{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T22:56:48Z","timestamp":1782514608493,"version":"3.54.5"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"777","license":[{"start":{"date-parts":[[1990,7,1]],"date-time":"1990-07-01T00:00:00Z","timestamp":646790400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1990,7,1]]},"abstract":"<jats:title>Summary<\/jats:title>\n               <jats:p>Myalgic encephalomyelitis is a common disability but frequently misinterpreted. Amongst 6,000 patients referred for general microbiological diagnosis between 1975 and 1987, 420 cases were recognized. Coxsackie B neutralization tests, in 205 of these, demonstrated significant titres in 103\/205 (50%), while of 124 additionally investigated for enteroviral IgM, 38\/124 (31%) were positive. This illness is distinguished from a variety of other post-viral states by an unique clinical and epidemiological pattern characteristic of enteroviral infection. Prompt recognition and advice to avoid over-exertion is mandatory. Routine diagnosis, specific therapy and prevention, await further technical advances.<\/jats:p>","DOI":"10.1136\/pgmj.66.777.526","type":"journal-article","created":{"date-parts":[[2008,12,29]],"date-time":"2008-12-29T21:01:03Z","timestamp":1230584463000},"page":"526-530","source":"Crossref","is-referenced-by-count":100,"title":["Myalgic encephalomyelitis\u2014a persistent enteroviral infection?"],"prefix":"10.1093","volume":"66","author":[{"given":"E G","family":"Dowsett","sequence":"first","affiliation":[{"name":"Basildon and Thurrock Health Authority, Basildon Hospital , Essex, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A M","family":"Ramsay","sequence":"additional","affiliation":[{"name":"Royal Free Hospital , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R A","family":"McCartney","sequence":"additional","affiliation":[{"name":"Enterovirus Reference Laboratory, Regional Virus Laboratory, Ruchill Hospital , Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E J","family":"Bell","sequence":"additional","affiliation":[{"name":"Enterovirus Reference Laboratory, Regional Virus Laboratory, Ruchill Hospital , Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[1990,7,1]]},"reference":[{"issue":"26","key":"ref_1","first-page":"569","article-title":"The clinical syndrome variously called benign myalgic encephalomyelitis, Iceland Disease and epidemic myasthenia","volume":"1959","author":"Acheson, E.D.","unstructured":"Acheson, E.D. The clinical syndrome variously called benign myalgic encephalomyelitis, Iceland Disease and epidemic myasthenia. Am J Med 1959, 26: 569-595.","journal-title":"Am J Med"},{"issue":"4","key":"ref_2","first-page":"157","article-title":"Postviral fatigue syndrome","volume":"1988","author":"Behan, P.O.; Behan, W.M.H.","unstructured":"Behan, P.O. & Behan, W.M.H. Postviral fatigue syndrome. CRC Crit Rev Neurobiol 1988, 4: 157-178.","journal-title":"CRC Crit Rev Neurobiol"},{"key":"ref_3","article-title":"Post viralfatigue syndrome - the saga of the Royal Free Disease","author":"Ramsay, A.M.","year":"1986","unstructured":"Ramsay, A.M. Post viralfatigue syndrome - the saga of the Royal Free Disease, London. Gower Medical Publishing, 1986 (M.E. Association, P.O. Box 8, Stanford le Hope, Essex SS17 8EX)."