A sore throat is the primary symptom of pharyngitis — inflammation of the throat (pharynx). But the terms “sore throat” and “pharyngitis” are often used interchangeably. The most common cause of a sore throat is a viral infection, such as a cold or the flu.
Sore throats can be either acute or chronic. Acute sore throats are more common but chronic sore throats can cause long term problem, should not be taken lightly and ignored.
Do you have a chronic sore throat infection and/or a constantly congested nose/sinuses that persist for many months or years, as well as anxiety, depression, loss of desires,emotional flatness and/or fatigue symptoms? There is an infectious respiratory virus in circulation which causes these and many other symptoms. There are some detailed references to personal experience in this article to give helpful insights to the readers.
- 1 Chronic Sore Throat
- 2 Summary of Chronic Sore Throat Symptoms
- 2.1 – COGNITIVE SYMPTOMS –
- 2.2 – MOOD SYMPTOMS –
- 2.3 – NEUROLOGICAL SYMPTOMS –
- 2.4 – RESPIRATORY AND ORAL SYMPTOMS –
- 2.5 – GASTROINTESTINAL SYMPTOMS –
- 2.6 – SKIN SYMPTOMS –
- 2.7 – HEART AND CIRCULATION SYMPTOMS –
- 2.8 – MUSCLE AND JOINT SYMPTOMS –
- 2.9 – MISCELLANEOUS SYMPTOMS –
- 2.10 Diagnosis of the Diseases Precipitated by the Virus
- 2.11 Chronic Fatigue Syndrome
- 2.12 Peripheral Neuropathy
- 2.13 Polymyositis or Dermatomyositis
- 2.14 Generalized Anxiety Disorder
- 2.15 Anhedonic Depression
- 2.16 Enterovirus Testing
- 2.17 Recommended By Readers
Chronic Sore Throat
The main symptoms precipitated by this virus are as follows (you may not have all of them):
Early Symptoms (first few weeks of infection)
• Chronic sore throat (pharyngitis) that never fully heals (but many don’t get this).
• Constantly congested nose/sinuses/post-nasal drip with unusually thick mucus.
Additional Symptoms (appear after a few months)
• Depression and low mood.
• Generalized anxiety disorder with very severe anxiety states (even bordering on psychosis).
• Psychological changes and cognition disruptions.
• Loss of desires and sense of pleasure (anhedonia); loss of libido.
• Social withdrawal – escaping social activities more and more.
• Loss of drive and motivation.
• Memory problems both short-term and long-term recall.
• Unusual sleepiness and a tendency to fall asleep more.
• Chronic fatigue – a notable loss of energy.
• Stomach aches and pains with stomach and bowel rumbling, and excessive gas.
• Pins and needles (paresthesias), especially in the legs.
• Receding gums — a sudden onset of periodontitis, with brown plaque appearing on teeth.
Later Symptoms (appear at approximately 12 to 18 months)
• Slight wrinkling of the skin with unusual, fine-textured crêpe paper-like wrinkles.
• Weak legs and hips: legs and pelvic girdle feel slack.
• Weight gain, mainly on the belly (abdominal fat).
• Subtle loss of hearing acuity, making you slower in identifying environmental sounds.
• Progressive sensorineural hearing loss in the elderly.
• Emotional frailty, emotional lability, emotional flatness; irritability.
• Less frequently: tinnitus; blurred vision; occasional transient joint pains (arthralgia).
Other Possible Sequelae
• Pericarditis, myocarditis and sudden heart attack in the previously healthy.
• Viral meningitis (can appear months after the initial infection).
Observation of multiple infectees indicates that this chronic sore throat virus has an unusually rapid incubation period: from the moment in time you first catch this virus (often picked up when kissing an infected person), it takes just 12 hours roughly for the initial sore throat or gastrointestinal symptoms to manifest.
