Lovell, D M · Journal of travel medicine · 1999 · DOI
This study interviewed 12 overseas development workers who developed ME/CFS while working abroad or shortly after visiting projects. Most felt they had been very healthy before getting sick, and they described typical ME/CFS symptoms like fatigue and pain. The researchers found that participants believed their illness was caused by a combination of overwork, stress, and infections—not depression.
This study challenges prevailing psychosomatic explanations for ME/CFS by documenting a cohort where depression does not appear to be the primary driver. It highlights occupational and environmental factors (stress, overwork, infection exposure) in CFS etiology and provides patient perspectives on coping strategies and the lived experience of diagnosis delay.
This small qualitative study does not establish causation or identify which specific infectious agents or stressors trigger CFS. It cannot determine whether these development workers represent a distinct CFS subtype or whether findings generalize to other populations. The lack of objective biomarkers or standardized CFS diagnostic criteria limits claims about disease mechanisms.
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
Lovell, D M (1999). Chronic fatigue syndrome among overseas development workers: A qualitative study.. Journal of travel medicine. https://doi.org/10.2310/7060.1999.00005
BibTeX
@article{mecfsatlas-lovell-1999-chronic-fatigue,
author = {Lovell, D M},
title = {Chronic fatigue syndrome among overseas development workers: A qualitative study.},
journal = {Journal of travel medicine},
year = {1999},
doi = {10.2310/7060.1999.00005},
note = {PubMed: 10071368},
url = {https://www.mecfsatlas.com/evidence/lovell-1999-chronic-fatigue},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/lovell-1999-chronic-fatigue
Contribute
Private, reviewed by a human. Not a public comment thread.