},{"issue":"1","key":"ref_4","first-page":"7","article-title":"Royal Free Disease Epidemic of 1955 - a reconsideration","volume":"1970","author":"McEvedy, C.P.; Beard, A.W.","unstructured":"McEvedy, C.P. & Beard, A.W. Royal Free Disease Epidemic of 1955 - a reconsideration. Br Med J 1970 1: 7-1 1.","journal-title":"Br Med J"},{"issue":"4","key":"ref_5","first-page":"30","article-title":"Myalgic encephalomyelitis presenting as a psychiatric illness","volume":"1986","author":"Winbow, A.","unstructured":"Winbow, A. Myalgic encephalomyelitis presenting as a psychiatric illness. Br J Clin Soc Psychol 1986, 4: 30-31.","journal-title":"Br J Clin Soc Psychol"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1017\/S0022172400064718","article-title":"Study of Coxsackie B virus infections 1972-1983","volume":"93","author":"Bell, E.J.; McCartney, R.A.","year":"1984","unstructured":"Bell, E.J. & McCartney, R.A. Study of Coxsackie B virus infections 1972-1983. J Hyg Camb 1984, 93: 197-203.","journal-title":"J Hyg Camb"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1002\/jmv.1890190302","article-title":"Routine use of j antibody-capture ELISA for the serological diagnosis of Coxsackie B virus infections","volume":"19","author":"McCartney, R.A.; Banatvala, J.E.; Bell, E.J.","year":"1986","unstructured":"McCartney, R.A., Banatvala, J.E. & Bell, E.J. Routine use of j antibody-capture ELISA for the serological diagnosis of Coxsackie B virus infections. J Med Virol 1986, 19: 205-212.","journal-title":"J Med Virol"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/S0140-6736(88)92722-5","article-title":"Chronic enterovirus infection in patients with post viral fatigue syndrome","volume":"i:","author":"Yousef, G.E.; Bell, E.J.; Mann, G.F.","year":"1988","unstructured":"Yousef, G.E., Bell, E.J., Mann, G.F. et al. Chronic enterovirus infection in patients with post viral fatigue syndrome. Lancet 1988, i: 146-149.","journal-title":"Lancet"},{"issue":"1","key":"ref_9","first-page":"696","article-title":"Post viral fatigue syndrome - time for a new approach","volume":"1988","author":"David, A.; Wessley, S.; Pelosi, A.J.","unstructured":"David, A., Wessley, S. & Pelosi, A.J. Post viral fatigue syndrome - time for a new approach. Br Med J 1988, 1: 696-698.","journal-title":"Br Med J"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/S0163-4453(89)91150-X","article-title":"Active Epstein-Barr virus infection in post viral fatigue syndrome","volume":"18","author":"Hotchin, N.A.; Read, R.; Smith, D.G.; Crawford, D.H.","year":"1989","unstructured":"Hotchin, N.A., Read, R., Smith, D.G. & Crawford, D.H. Active Epstein-Barr virus infection in post viral fatigue syndrome. J Infect 1989, 18: 143-150.","journal-title":"J Infect"},{"issue":"51","key":"ref_11","first-page":"248","article-title":"An outbreak of disease believed to have been caused by an Echo 9 virus","volume":"1959","author":"Lyle, W.H.","unstructured":"Lyle, W.H. An outbreak of disease believed to have been caused by an Echo 9 virus. Ann Intern Med 1959, 51: 248-269.","journal-title":"Ann Intern Med"},{"key":"ref_12","first-page":"339","article-title":"Sporadic myalgic encephalomyelitis in a rural practice","volume":"33","author":"Keighley, B.D.; Bell, E.J.","year":"1983","unstructured":"Keighley, B.D. & Bell, E.J. Sporadic myalgic encephalomyelitis in a rural practice. J R Coil Gen Pract 1983, 33: 339-341.","journal-title":"J R Coil Gen Pract"},{"key":"ref_13","first-page":"11","article-title":"Coxsackie B viruses and the post viral syndrome - a prospective study in general practice","volume":"37","author":"Calder, B.D.; Warnock, P.J.; McCartney, R.A.; Bell, E.J.","year":"1987","unstructured":"Calder, B.D., Warnock, P.J., McCartney, R.A. & Bell, E.J. Coxsackie B viruses and the post viral syndrome - a prospective study in general practice. J R Coll Gen Pract 1987, 37: 11-14.","journal-title":"J R Coll Gen Pract"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1177\/003693308302800212","article-title":"Coxsackie