Once caught, this viral infection does not seem to resolve, but remains as a persistent ongoing infection, and infected individuals seem to remain contagious for a long time (they can be infecting others even years later). It has been observed that this chronic sore throat virus gradually transmits from person-to-person through normal household contact, and once one person in a household contracts this virus, most other household members will catch it from them within a year or so. Several years after I caught this virus, it had slowly spread to more than 30 friends and family, and many of the above listed symptoms manifested to varying degrees in these 30+ people. The more severe symptoms listed above only appeared in around 10% of the infected people, but the majority of people contracting this chronic sore throat virus just manifested much milder symptoms (as described here).
We will see below that this “chronic sore throat virus” is most probably an enterovirus of some type, such as a coxsackievirus B.
Here is my account of how I caught this chronic sore throat virus, and how it gradually began infecting my whole body.
This infection began with a bad sore throat that I caught. Being in excellent physical shape at that time, I thought nothing of it. I had no rash on my body, though the back of my throat and the rear arch of my soft palette were red and inflamed (see image), looking a bit like a herpangina sore throat, but without pain, and without the blisters and ulcers that normally accompany herpangina. I paid little attention to it. Several weeks later, however, I noticed that my sore throat had not cleared up, and instead, the infection started spreading. This was strange, because I was very healthy at that point, HIV negative, with no previous medical problems, usually fighting off colds and infections very quickly. Yet this sore throat would not go away.
Within a month, this chronic sore throat virus had spread to my nose, which started producing unusually thick and heavy mucus. My nose and sinuses thus became blocked and stuffy, needing to be regularly cleared of this thick mucus every hour or two. (This thick nasal mucus congestion is now a permanent symptom). A constant stuffy nose like this can be classified as chronic sinusitis, chronic rhinitis, post-nasal drip, or rhinorrhea.
Then my lungs became infected, leading to a mild chest infection and a dry cough. Soon after this, the virus reached my stomach, which started aching a little and producing gas and bubbling sounds, which created some belching. My rumbling, aching stomach became a chronic – but thankfully intermittent – symptom. The virus also spread to my intestines, where it produced odorless intestinal gas (odorless flatulence), bowel rumbles and bowel bloating (now all permanent symptoms).
After another month, this viral infection manifested a distinct new phase: intense mental state changes suddenly appeared. These disturbing psychological symptoms started with a feeling of being very tense, anxious and uncomfortable, especially in company (even with friends and family). I also became very weak mentally: my strength of mind disintegrated, and in particular, I became very frail and feeble emotionally, as if I’d lost my emotional backbone. Being with other people seemed to further perturb my mind, and so it became quite unpleasant to socialize.
As a result of these psychological changes, I started avoiding social contact more and more, just because I found it a mental strain to be with people. Avoiding company made me lonely, yet being with people caused severe tension. This extreme anxiety made it impossible for me to continue working, so I left my job.
Additionally, just reading or listening to facts and ideas created strong tensions in my mind, as I tried to process the information. So it seemed I could not cope with structured information very well either, even from a book, television or radio. This is more or less psychosis. As a coping strategy, I limited my time with people and information to help reduce this unpleasant mental tension.
Then I quickly became very apathetic. The apathy was towards all sorts of tasks and activities. My normal pro-active ‘can do’ attitude was replaced by a ‘not interested’ feeling – totally out of character. I am normally a motivated, enthusiastic and highly organized person. However, as this infection and its psychological effects progressed, I began to lose interest in the usual pleasures of life (a condition called anhedonia), including pleasure from sex. There was also a large loss of libido (loss of the desire for sex). Furthermore, much of my enthusiasm, drive and motivation just evaporated away.
I also began to experience some short-term memory difficulties, and inability to concentrate which caused problems in my day-to-day activities. There was some intelligence loss, particularly in my verbal, spelling and grammatical skills, and I found it a lot harder to recall words, names and other information from my long-term memory. Thus I found myself becoming less articulate, often mispronouncing words, and forgetting names.
Additionally, my physical body movements started getting a little more clumsy; I seemed to become physically less coordinated.
