Kramer, Axel, Wichelhaus, Thomas A, Kempf, Volkhard et al. · GMS hygiene and infection control · 2021 · DOI
A family of five living in a house with severe mold damage all developed health problems. The mother developed symptoms very similar to ME/CFS, including extreme fatigue, cognitive problems, sleep issues, and respiratory complaints. After the family moved out, symptoms improved gradually—the father recovered in 2 weeks, the children in 6 months, and the mother took 18 months to fully recover.
This case is relevant to ME/CFS research because it documents a family with confirmed environmental exposure causing a chronic fatigue syndrome phenotype with cognitive dysfunction, sleep disturbance, and autonomic features similar to ME/CFS. It provides naturalistic evidence linking specific environmental toxins (mold-derived MVOCs) to post-exposure symptom persistence and highlights variable recovery timelines that may inform understanding of illness severity and individual susceptibility factors.
This single case report cannot prove that mold exposure causes ME/CFS generally, nor that MVOCs are the primary mechanism in typical ME/CFS cases. The study does not establish whether pre-existing susceptibilities made this family vulnerable, whether similar exposure would produce identical outcomes in other individuals, or whether other environmental triggers might produce similar syndromes. Causality is inferred from symptom resolution rather than proven through controlled experimental design.
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
Kramer, Axel, Wichelhaus, Thomas A, Kempf, Volkhard, Hogardt, Michael, & Zacharowski, Kai (2021). Building-related illness (BRI) in all family members caused by mold infestation after dampness damage of the building.. GMS hygiene and infection control. https://doi.org/10.3205/dgkh000403
BibTeX
@article{mecfsatlas-kramer-2021-building-related,
author = {Kramer, Axel and Wichelhaus, Thomas A and Kempf, Volkhard and Hogardt, Michael and Zacharowski, Kai},
title = {Building-related illness (BRI) in all family members caused by mold infestation after dampness damage of the building.},
journal = {GMS hygiene and infection control},
year = {2021},
doi = {10.3205/dgkh000403},
note = {PubMed: 34956824},
url = {https://www.mecfsatlas.com/evidence/kramer-2021-building-related},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/kramer-2021-building-related
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