Jason, Leonard A, Cotler, Joseph, Islam, Mohammed F et al. · Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021 · DOI
This study followed college students to see who developed ME/CFS after getting infectious mononucleosis (mono). Researchers found that about 23% of students who got mono later met criteria for ME/CFS within 6 months. Before getting mono, students who later developed ME/CFS had more physical symptoms and certain immune markers that were different from those who recovered, but they didn't have more stress, anxiety, or depression.
This study is important because it provides prospective evidence that certain physical and immune characteristics before infection may predict who develops ME/CFS after mono—not psychological factors alone. This challenges assumptions that ME/CFS is primarily psychologically-driven and suggests biological vulnerability markers that could guide early identification and intervention.
This study does not prove that the immune markers identified cause ME/CFS, only that they are associated with it. The findings are limited to college students with mono and may not apply to ME/CFS developing from other infections or in other populations. Additionally, the study cannot explain the biological mechanisms behind why these immune patterns predict ME/CFS development.
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
Jason, Leonard A, Cotler, Joseph, Islam, Mohammed F, Sunnquist, Madison, & Katz, Ben Z (2021). Risks for Developing Myalgic Encephalomyelitis/Chronic Fatigue Syndrome in College Students Following Infectious Mononucleosis: A Prospective Cohort Study.. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. https://doi.org/10.1093/cid/ciaa1886
BibTeX
@article{mecfsatlas-jason-2021-risks-developing,
author = {Jason, Leonard A and Cotler, Joseph and Islam, Mohammed F and Sunnquist, Madison and Katz, Ben Z},
title = {Risks for Developing Myalgic Encephalomyelitis/Chronic Fatigue Syndrome in College Students Following Infectious Mononucleosis: A Prospective Cohort Study.},
journal = {Clinical infectious diseases : an official publication of the Infectious Diseases Society of America},
year = {2021},
doi = {10.1093/cid/ciaa1886},
note = {PubMed: 33367564},
url = {https://www.mecfsatlas.com/evidence/jason-2021-risks-developing},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/jason-2021-risks-developing
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