To sum up, psychologically, I became: anxious, depressed, avoiding social contact, unmotivated, emotionally delicate, confused, forgetful, clumsy, uncoordinated, with a dulled intellect, decreased verbal intelligence, and an impaired memory.
My virus also spread to friends and family (and then later to their friends and families), but quite slowly. For example, I would infect someone new only every month or two (just by normal household and social contact). That newly infected person would initially come down with the same herpangina-like sore throat symptom, and/or a gastrointestinal upset (gastroenteritis). Then in most cases, they would progress to similar long-term physical and mental symptoms, though usually much milder than mine. In fact only around 1 in every 10 individuals seem get the more severe long-term symptoms from this virus. In certain people (but not in my case) infection with this virus caused uncharacteristic and irrational outbursts of sustained aggression to appear a few weeks after catching it. For most people catching this virus, there seems to be a delay of a few weeks to a month before the first psychological and cognitive mental symptoms begin to manifest.
(As an aside, these psychological symptoms make me wonder whether a virulent virus such as this one may be responsible for the apparent worldwide rise in autism, since its psychological manifestations are not dissimilar to this condition. Certainly a lot of previously normal people who caught this virus have reported that their “mind is definitely not functioning right”. And when this virus hits a whole family, as a result of the mental changes it induces, family members can become a little more emotionally distant from each other, with family relations in general turning to a functional pragmatism. Some people with this virus start to avoid social contact a little, becoming less interested in other people. I noticed within my own mind that I lost the pleasure that normally arises from seeing friends, and from making new friendships. I think this loss of the ability to take pleasure in company is one reason this virus makes socializing less appealing. And a second reason is the huge stress and mental tension this virus can cause, so you find you cannot relax in company.)
The next symptoms I experienced were more and more fatigue and sleepiness (hypersomnia). I seemed to fall asleep all the time, even when I was not that tired. Perhaps this virus affects an area of the brain that regulates sleep (such as the hypothalamus). As this sleepiness and fatigue progressed, wondered if this virus was beginning to precipitate chronic fatigue syndrome. A largeloss of appetite appeared at this point also.
Four months after first catching this virus, a pins and needles or skin crawling sensation began to appear, first in my legs, but soon spreading across my entire body. There were constant sharp prickling sensations everywhere, which felt like they were located just beneath my skin. The severity of this prickling sensation varied from one day to the next. These type of sensations are calledparesthesias. Also at this stage, I noticed the onset of a very mild loss of sensation and tactile sensitivity in the skin throughout my body.
The next symptom to arise was a severe loss of smell (a condition known as anosmia). During some weeks my sense of smell would return a bit, but then the next week it would more or less disappear again. (It continued in these up-and-down cycles for two years. However, after several years, my olfactory capabilities have slowly improved, but have still not returned to anywhere near their original form.)
My oral health was then affected: my gums, previously extremely healthy and pink, began receding quite noticeably. Lots of brown plaque was suddenly deposited on my previously perfectly white teeth. No matter how much I brushed it away, the plaque still came back. Along with this increased plaque formation, and in spite of frequent tooth brushing, new dental caries (tooth decay/cavities) suddenly appeared. Previous to this, my oral health was excellent. Therefore, it seems I developed periodontitis (receding gums) from this virus within a matter of months.
This gum disease may be a manifestation of the immune-weakening effect this virus creates in the body, allowing bacteria to thrive and colonize the oral region. In addition, gum tissue can be directly attacked by connective tissue-dissolving enzymes created in viral infections (enzymes such as MMP-9).
Next, I noticed my vision began to deteriorate. So I had my eyes tested; nothing appeared to be wrong with my eyes or my ophthalmic prescription. My vision seemed “smudged”, rather than optically blurred. For example, looking at black text on a white page or computer screen, the letters are focussed, yet are slightly “smudged” on the white background.
