Bell, E J, McCartney, R A, Riding, M H · Journal of the Royal Society of Medicine · 1988 · DOI
This study examined whether a common virus called Coxsackie B might be linked to ME/CFS. Researchers tested blood samples from ME/CFS patients and healthy people, and found that ME/CFS patients had higher rates of antibodies to this virus—suggesting they may have been infected with it. The findings suggest Coxsackie B viruses may play a role in this illness, though more research is needed to understand exactly how.
This study provides early serological evidence that Coxsackie B viruses may be associated with ME/CFS in a subset of patients, which could help explain the post-viral nature many patients report. Understanding potential viral triggers is important for developing targeted diagnostic tests and future therapeutic approaches for this disabling condition.
This study does not prove that Coxsackie B viruses cause ME/CFS—it only shows an association in a cross-sectional design. The presence of antibodies indicates past or current infection but does not establish direct causality. Additionally, the study cannot determine whether CBV infection triggers ME in susceptible individuals or whether CBV reactivates as a consequence of ME-related immunological changes.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Bell, E J, McCartney, R A, & Riding, M H (1988). Coxsackie B viruses and myalgic encephalomyelitis.. Journal of the Royal Society of Medicine. https://doi.org/10.1177/014107688808100609
BibTeX
@article{mecfsatlas-bell-1988-coxsackie-viruses,
author = {Bell, E J and McCartney, R A and Riding, M H},
title = {Coxsackie B viruses and myalgic encephalomyelitis.},
journal = {Journal of the Royal Society of Medicine},
year = {1988},
doi = {10.1177/014107688808100609},
note = {PubMed: 2841461},
url = {https://www.mecfsatlas.com/evidence/bell-1988-coxsackie-viruses},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/bell-1988-coxsackie-viruses
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