Mawle, A C, Reyes, M, Schmid, D S · Infectious agents and disease · 1993
This 1993 paper examines whether chronic fatigue syndrome (ME/CFS) might be caused by an infection. The authors reviewed evidence about infectious agents and their possible role in ME/CFS development. While the study explores this connection, it does not provide definitive answers about whether an infection causes the illness.
This early exploration of infectious triggers in ME/CFS helped establish a research direction that continues today. Understanding whether infections initiate or perpetuate ME/CFS is crucial for developing preventive strategies and targeted treatments for patients.
This review does not prove that ME/CFS is caused by any specific infection, nor does it establish causation versus association. The study cannot identify mechanisms by which infections might trigger the disease, and findings are limited by the diagnostic capabilities available in 1993. It does not address whether multiple infections might contribute or whether infections are necessary or sufficient for disease 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
Mawle, A C, Reyes, M, & Schmid, D S (1993). Is chronic fatigue syndrome an infectious disease?. Infectious agents and disease. https://pubmed.ncbi.nlm.nih.gov/8173816/
BibTeX
@article{mecfsatlas-mawle-1993-chronic-fatigue,
author = {Mawle, A C and Reyes, M and Schmid, D S},
title = {Is chronic fatigue syndrome an infectious disease?},
journal = {Infectious agents and disease},
year = {1993},
note = {PubMed: 8173816},
url = {https://www.mecfsatlas.com/evidence/mawle-1993-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/mawle-1993-chronic-fatigue
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