About 12 to 18 months after first catching this virus, more strange symptoms manifested: a fine, crêpe paper-like wrinkling of the skin began appearing all over my body. This fine wrinkled skin tends to first appear on the tops of the hands. The skin also shows a slight red, blotchy quality beneath its surface (but this is barely noticeable). I am guessing that this wrinkling is the result of collagen or elastin loss or damage under the skin, caused by the viral infection (again, probably due to connective tissue-dissolving enzymes).
This crêpey wrinkling is certainly not normal skin aging; its appearance is distinct from normal aging, and moreover, it manifests very quickly, within a year or two. However, the strange skin wrinkling caused by this virus is usually only noticeable in people older than 30 or so; younger people don’t seem to get it. And even for people 30 to 60 say, this crêpe paper-like wrinkling is only slight. In those older than around 60, though, this virally-induced skin wrinkling manifests more significantly, and in addition, in the more elderly the skin also becomes loose and sagging. Searching through known dermatological conditions, the closest fit to my skin’s appearance is found in a disease called mid-dermal elastolysis.
Another symptom that manifested at this 12 to 18 month stage was weak legs and a weak pelvic girdle. My pelvis-to-leg joints feel a little spongy and lacking in normal firmness. I suspect that the virus may be damaging the connective tissue in the ligaments of my pelvis, thus weakening the ligaments, and/or causing neuromuscular damage to the pelvic muscles. The result is a slightly less than sure walking gait, and a bit of a shuffling gait. This leg weakness and pelvic laxity is constant: it does not vary hour to hour, nor day to day. There is no loss of strength or spasm in the muscles either (except occasional cramps in my calf muscles). As we will see below, this weak legs symptom may a manifestation of some mild polymyositis. Differential diagnosis: in generalized anxiety disorder (GAD), weak legs are a common symptom, but a variable one. In GAD the legs are fine one minute, and the next they suddenly get weak and can almost give way, due to nervous system fluctuations. But my case is not like GAD: my leg weakness is constant, never varied. And not that weak.
Beginning at the 18 month stage, weight gain appears, mainly in the belly area. This abdominal fat can appear even in people who were previously athletically lean and muscular. Note that the abdominal fat build-up can be caused by reduced growth hormone output, and/or the development of resistance to the hormones insulin or leptin (leptin resistance often arises in conditions of chronic inflammation).
After 2 or 3 years with this virus, further skin symptoms appear. In a V-shaped area on the upper chest just under the neck (the precise area exposed when wearing a V-neck jumper) the skin becomes a red/pink in color, and the skin texture in this area gets quite thick and oily/waxy. The color of this upper chest rash is that of a heliotrope rash. In addition, seborrheic keratosis(seborrheic warts) may appear on the skin: these are benign brown spots looking similar to moles; see this picture I took of one the seborrheic keratosis spots that appeared on my skin.
This virus generally appears to cause slight immune system weakening, and this can result in opportunistic infections arising, for example: fungal skin infections, urinary tract infections, ear infections, tooth infections with toothache, etc (all requiring antibiotics or antimicrobials to clear). The highest immunosuppression seems to occur in the first few years of infection with this virus; but after that, these opportunistic infections abate.
Several sudden heart attacks occurred in my group of 30+ friends and family soon after they were infected with this virus, one of which was fatal. All of these heart attacks happened in people who were previously healthy, with no prior heart conditions. One individual who caught this virus not only had a heart attack, but soon after also developed myocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the heart sac) lasting for many months. I myself experienced an episode of aseptic meningitis a couple of years after catching this virus, which I think was most likely caused by this virus. We will explain below why this virus is most likely an enterovirus of some type, such as a coxsackievirus B. Coxsackievirus B is very commonly associated with heart attacks, myocarditis and aseptic meningitis (enteroviruses such as coxsackievirus B cause 85% of all viral meningitis cases).
