Magazine article Clinical Psychiatry News

CDC Campaign Targets Chronic Fatigue Syndrome

Magazine article Clinical Psychiatry News

CDC Campaign Targets Chronic Fatigue Syndrome

Article excerpt

WASHINGTON -- Chronic fatigue syndrome has gained new stature as a public health concern with the launch by the Centers for Disease Control and Prevention of a national education campaign aimed at promoting diagnosis and treatment of the illness.

The CDC's message that more than 1 million Americans have CFS--and that more than 80% have not yet been diagnosed--means the campaign could have tens of thousands of patients seeking care for the prolonged fatigue and sleep difficulties, muscle and joint pain, problems with memory and concentration as well as other symptoms that characterize the long-controversial illness.

"Our strategy is to help patients know they require medical attention and to help clinicians be able to understand, diagnose, and help patients ... but most importantly, to be able to validate the disease and understand the incredible suffering," said Dr. Julie Gerberding, director of the CDC.

"We're committed to awareness that this is real," Dr. Gerberding said.

In addition to national print and broadcast advertising, the $4.5 million campaign--"Get Informed. Get Diagnosed. Get Help."--includes a brief guide and fact sheets for health care professionals, collectively called the "CFS Toolkit." These describe the diagnostic process and recommend management that consists largely of "individualized supportive and symptomatic treatment."

The campaign was developed in conjunction with the CFIDS (chronic fatigue and immune dysfunction syndrome) Association of America, an advocacy group that has worked with the CDC for several years on provider education efforts.

Dr. Nancy Klimas, professor of medicine at the University of Miami and director of the university's CFS research center, said that "every single physician (and physician assistant) in this country" should know the diagnostic criteria for CFS and the principles of medical management.

"There are effective treatments that do help patients right now," such as medication for pain and poor sleep, activity management, and coping strategies for fatigue, Dr. Klimas said. "It is possible to make a difference in patients' quality of life and function," she said.

The CDC's new toolkit gives physicians "permission to do (step-by-step) symptom management" rather than feeling as if they need to tackle it all and then being overwhelmed by time constraints and by the complexity of the illness and its unknowns, Dr. Klimas said.

The CDC's decision to launch the campaign--one of the first campaigns to be run by the agency's new National Center for Health Care Marketing--reflects the efforts of patient advocates, a growing cadre of investigators interested in CFS, and the fact that "the science has progressed," Dr. Gerberding said.

Dr. Anthony Komaroff, professor of medicine at Harvard Medical School, Boston, noted that more than 4,000 papers published in peer-reviewed publications have documented underlying biologic abnormalities in CFS.

Since 2000, the CDC's "CFS research group" has published about 80 peer-reviewed articles on the illness. Last spring, the group issued a series of articles suggesting that genetic factors related to the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system may influence the body's responses to stress, making certain people susceptible to CFS.

The studies were part of a larger, longitudinal study that formed the basis of the CDC's most recent prevalence estimates. The CDC reported a prevalence of CFS of 235/100,000 adults in Wichita, Kan., based on a telephone survey of one-quarter of the city's population and detailed clinical assessments of about 7,000 residents. About half of the residents identified as having CFS had consulted their physicians about the illness, and only 16% had received a diagnosis and treatment. …

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