Reyes, M, Gary, H E, Dobbins, J G et al. · MMWR. CDC surveillance summaries : Morbidity and mortality weekly report. CDC surveillance summaries · 1997
Between 1989 and 1993, researchers in four U.S. cities tracked patients with chronic fatigue syndrome (CFS) to understand how common it was and what it looked like. Of 565 patients evaluated, 130 met the CFS criteria. The study found that CFS affected about 4 to 9 people per 100,000 in the general population, but was much more common in white women. Most CFS patients were in their 30s when they got sick and had been ill for about 7 years.
This was one of the first systematic, multisite efforts to establish CFS prevalence and clinical characteristics in the United States, providing baseline epidemiologic data that helped establish CFS as a real disease affecting thousands of Americans. The findings highlighted that CFS disproportionately affects white women and has a substantial disease burden, informing public health resource allocation and clinical recognition.
This study does not establish the cause of CFS or prove any specific infectious, genetic, or immunologic mechanism. The cross-sectional design cannot determine prognosis, long-term outcomes, or whether the observed demographic patterns reflect true disease distribution or bias in who sought medical care and was referred to the surveillance system.
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
Reyes, M, Gary, H E, Dobbins, J G, Randall, B, Steele, L, Fukuda, K, et al. (1997). Surveillance for chronic fatigue syndrome--four U.S. cities, September 1989 through August 1993.. MMWR. CDC surveillance summaries : Morbidity and mortality weekly report. CDC surveillance summaries. https://pubmed.ncbi.nlm.nih.gov/12412768/
BibTeX
@article{mecfsatlas-reyes-1997-surveillance-chronic,
author = {Reyes, M and Gary, H E and Dobbins, J G and Randall, B and Steele, L and Fukuda, K and Holmes, G P and Connell, D G and Mawle, A C and Schmid, D S and Stewart, J A and Schonberger, L B and Gunn, W J and Reeves, W C},
title = {Surveillance for chronic fatigue syndrome--four U.S. cities, September 1989 through August 1993.},
journal = {MMWR. CDC surveillance summaries : Morbidity and mortality weekly report. CDC surveillance summaries},
year = {1997},
note = {PubMed: 12412768},
url = {https://www.mecfsatlas.com/evidence/reyes-1997-surveillance-chronic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/reyes-1997-surveillance-chronic
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