Rasa, Santa, Nora-Krukle, Zaiga, Henning, Nina et al. · Journal of translational medicine · 2018 · DOI
This review examined all existing research on whether viruses might cause ME/CFS. Scientists found that while many studies have looked at different viruses, the research has been poorly designed and inconsistent, making it hard to draw firm conclusions. The authors suggest that future studies need better planning and more rigorous methods to properly answer whether viruses play a role in ME/CFS.
Understanding whether viruses cause or contribute to ME/CFS is crucial for developing effective treatments and diagnostic approaches. This review synthesizes decades of research to identify what we actually know versus what remains speculative, helping patients and doctors recognize the current limits of evidence. The study also provides a roadmap for better-designed future research that could finally clarify the viral connection.
This review does not prove whether viruses do or do not cause ME/CFS—it shows that existing evidence is too inconsistent to make that determination. The systematic review cannot establish causation; it documents that past studies had significant design flaws that undermine their conclusions. It also does not provide new experimental data, only an analysis of what others have published.
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
Rasa, Santa, Nora-Krukle, Zaiga, Henning, Nina, Eliassen, Eva, Shikova, Evelina, Harrer, Thomas, et al. (2018). Chronic viral infections in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).. Journal of translational medicine. https://doi.org/10.1186/s12967-018-1644-y
BibTeX
@article{mecfsatlas-rasa-2018-chronic-viral,
author = {Rasa, Santa and Nora-Krukle, Zaiga and Henning, Nina and Eliassen, Eva and Shikova, Evelina and Harrer, Thomas and Scheibenbogen, Carmen and Murovska, Modra and Prusty, Bhupesh K and European Network on ME/CFS (EUROMENE)},
title = {Chronic viral infections in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).},
journal = {Journal of translational medicine},
year = {2018},
doi = {10.1186/s12967-018-1644-y},
note = {PubMed: 30285773},
url = {https://www.mecfsatlas.com/evidence/rasa-2018-chronic-viral},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/rasa-2018-chronic-viral
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