ME Epidemiology - prevalence and peak ages of onset

Two threads on ME epidemiology, prevalence and incidence rates have been merged, and posts on prevalence from the thread BBC: Isle of man government pledge to support ME patients by 2020 have also been moved here.

 

I might have to come back to this later - I think we have discussions about this on other threads. But the Norwegian study is doing an awful lot of the heavy lifting here. I'm pretty sure that there are other studies that have not found the 'twin peaks'.

For a start, look at that age range. Puberty, say 10 years, through to early 20s, say 22 or 23? Then another "peak" from 30s to early 40s. So, from 30 to 43? So is the suggestion that there is a gap of 7 years where onset is less common? Those are pretty broad peaks. The proposed situation is sounding more like a plateau with a bit of a valley in the late 20s to me.

I think there were issues with age and gender skews related to exposure in Norway attributed to outbreaks related to contaminated water. Also if the health system is much more likely to diagnose ME/CFS in a 19 year old woman who has had EBV and much less likely to diagnose ME/CFS in a 28 year man who has had Q fever, then rates will be incorrectly skewed by age and gender.

After the early 40s, people are more likely to attribute ME/CFS symptoms to 'getting old' or 'menopause'. Certainly their doctors will be much more likely to do that. Until we have a good biomarker, /I doubt that we will be able to get a good understanding of ME/CFS onset in older people.

We know that a substantial proportion of people developing persistent symptoms after a Covid-19 infection meet ME/CFS criteria. Therefore, and given they don't have any other obvious pathology explaining their symptoms, they have ME/CFS. The numbers are too high to suggest that these people all had ME/CFS before their Covid-19 infection, or they developed ME/CFS from some other trigger. I don't think the relationship is known with a lower degree of confidence than for EBV. Similary for SARS-1. I'll give you Ebola as an ME/CFS trigger that we have less evidence for, because people haven't really looked hard at it, but the symptoms that people are left with sound very much like ME/CFS to me.

 

Some posts have been moved to a new thread:
Question: what do you think is a reasonable time that passes between an infection and ME/CFS onset?

 

We have split off posts primarily about sex ratios to a new discussion thread dedicated to that topic:
ME/CFS Epidemiology - sex ratios, female predominance