Devanur, L D, Kerr, J R · Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology · 2006 · DOI
ME/CFS affects about 1 in 100 to 1 in 250 people worldwide and is diagnosed based on clinical symptoms after ruling out other diseases. Research shows that ME/CFS likely involves multiple factors: immune system problems, stress, infections (such as Epstein-Barr virus), and exposure to certain chemicals or toxins. Currently there is no proven cure, but treating underlying infections may help some patients.
This review consolidates evidence that ME/CFS is a multifactorial disease with biological substrates—immune, endocrine, and infectious—rather than purely psychiatric, validating patient experiences and directing research toward biomarker development and mechanism-based treatments. Understanding the interplay between stress, infection, and immune dysfunction provides a framework for identifying therapeutic targets.
This review does not establish causality for any specific pathogen or toxin; it documents associations and temporal relationships. It does not provide prevalence estimates based on prospective cohort data or demonstrate that identified abnormalities are disease-specific rather than secondary consequences of chronic illness. The distinction between emotional stress and depression is asserted but not formally tested in this abstract.
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
Devanur, L D & Kerr, J R (2006). Chronic fatigue syndrome.. Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology. https://doi.org/10.1016/j.jcv.2006.08.013
BibTeX
@article{mecfsatlas-devanur-2006-chronic-fatigue,
author = {Devanur, L D and Kerr, J R},
title = {Chronic fatigue syndrome.},
journal = {Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology},
year = {2006},
doi = {10.1016/j.jcv.2006.08.013},
note = {PubMed: 16978917},
url = {https://www.mecfsatlas.com/evidence/devanur-2006-chronic-fatigue},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/devanur-2006-chronic-fatigue
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