Chronic fatigue syndrome and susceptibility to upper respiratory tract illness

Objectives. First, to determine whether chronic fatigue syndrome (CFS) patients report increased susceptibility to upper respiratory tract illnesses (URTIs) compared with healthy volunteers. Second, to determine whether symptom severity and use of medication is greater in CFS patients. Finally, to assess the impact of the URTIs on the subsequent clinical state of the patients. Design. A 10-week diary study. Methods. The frequency and severity of URTIs were recorded over a 10-week period by CFS patients (N = 62) and healthy controls (N = 44). The patients were selected according to the Oxford criteria and had previously been assessed at the Cardiff Chronic Fatigue Clinic. One group of patients and controls carried out the diary study from October to December, and another group from January to March. At the end of each of the 10-week periods the volunteers completed standard questionnaires about the frequency and severity of symptoms of colds and influenza and their general clinical condition. Results. CFS patients reported more cold and influenza illnesses than the controls. The patients also reported greater symptom severity and use of medication for the URTIs; these differences were still observed when trait anxiety was covaried. There was little evidence of the URTIs leading to longer term changes in the primary symptoms of CFS. Conclusions. CFS patients report more URTIs, greater symptom severity and greater use of medication for these illnesses than healthy controls. Further studies are now necessary to determine whether these results reflect greater susceptibility to infection or differences in symptom reporting. The present findings also suggest that acute infections do not play a major role in the pathogenesis of CFS.