Atlanta - Evidence is mounting that Chronic Fatigue Syndrome, the so-called yuppie flu, is a physical illness, not a psychological one, despite the skepticism of some physicians.
The earmarks of a real disease include a drug to treat it, the identification of an agent that may cause it and a Centers for Disease Control study to determine how many people have the disease and what its impact is.
CDC officials in Atlanta asked doctors in four cities -- Atlanta; Reno, Nev.; Wichita, Kan.; and Grand Rapids, Mich. -- to direct them to patients who may have the exhausting, flulike disease that leaves patients aching and tired and robs them of the strength to do daily chores or concentrate. So far doctors have referred more than 500 patients to the agency, which has evaluated half of them. Some patients have been followed for as long as two years.
Among the CDC findings:
*27 percent of those evaluated met a CDC definition of the disease -- debilitating fatigue for at least six months that cuts in half a patient's ability to be active, and eight of 11 flu-like symptoms.
*Another 15 percent nearly met the definition.
*70 to 80 percent of all cases occur in women. The disease strikes all ages, including children as young as 8. Only four of the patients referred to the CDC were black.
Depression, thought by some doctors to be the actual problem, seems to be a reaction to the exhausting illness, not a cause -- 50 percent of patients don't show any psychological symptoms.
This may be important because doctors who thought the disease was psychologically based treated patients with anti-depressants. CDC investigators say anti-depressant therapy may still be useful in treating a response to the disease.
What remains virtually unknown is how someone gets the disease.
"We don't know if it's inherited, in food, water or if it's something you catch or spread," said Walter Gunn, principal investigator for the CDC study. "We know people are ill with something, but it may be more than one cause."
Also still largely undetermined is whether a virus is involved. Some recent studies suggest that something called a foamy virus -- virtually unheard of in humans but found in cats, cows, monkeys and hamsters -- may cause the illness.
Other researchers have linked retroviruses to chronic fatigue patients. Retroviruses are pieces of genetic material that slip themselves into a cell's genetic chain and direct its reproduction. The virus thought to cause AIDS is a retrovirus.
Evidence released this week adds to the probability of viral involvement. Researchers in Philadelphia found an anti-viral drug, Ampligen, helps relieve tiredness and memory loss in many chronic fatigue patients.
Researchers want to rename the illness, once called Epstein Barr Virus, because they say "chronic fatigue" belittles the severity of symptoms patients have. Dr. Gunn said one name under consideration is Chronic Immune Deficiency Syndrome.