The American medical scene uses the term ‘chronic fatigue syndrome’ (CFS) instead of ‘myalgic encephalitis’ (ME) and some of their experts believe that if ME/CFS doesn’t significantly improve after a five-year duration the most prominent symptom changes from fatigue to muscle pain, the latter being the most prominent symptom of fibromalgia (FM).

A small Mater Dei team can easily be established to offer these patients an overdue service

However, the crucial point is not to waste time and energy on semantic and disease classification controversies, but for Malta’s health service to recognise that these are potentially seriously disabling diseases which require, not only de-tailed clinical and laboratory investigation, but also treatment.

Besides physical examination and investigations for other abnormalities, such as autoimmune disease, low thyroid function, eating disorders, food allergies, anaemia and chronic infections, special laboratory tests for immune system competence are required to diagnose ME/CFS.

The immune competence tests are carried out by very few specialised overseas laboratories. Furthermore, these patients need also to be tested for chronic Lyme disease – again, very few overseas specialised laboratories are capable of reliably carrying this out.

These patients may require repeated antibiotic treatment besides immune system boosting compounds and vitamin/food supplements. They may be very anxious about their disability and might require occasional anti-anxiety drugs, but they are not psychiatric cases and pharmaceutical anti-depressants should not be part of their treatment protocols.

With the right attitude, a small Mater Dei team (including a nutritional therapist) can easily be established to offer these patients an overdue service.