The Epidemiology of Myalgic Encephalomyelitis (ME) in the UK (1919–1999)
Purpose: This document, compiled by Dr. E.G. Dowsett and Dr. J. Richardson, provides a comprehensive overview of Myalgic Encephalomyelitis (ME) in the UK from 1919 to 1999. It focuses on ME’s prevalence, historical significance, demographic trends, and associated occupational risks, advocating for epidemiological research to improve understanding and management.
Key Points:
- Prevalence and Demographics
- Estimated point prevalence of ME is around 300,000 in the UK, affecting young adults and peaking at puberty.
- Women are disproportionately affected during childbearing years, with severe cases showing a Female-to-Male ratio as high as 5:1.
- Historical Perspective
- ME was historically considered a milder form of poliomyelitis, with outbreaks reported worldwide from the early 1900s.
- Epidemics were linked to improved sanitation disrupting natural immunization by childhood infections, creating “diseases of affluence” in temperate climates.
- Clinical Features and Diagnosis
- ME is primarily a neurological illness classified by WHO as such (ICD-10).
- Symptoms include neuroendocrine dysfunction, autonomic disturbances, cognitive impairments, and musculoskeletal issues.
- Clinical differentiation from Chronic Fatigue Syndrome (CFS) is emphasized, supported by tests like brain imaging, autonomic function tests, and exercise analysis.
- Occupational Risks and Social Impact
- Professionals with frequent exposure to infections (e.g., teachers, healthcare workers) show higher incidence rates, aligning with Canadian data.
- Long-term sickness absence in schools reflects ME’s impact on education and employment.
- Geographic and Seasonal Trends
- ME cases peak in summer/autumn and are more prevalent in temperate regions.
- Ethnic minorities living in the UK show similar prevalence to the native population, supporting environmental rather than genetic causation.
- Impact and Progression
- ME is a chronic illness with a variable course, ranging from steady recovery to gradual decline.
- Around 25% of patients experience severe progression leading to significant disability; mortality is primarily linked to end-organ failure.
- Call for Epidemiological Studies
- Advocates for government-funded research to assess prevalence, identify risk factors, and develop diagnostic, therapeutic, and preventive measures.
- Suggests targeting institutions with high risk (e.g., schools, hospitals) for cost-effective identification of triggering infections.
Overall Outcome: The report underscores the urgent need for epidemiological studies to address ME’s rising prevalence, economic burden, and public health implications. It emphasizes the importance of accurate diagnosis, patient support, and research funding to improve management strategies.
Acknowledgments: Data compiled by Dr. E.G. Dowsett, Dr. J. Richardson, Ray Jenkins, and Chris Richards.