B infection in a general medical unit","volume":"28","author":"Bell, E.J.; Irvine, K.G.; Gardiner, A.J.S.; Rodger, J.C.","year":"1983","unstructured":"Bell, E.J., Irvine, K.G., Gardiner, A.J.S. & Rodger, J.C. Coxsackie B infection in a general medical unit. Scott Med J 1983, 28: 157-159.","journal-title":"Scott Med J"},{"key":"ref_15","first-page":"804","article-title":"Chronic relapsing pericarditis and dilated cardiomyopathy: serological evidence of persistent enterovirus infection","volume":"i:","author":"Muir, P.; Tilzey, A.J.; English, T.A.H.; Nicholson, F.; Signy, M.; Banatvala, J.E.","year":"1989","unstructured":"Muir, P., Tilzey, A.J., English, T.A.H., Nicholson, F., Signy, M. & Banatvala, J.E. Chronic relapsing pericarditis and dilated cardiomyopathy: serological evidence of persistent enterovirus infection. Lancet 1989, i: 804-807.","journal-title":"Lancet"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1007\/978-1-4757-0247-7_9","article-title":"Host conditions affecting the course of Coxsackievirus infections","volume-title":"Coxsackieviruses. A General Update","author":"Loria, R.M.","year":"1988","unstructured":"Loria, R.M. Host conditions affecting the course of Coxsackievirus infections. In: Bendinelli, M. and Friedman, H. (eds). Coxsackieviruses. A General Update. Plenum Press, New York and London, 1988, pp. 135-157."},{"key":"ref_17","first-page":"1","article-title":"Epidemiological Research Laboratory PHLS - Viruses associated with neurological manifestations. Communicable Disease Report","volume":"48","year":"1976","unstructured":"Epidemiological Research Laboratory PHLS - Viruses associated with neurological manifestations. Communicable Disease Report, 1976: No. 48, page 1."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1136\/jnnp.53.3.247","article-title":"Sensory and cognitive event - related potentials in myalgic encephalomyelitis","volume":"53","author":"Prasher, D.; Smith, A.; Findley, L.","year":"1990","unstructured":"Prasher, D., Smith, A. & Findley, L. Sensory and cognitive event - related potentials in myalgic encephalomyelitis. J Neurol Neurosurg Psychiatry, 1990, 53: 247-253.","journal-title":"J Neurol Neurosurg Psychiatry"},{"issue":"6","key":"ref_19","first-page":"326","article-title":"Post viral fatigue syndrome; persistence of enterovirus RNA in muscle and elevated creatine kinase","volume":"1988","author":"Archard, L.C.; Bowles, N.E.; Behan, P.O.; Bell, E.J.; Doyle, D.","unstructured":"Archard, L.C., Bowles, N.E., Behan, P.O., Bell, E.J. & Doyle, D. Post viral fatigue syndrome; persistence of enterovirus RNA in muscle and elevated creatine kinase. J R Soc Med 1988, 6: 326-329.","journal-title":"J R Soc Med"},{"key":"ref_20","first-page":"1367","article-title":"Excessive intra cellular acidosis of skeletal muscle on exercise in a patient with post viral exhaustion\/fatigue syndrome","volume":"i:","author":"Arnold, D.L.; Radda, G.K.; Bore, P.J.; Styles, P.","year":"1984","unstructured":"Arnold, D.L., Radda, G.K., Bore, P.J. & Styles, P. Excessive intra cellular acidosis of skeletal muscle on exercise in a patient with post viral exhaustion\/fatigue syndrome. Lancet 1984, i: 1367-1369.","journal-title":"Lancet"},{"issue":"48","key":"ref_21","first-page":"691","article-title":"Electrophysiological studies in the post viral fatigue syndrome","volume":"1985","author":"Jamal, G.A.; Hansen, S.","unstructured":"Jamal, G.A. & Hansen, S. Electrophysiological studies in the post viral fatigue syndrome. J Neurol Neurosurg Psychiatry 1985, 48: 691-694.","journal-title":"J Neurol Neurosurg Psychiatry"},{"issue":"56","key":"ref_22","first-page":"651","article-title":"Coxsackie