As with many respiratory infections, once one person catches this virus, it will spread to most other members of their household. However, this happens slowly: it takes a year or more before everyone in the household catches this virus. So clearly the contagiousness of this virus is relatively low. Nevertheless, in time, most of the household will have it, and will typically display either a chronically-congested nose/sinuses with thick viscous mucus (arises in around two-thirds of people), and/or a chronic sore throat (arises in one-third of people), plus some of the psychological symptoms such as more fatigue, slight loss of short-term memory, slight social withdrawal, and slight loss of motivation. Generally, once an individual catches this virus, they are not quite themselves anymore. However, there is a range of individual responses to this virus: about 10% of people contracting this virus experience very disturbing and distressing mental symptoms and personality changes; the rest are more lucky, and their mental symptoms are much milder.
Myself and my friends and family who were infected have had this virus for around a decade now, and judging by the permanence of the symptoms it causes, it is apparent that this viral infection is not cleared from the body and remains as a chronic low-level infection.
Summary of viral characteristics: this virus is a systemic, respiratory, gastrointestinal and neurological virus, which remains chronically in the body as a persistent infection, and can cause gastroenteritis, herpangina, chronic sore throat, a constantly congested nose/sinuses, heart attacks, heart inflammation, pelvic and leg muscle weakening, skin wrinkling, increased fatigue or chronic fatigue syndrome, and seems to have the ability to enter or affect the central nervous system, causing powerful and permanent mental state alterations such as mild memory problems, anhedonia, severe generalized anxiety disorder, and depression. The virus has a very fast incubation period of around about 12 hours. This rapid incubation has been reliably observed in several people when they initially caught this virus.
Summary of Chronic Sore Throat Symptoms
The following list of symptoms cover all the symptoms that were observed in myself and others as a result of this viral infection. Generally, I have only listed symptoms when at least two (and preferably more) people infected with this virus have manifested them — this is just to try to avoid the possibility of listing any co-incidental symptoms appearing in the infected people that were not in fact caused by this virus.
– COGNITIVE SYMPTOMS –
Cognitive decline — reduced attention, concentration and consciousness.
Short term memory problems and increased forgetfulness.
“Tip-of-the-tongue” phenomenon — the inability to retrieve a word or name from memory during conversation.
Forgetting words and losing some of your vocabulary; more difficulty in spelling words.
Aversions to the smell and taste of certain foods (eg, meat) which were previously enjoyed.
Sound sensitivity (hyperacusis) may appear after a few years with this virus (finding it harder to cope with environmental sounds and noises).
A dislike of hectic environments, loud music, and overwhelming social ambiances may appear in some people after a few years with this virus.
– MOOD SYMPTOMS –
Depression and low mood.
Anhedonia — anhedonia is the loss of interest in things once found enjoyable, due to the brain finding life’s activities less rewarding and pleasurable.
Loss of libido — a loss of interest in and desire for sex.
Loss of drive and motivation.
Emotional frailty — emotions seem weak and fragile.
Emotional flatness/numbness — the brain’s emotional circuitry seems to get hit after a year or two with this virus, such that emotional responses become numbed (blunted affect).
Social withdrawal — some people may tend to shy away from social activities.
Generalized anxiety disorder with very severe anxiety states (even bordering on psychosis).
– NEUROLOGICAL SYMPTOMS –
Progressive sensorineural hearing loss in elderly people (loss of the ability to hear low frequency sounds, typically in the range 125 Hz to 1000 Hz).
Subtle loss of hearing acuity is noticed in younger people, meaning that it becomes a little more difficult to identify environmental sounds, and interestingly, more difficult to sense their exact spatial location.
Tinnitus — high pitched sounds in the ears.
– RESPIRATORY AND ORAL SYMPTOMS –
Herpangina-like sore throat (during prodrome) where there are papules, but no blisters or ulcers.
Chronic sore throat that never fully goes away even after many years (appears in around ⅓ of people with this virus).
Constantly congested nose/sinuses/post-nasal drip with unusually thick mucus (appears in around ⅔ of people with this virus).
Dry mouth (Sjögren’s syndrome?).
Receding gums — a sudden onset of periodontitis, with brown plaque appearing on teeth.
