Okano, M · Nihon rinsho. Japanese journal of clinical medicine · 1992
This review examines whether viral infections, particularly Epstein-Barr virus (EBV), cause ME/CFS. The author notes that ME/CFS shares symptoms with chronic EBV infection—including fatigue, swollen lymph nodes, and fever—but the connection remains unclear. The review also discusses a more severe condition called severe chronic active EBV infection and highlights that the true cause and best treatment for ME/CFS are still unknown.
This review synthesizes early evidence on viral contributions to ME/CFS at a critical juncture in the disease's recognition. Understanding whether specific viruses trigger or perpetuate ME/CFS is fundamental to developing targeted treatments and diagnostic criteria for patients experiencing these debilitating symptoms.
This review does not establish a causal relationship between any specific virus and ME/CFS, only notes clinical similarities between conditions. The review cannot prove viral infection causes the syndrome or determine which, if any, viral agent is primarily responsible. It represents a summary of existing evidence rather than new experimental data demonstrating causation.
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
Okano, M (1992). [Viral infection and its causative role for chronic fatigue syndrome].. Nihon rinsho. Japanese journal of clinical medicine. https://pubmed.ncbi.nlm.nih.gov/1337559/
BibTeX
@article{mecfsatlas-okano-1992-viral-infection,
author = {Okano, M},
title = {[Viral infection and its causative role for chronic fatigue syndrome].},
journal = {Nihon rinsho. Japanese journal of clinical medicine},
year = {1992},
note = {PubMed: 1337559},
url = {https://www.mecfsatlas.com/evidence/okano-1992-viral-infection},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/okano-1992-viral-infection
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