Chia, J, Chia, A, Voeller, M et al. · Journal of clinical pathology · 2010 · DOI
This study tracked patients who had acute enterovirus infections (common viral illnesses) and then developed ME/CFS symptoms. Researchers found that in three patients, the virus persisted in their stomach tissue years after the initial infection. This suggests that some ME/CFS cases may be triggered by enterovirus infections that don't fully clear from the body.
For decades, ME/CFS has lacked a clear biological mechanism. This study provides evidence that at least some ME/CFS cases may originate from acute viral infections where the virus persists in the gastrointestinal tract, offering potential targets for diagnosis and treatment. Understanding viral persistence could help explain why some people develop chronic illness after infections while others recover normally.
This study does not prove that all ME/CFS cases are caused by enteroviral persistence, nor does it establish causation definitively—viral persistence may be a marker rather than the cause. The small sample size and lack of age-matched controls without ME/CFS limits generalizability. Correlation between viral presence and symptom development does not establish that the virus is the sole or primary mechanism of pathogenesis.
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
Chia, J, Chia, A, Voeller, M, Lee, T, & Chang, R (2010). Acute enterovirus infection followed by myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and viral persistence.. Journal of clinical pathology. https://doi.org/10.1136/jcp.2009.070466
BibTeX
@article{mecfsatlas-chia-2010-acute-enterovirus,
author = {Chia, J and Chia, A and Voeller, M and Lee, T and Chang, R},
title = {Acute enterovirus infection followed by myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and viral persistence.},
journal = {Journal of clinical pathology},
year = {2010},
doi = {10.1136/jcp.2009.070466},
note = {PubMed: 19828908},
url = {https://www.mecfsatlas.com/evidence/chia-2010-acute-enterovirus},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/chia-2010-acute-enterovirus
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