Chronic white coating on tongue that never goes away (called geographic tongue or migratory glossitis).
Linea alba — a horizontal white line on the inside of the cheeks, one on each side of the mouth, level with where the teeth meet.
– GASTROINTESTINAL SYMPTOMS –
Gastroenteritis (can appear for one day during prodrome).
Bowel rumbles and bowel bloating — often a chronic symptom.
Flatulence — mild but chronic flatulence (which is odorless) and bowel rumbling.
Stomach rumbling and excessive stomach gas leading to belching.
– SKIN SYMPTOMS –
Wrinkling of the skin all over the body, with unusual, fine-textured crêpe paper-like wrinkles.
Pins and needles (paresthesias) especially in the legs, but often body-wide.
Slight numbness of the skin and loss of tactile sensitivity of the skin.
Red heliotrope rash and waxy-textured skin on the chest just below the neck.
Cherry angiomas (tiny cherry red pimples on the skin) may appear after a few years
Seborrheic keratosis (seborrheic warts) spots may appear on the skin after a few years with this virus: these are brown spots that look similar to skin moles. Here is one of my seborrheic keratosis spots (diagnosed by a dermatologist).
Slow healing wounds – small cuts may heal very slowly.
– HEART AND CIRCULATION SYMPTOMS –
Myocarditis, pericarditis, and sudden heart attack in the previously healthy.
Cold hands and feet and sometimes nose (Raynaud’s syndrome) — this common symptom tends to appear a few years after the initial infection.
– MUSCLE AND JOINT SYMPTOMS –
Weak legs and hips — the legs and pelvic girdle feel a little weak and slack.
Muscle cramps, especially in the calf muscles.
– MISCELLANEOUS SYMPTOMS –
Increased hair loss (alopecia).
Viral headache lasting for several days (can appear during prodrome).
Viral meningitis causing non-trivial and permanent changes in mental function.
Glaucoma: it was observed that 10% of people developed glaucoma after about 5 years or so with this virus. (I noted that 3 out 30 people who caught this virus developed glaucoma 5 years or so later; all 3 of these people were over 40 years in age). In the US, the normal prevalence of glaucoma in the over 40s is about 2%.
Weight gain often appears in the belly area (abdominal fat).
Chronic fatigue – a notable loss of energy.
Unusual sleepiness (hypersomnia) and a tendency to fall asleep more.
Immunosuppressive — during the first two or three years with this viral infection, other opportunistic infections may arise due to weakened immunity.
Chronic systemic inflammation (requiring prolonged corticosteroids to control in one severe case).
Certain individuals who are more severely affected by this virus can experience intense suicidal thoughts (suicidal ideation) every moment of every day, for several years, as if suicide is the only option that makes sense. These constant and harrowing suicidal thoughts are, I guess, a result of the high levels of anhedonia (complete loss of the capacity for joy and pleasure) and mental chaos induced by this virus. However even knowing that this suicidal mind state is caused by the virus does not help mitigate its piercing intensity. And although most people do not necessarily act on their suicidal ideations, the unrelenting presence of these thoughts shows just how profoundly this virus can disturb the normal brain chemistry of some individuals it infects.
I found that taking SSRI antidepressant drugs (such as citalopram, escitalopram, fluoxetine, paroxetine, sertraline) greatly increases the intensity of these suicidal thoughts, within hours of first taking these drugs; so if you think you may have this virus, be very wary if you try SSRI antidepressants. Conversely, I found the tricyclic antidepressant drug imipramine quite helpful for both my anhedonia and depression; but I found that an even better antidepressant is very low dose low doses of the drug amisulpride. At very low doses, amisulpride acts as an antidepressant (for dysthymia), 1 and very low amisulpride has also been shown useful for treating chronic fatigue syndrome. 1
None of the 10 or so medical professionals I saw were able to identify this disease or the pathogen causing it, but one infectious disease expert I communicated with, Dr John Chia, said that, based on its symptoms, the pathogen I caught is very likely an enterovirus of some type, such as a coxsackievirus B.