viruses readily establish persistent infections in human lymphoid cell lines","volume":"1985","author":"Matteucci, D.; Paglianti, F.; Giangregorio, A.M.; Capobianchi, M.R.; Dianzani, F.; Bendinelli, M.Group B.","unstructured":"Matteucci, D., Paglianti, F., Giangregorio, A.M., Capobianchi, M.R., Dianzani, F. & Bendinelli, M. Group B Coxsackie viruses readily establish persistent infections in human lymphoid cell lines. J Virol 1985, 56: 651-654.","journal-title":"J Virol"},{"issue":"9","key":"ref_23","first-page":"590","article-title":"Prolonged intra cerebral infection with polio virus in asymptomatic mice","volume":"1981","author":"Miller, J.R.","unstructured":"Miller, J.R. Prolonged intra cerebral infection with polio virus in asymptomatic mice. Ann Neurol 1981, 9: 590-596.","journal-title":"Ann Neurol"},{"key":"ref_24","article-title":"Coxsackie B viral infections in cardiac disease","volume-title":"Clinical Virology, ChurchillLivingstone","author":"Banatvala, J.E.","year":"1983","unstructured":"Banatvala, J.E. Coxsackie B viral infections in cardiac disease. In: Waterson, A.P. (ed.) Clinical Virology, ChurchillLivingstone, Edinburgh, London 1983."},{"key":"ref_25","first-page":"253","article-title":"Clinical and experimental correlates","volume-title":"Coxsackiesviruses. A General Update","author":"Reyes, M.P.; Lerner, A.M.Myocarditis","year":"1988","unstructured":"Reyes, M.P. & Lerner, A.M. Myocarditis. Clinical and experimental correlates. In: Bendinelli, M. and Friedman, H. (eds) Coxsackiesviruses. A General Update. Plenum Press, New York, London, 1988, pp. 253-270."},{"key":"ref_26","first-page":"9","article-title":"Myalgic encephalomyelitis - a consideration of treatment. The New Zealand Fwnily","volume":"16","author":"Vallings, R.","year":"1989","unstructured":"Vallings, R. Myalgic encephalomyelitis - a consideration of treatment. The New Zealand Fwnily Physician 1989, 16: 9-13.","journal-title":"Physician"},{"key":"ref_27","first-page":"678","article-title":"Use of WIN 51711 to prevent Echo virus type 9 induced paralysis in suckling mice","volume":"154","year":"1986","unstructured":"McKinlay, M.A., Frank, J.A. Jr., Benziger, D.P. & Steinberg, B.A. Use of WIN 51711 to prevent Echo virus type 9 induced paralysis in suckling mice. J Infect Dis 1986, 154: 678-681.","journal-title":"J Infect Dis"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/0195-6701(88)90051-5","article-title":"Human enteroviral infections","volume":"11","author":"Dowsett, E.G.","year":"1988","unstructured":"Dowsett, E.G. Human enteroviral infections. J Hosp Infect 1988, 11: 103-115.","journal-title":"J Hosp Infect"}],"container-title":["Postgraduate Medical Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/pmj\/article-pdf\/66\/777\/526\/50077516\/postgradmedj-66-526.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/pmj\/article-pdf\/66\/777\/526\/50077516\/postgradmedj-66-526.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,28]],"date-time":"2023-04-28T14:19:40Z","timestamp":1682691580000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/pmj\/article\/66\/777\/526\/7061518"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1990,7,1]]},"references-count":28,"journal-issue":{"issue":"777","published-online":{"date-parts":[[1990,7,1]]},"published-print":{"date-parts":[[1990,7,1]]}},"URL":"https:\/\/doi.org\/10.1136\/pgmj.66.777.526","relation":{},"ISSN":["0032-5473","1469-0756"],"issn-type":[{"value":"0032-5473","type":"print"},{"value":"1469-0756","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[1990,7]]},"published":{"date-parts":[[1990,7,1]]}}}