Swanink, C M, Melchers, W J, van der Meer, J W et al. · Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 1994 · DOI
Researchers investigated whether a common virus called enterovirus might be causing ME/CFS by hiding in the body. They tested 76 ME/CFS patients and 76 healthy controls using multiple methods, including blood tests, stool samples, and genetic analysis. The study found no evidence that enterovirus plays a role in ME/CFS—only one patient showed traces of the virus in one test, which disappeared three months later.
Early in ME/CFS research, many theories about its cause were proposed, including viral persistence. This well-designed study helped rule out one persistent hypothesis, allowing researchers to focus efforts on other potential biological mechanisms. Understanding what does not cause ME/CFS is valuable for redirecting investigation toward more promising leads.
This study does not prove that enteroviruses never trigger ME/CFS or play no role in initial illness onset—it only argues against chronic viral persistence as a continuing cause. The study's single PCR-positive case suggests enteroviral exposure occurs but does not establish clinical relevance. Negative findings cannot completely rule out a role in a subset of patients or in earlier disease stages not captured here.
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
Swanink, C M, Melchers, W J, van der Meer, J W, Vercoulen, J H, Bleijenberg, G, Fennis, J F, et al. (1994). Enteroviruses and the chronic fatigue syndrome.. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. https://doi.org/10.1093/clinids/19.5.860
BibTeX
@article{mecfsatlas-swanink-1994-enteroviruses-chronic,
author = {Swanink, C M and Melchers, W J and van der Meer, J W and Vercoulen, J H and Bleijenberg, G and Fennis, J F and Galama, J M},
title = {Enteroviruses and the chronic fatigue syndrome.},
journal = {Clinical infectious diseases : an official publication of the Infectious Diseases Society of America},
year = {1994},
doi = {10.1093/clinids/19.5.860},
note = {PubMed: 7893870},
url = {https://www.mecfsatlas.com/evidence/swanink-1994-enteroviruses-chronic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/swanink-1994-enteroviruses-chronic
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