Kerr, Jonathan R, Bracewell, Janice, Laing, Ian et al. · The Journal of rheumatology · 2002
This study looked at whether parvovirus B19 infection (a common virus that causes rash and joint pain) can lead to chronic fatigue syndrome (CFS). Researchers followed 51 patients with acute B19 infection and found that some developed lasting joint pain and fatigue months later. Five patients met the diagnostic criteria for CFS after B19 infection, but the study found it very difficult to prove that B19 was the cause without clear evidence of infection at the time fatigue started.
This study provides evidence that parvovirus B19 infection may trigger ME/CFS in some patients, potentially identifying a viral trigger for disease onset. Understanding post-viral ME/CFS mechanisms and the challenges in proving causation is important for developing better diagnostic criteria and investigating whether specific viral infections contribute to ME/CFS pathogenesis.
This study does not establish a direct causal mechanism linking B19 to CFS—it shows temporal association but not causation. The small number of CFS cases (n=5) and the absence of specific B19 marker patterns in CFS patients means B19 cannot be considered a reliable diagnostic marker or universal cause of ME/CFS. The study also does not characterize the full clinical course or outcomes of post-B19 CFS.
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
Kerr, Jonathan R, Bracewell, Janice, Laing, Ian, Mattey, Derek L, Bernstein, Robert M, Bruce, Ian N, et al. (2002). Chronic fatigue syndrome and arthralgia following parvovirus B19 infection.. The Journal of rheumatology. https://pubmed.ncbi.nlm.nih.gov/11911112/
BibTeX
@article{mecfsatlas-kerr-2002-chronic-fatigue,
author = {Kerr, Jonathan R and Bracewell, Janice and Laing, Ian and Mattey, Derek L and Bernstein, Robert M and Bruce, Ian N and Tyrrell, David A J},
title = {Chronic fatigue syndrome and arthralgia following parvovirus B19 infection.},
journal = {The Journal of rheumatology},
year = {2002},
note = {PubMed: 11911112},
url = {https://www.mecfsatlas.com/evidence/kerr-2002-chronic-fatigue},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/kerr-2002-chronic-fatigue
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