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The epidemiology of chronic fatigue in San Francisco

  • Lea Steele
    Footnotes
    Affiliations
    Viral Exanthems and Herpesvirus Branch, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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  • James G Dobbins
    Affiliations
    Viral Exanthems and Herpesvirus Branch, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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  • Keiji Fukuda
    Affiliations
    Viral Exanthems and Herpesvirus Branch, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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  • Michele Reyes
    Affiliations
    Viral Exanthems and Herpesvirus Branch, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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  • Bonnie Randall
    Affiliations
    Abt Associates, Cambridge, Massachusetts, USA
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  • Michele Koppelman
    Affiliations
    Viral Exanthems and Herpesvirus Branch, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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  • William C Reeves
    Correspondence
    Requests for reprints should be addressed to William C. Reeves, MD, at MS A-15, US Centers for Disease Control and Prevention, Atlanta, Georgia 30333
    Affiliations
    Viral Exanthems and Herpesvirus Branch, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA

    Abt Associates, Cambridge, Massachusetts, USA
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  • Author Footnotes
    1 Communications regarding manuscript should be addressed to Lea Steele, PhD, Kansas Commission on Veterans’ Affairs, 700 SW Jackson, Suite 701, Topeka, Kansas 66603

      Abstract

      Despite considerable research on chronic fatigue syndrome (CFS) and conditions associated with unexplained chronic fatigue (CF), little is known about their prevalence and demographic distribution in the population. The present study describes the epidemiology and characteristics of self-reported CF and related conditions in a diverse urban community. The study used a cross-sectional telephone screening survey of households in San Francisco, followed by interviews with fatigued and nonfatigued residents. Respondents who appeared to meet case definition criteria for CFS, based on self-reported fatigue characteristics, symptoms, and medical history, were classified as CFS-like cases. Subjects who reported idiopathic chronic fatigue (ICF) that did not meet CFS criteria were classified as ICF-like cases. Screening interviews were completed for 8,004 households, providing fatigue and demographic information for 16,970 residents. Unexplained CF was extremely rare among household residents <18 years of age, but was reported by 2% of adult respondents. A total of 33 adults (0.2% of the study population) were classified as CFS-like cases and 259 (1.8%) as ICF-like cases. Neither condition clustered within households. CFS- and ICF-like illnesses were most prevalent among women and persons with annual household incomes below $40,000, and least prevalent among Asians. The prevalence of CFS-like illness was elevated among African Americans, Native Americans, and persons engaged in clerical occupations. Although CFS-like cases were more severely ill than those with ICF-like illness, a similar symptom pattern was observed in both groups. In conclusion, conditions associated with unexplained CF occur in all sociodemographic groups but appear to be most prevalent among women, persons with lower income, and some racial minorities.
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