Chronic fatigue a major worry in China

Symptoms of chronic fatigue syndrome include impaired cognitive ability and the feeling of exhaustion after minimal physical or mental exertion. (Photo: GT/Li Hao)

For the past year, Bai Mei (pseudonym), 33, has been crippled by debilitating exhaustion that no amount of rest seems to be able to alleviate.

"I always feel so tired, and my head and throat ache from time to time," said Bai. "At the end of last year, I couldn't even sit at my desk to work for more than two hours at a time."

Bai started feeling constantly tired about a year ago, six months after starting a new job as the marketing manager at an automobile company in Beijing. The hours were demanding at her new company, and she had to work until 11 pm almost every night.

Last December, Bai checked herself into hospital. The doctor discovered no signs of common medical conditions that could lead to the incapacitating tiredness she was feeling, such as anemia or diabetes, and eventually diagnosed her with chronic fatigue syndrome (CFS).

The diagnosis of CFS has been controversial for many years, as there has been little consensus in the medical community as to how it is caused, how it should be diagnosed and treated, whether it is primarily a physiological or a psychosocial illness, or whether it actually exists.

Earlier this month however, a panel from the Institute of Medicine, an influential independent government advisory body in the US, published a report that strongly stated CFS "is real." The report provided a simplified diagnostic criteria: "total exhaustion" after minimal physical or mental exertion; "profound fatigue" lasting six months or more; "unrefreshing" sleep; and "brain fog," describing impaired cognitive ability due to fatigue.

The institute also proposed a new name for the condition - systemic exertion intolerance disease (SEID), on the basis that it better reflected what patients, clinicians and researchers agree is the core symptom of the illness: a sustained depletion of energy following minimal activity.

A tricky disease

Dr. Gilbert Shia, a general practitioner at Beijing international health clinic MedicGo, said that SEID was a serious condition that could leave sufferers incapable of going to work, as well as affecting other areas of their life.

According to an article published in the US medical journal Arch Intern Med in 2004, more than 50 percent of patients who suffer from SEID are unable to work and nearly two-thirds are limited in their capacity to work.

Because of the tendency for SEID to go undiagnosed, the prevalence of the illness is difficult to determine.

An NPR report estimated that between 860,000 and 2.5 million Americans were affected by SEID, and Shia, who previously practiced medicine [for more than a decade] in the UK, said that he believed its prevalence there to be around one in 300.

According to a Shenyang Evening News report this month, the prevalence of SEID in China could be considerably higher.

A study conducted by China Association of Health Promotion and Education looking at 10 cities in China, including Beijing and Shanghai, estimated that between 10 and 25 percent of the population could suffer from SEID.

Although the causes for SEID remain unknown, Shia said that its onset was usually accompanied by a "flu-like illness or other viral illness" and most often came about after a prolonged period of severe stress.

"Patients with SEID suffer especially from post-exertion malaise, that is, when even minimal physical and mental activities bring extreme and prolonged exhaustion," Shia said.

"Most importantly, SEID patients' fatigue cannot be substantially relieved by rest."

The "brain fog" described by the diagnostic criteria, said Shia, referred to impaired memory or concentration. Under the previous definition of SEID, he said, other symptoms could include joint and muscle pain, headaches, sore throat, stomach pain, diarrhea, constipation and nausea.

"Some patients also say they have a lack of appetite," said Shia.