JONES, J.F., GURBAXANI, B., SOLOMON, L., PAPANICOLAOU, D.A., UNDER, E.R., VERNON, S.D., & HEIM, C. (2005) Chronic Fatigue Syndrome - A Clinically Empirical Approach to its Definition and Study. DMC Medicine, 19, 1)
Be aware that these criteria were for research purposes. Clinical assessment of CFS is applied less rigidly through the application of clinical judgement. The guidelines section covers this issue within the guidelines themselves.
CFS is NOT the same as chronic fatigue. CF is classified by the World Health Organiscations a psychological condition under "fatigue syndromes": ((WORLD HEALTH ORGANISATION (1994) ICD - 10, Mental and Behavioural Disorders Neurological Disorders F 48.0 (in Other Neurotic Disorders). International Statistical Classification of Diseases and Related Health Problems. Geneva.) CFS is included by the WHO under the same heading of ME (ie by the Aphabetic list which lists CFS among other terms as synonymous or clinically similar - e.g. Post Viral Syndrome).
What is ME?
ME is an acronym for Myalgic Encephalomyelitis. It has also been used to represent Myalgic Encephalopathy and Myalgic Encephalitis.
ME was first coined in 1955 as Benign Myalgic Encephalomyelitis: (Acheson, E.D. (1955) Letter. Lancet, 2, 395; ACHESON, A. D. (1959) The Clinical Syndrome Variously Called Benign Myalgic Encephalomyelitis, Iceland Disease and Epidemic Neuromyasthenia. American Journal of Medicine, 26, 569 - 595) in the United Kingdom.
ME (as benign ME) was classified as a neurological condition in 1969 by the World Health Organisation: (WORLD HEALTH ORGANISATION (1994) ICD - 10, Neurological Disorders G 93.3 (in Other Disorders of the Nervous System). International Statistical Classification of Diseases and Related Health Problems. Geneva. at pp 422-424)
ME is not the same as CFS - a fact pointed out by the CDC in 2007: (JONES, J., LUPTON, T., MCCLEARY, K. K., REEVES, W. C. & WALKER, V. (2007) Diagnosis and Management , Course WB1032: Chapter 1)
In Australia ME was subsumed into CFS. CFS was the name to be adopted because ME was associated with a psychological condition (thanks to the UK psychiatric community's adoption of a 1970 paper that painted the condition as hysteria: (MCEVEDY, C. P., & BEARD, A.W., (1970) Royal Free Epidemic of 1955: A Reconsideration. British Medical Journal, 1, 7-11; MCEVEDY, C. P. & BEARD, A. W. (1973) A Controlled Follow-up of Cases Involved in an Epidemic of ‘Benign Myalgic Encephalomyelitis’. British Journal of Psychiatry, 122, 141-150) and CFS was to put forward by a group of leading medical researchers in Australia, until such time as its pathophysiology was known: (LLOYD, A., WAKEFIELD, D., BROUGHTON, C., & DWYER, J. (1988) What is Myalgic Encephalomyelitis? Lancet, 1, 1286-1287).
Dr Byron Hyde of the Nightingale Research Foundation has spent over 25 years of his career as a investigative ME doctor. He is the world expert on ME and currently has the only definition of ME in print. The Nightingale Research Foundation Definition of Myalgic Encephalomyelitis (M.E.).
What is ME/CFS?
ME/CFS is a hybrid. A compromise of sorts that brings together a number of political issues (ie issues with the stigma associated with the term CFS for example) the pressure of the patient support groups.
Under this hybrid, the two conditions are presumed to be the same or at least on the same continuum of the same disease: (CARRUTHERS, B. M. & VAN DE SANDE, M. I. (2005) Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Clinical Case Definition and the Guidelines for Medical Practitioners - An overview of the Canadian Consensus Document, Calgary, Alberta, Canada, Carruthers & van de Sande; TURNBULL, N., SHAW, E. J., BAKER, R., DUNSDON, S., COSTIN, N., BRITTON, G., KUNTZE, S. & NORMAN, R. (2007) Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (or Encephalopathy): Diagnosis and Management of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (or Encephalopathy) in Adults and Children)
Under the Australian Clinical Guidelines for CFS, ME and CFS are represented as synonymous: (LOBLAY, R., G., S., BERTOUCH, J., CISTULLI, P., DARVENIZA, P., ELLIS, C., GATENBY, P., GILLS, D., HICKIE, I., LLOYD, A., PHILLIPS, B., PHOON, W., ROWE, K., STEVEN, I., WAKEFIELD, D., WATSON, D. O. & TOULKIDIS, V. (2002) RACP Chronic Fatigue Syndrome: Clinical Practice Guidelines. Medical Journal of Australia, 176, S17 - S56)
In Australia ME CFS as a terminology is still in a state of flux. However, with the work of the patient support groups, the hybrid term is being presented to the medical fraternity and is used by the patient support groups: (SOUTH AUSTRALIAN DEPARTMENT OF HUMAN SERVICES (2004) ME CFS Guidelines: Myalgic Encephalopathy (ME)/Chronic Fatigue Syndrome(CFS): Management Guidelines for General Practitioners, South Australia. Adelaide: Australia, Department of Human Services. Metropolitan Division)
Symptomology
ME CFS symptomology is an important issue in terms of the legal experience. The symptomology is detailed here.
Legal Perspective
ME, CFS, ME/CFS, Post Viral Syndrome (PVS), Post Viral Fatigue Syndrome (PVFS) or even Post Infectious Fatigue Syndrome (PIFS) are detailed in the decisions that have been reviewed. The terms are interchangeable in the eyes of the law, although there has not been an argument run with any degree of intent to argue otherwise.