Certainly this infectious pathogen is likely to be a virus (rather than a bacterium, fungus or protozoan), as three separate bacterial throat swab cultures my doctors conducted (one at a university hospital infectious disease center), showed negative results. Furthermore, stronger evidence that my pathogen is viral comes from its unusually rapid incubation period of around 12 hours; few bacteria can incubate this fast, and the bacterial species than can are easily detectable in a bacterial culture. Thus analysis of the incubation period suggests we are almost certainly dealing with a virus.
Should any readers have the same symptoms themselves and wish to share their experience and circumstances, please leave a comment. One purpose of this web site is to find people in a similar situation, and to share information and experiences. When posting a comment, you may want to make up an online name for yourself for anonymity purposes. No registration is required to post a comment, but filling out the email address field is a good idea, as when new information or treatments for this virus are found, I will send out details via email.
Note: there are many causes of chronic sore throat; so your chronic sore throat is unlikely to be caused by this virus, unless you have very similar symptoms. So for anyone with a sore throat for a few days: don’t panic, it is probably not this virus.
You may wish to go to the Treatments page, to see which supplements and drugs have proven beneficial in treating the symptoms of this virus. If you are suffering from the hellish constant anxiety symptoms that this virus seems to induce in certain people, the anti-anxiety treatments detailed on the Treatments page have proved highly effective in treating these symptoms.
If you are experiencing persistent fatigue, sensitivity to sounds, and “brain fog” after catching this virus, then you may have developed chronic fatigue syndrome (ME/CFS) as a result of this virus, a condition which is detailed on the ME/CFS Info page.
Note on Gastroesophageal Reflux Disease (GERD) / Acid Reflux: A Wastebasket Diagnosis
Did the ENT specialist tell you your persistent sore throat is due to acid reflux (GERD)? Acid reflux appears to be a bit of a wastebasket diagnosis, which may be given by default when the ENT doctor cannot find the cause for a sore throat. So take any diagnosis of acid reflux with a pinch of salt.
Diagnosis of the Diseases Precipitated by the Virus
In this section, by examining the symptoms produced by this virus, we will attempt to diagnose the multiple diseases that this virus has precipitated in me, and in other people who caught this virus.
We will see below that the most likely diagnosis for the main illness that I have developed from this virus is chronic fatigue syndrome (CFS), which is also called myalgic encephalomyelitis (ME), and often denoted as ME/CFS. However this virus also precipitated several other diseases and conditions, including what I suspect may be: peripheral neuropathy, mild polymyositis, generalized anxiety disorder and anhedonic depression. We now take a look at these various diseases and conditions individually.
Chronic Fatigue Syndrome
This virus seems to have precipitated chronic fatigue syndrome in me. The symptoms of ME/CFS are the following: persistent fatigue, cognitive dysfunction, aka: “brain fog” (which is short-term/working memory deficits, problems recalling words or names, disorientation, loss of focus and awareness), mood disorders (motional lability, depression, irritability, anxiety, panic attacks), post-extertional malaise (symptoms profoundly worsen for several days after physical and/or mental exercise), new types of headache, tinnitus, dizziness, balance problems, fainting, irregular heartbeat, abdominal pain, irritable bowel, diarrhea, unrefreshing sleep, chronic sore throat or recurring sore throat, chronic cough, chest pain, dry mouth, dry eyes, blurred vision, sensitivities to light, noise and chaotic or busy environments, sensitivity to heat and/or cold, increased allergies or sensitivities to foods, alcohol, odors, chemicals or medications, muscle aches/weakness, tingling sensations, enlarged/painful lymph nodes in neck/armpits, joint pain moving from one joint to another without swelling or redness. I have pretty much all these symptoms, thus it does seem that I have developed ME/CFS from this virus.
This virus also seems to cause some mild (but permanent) chronic fatigue syndrome symptoms in most people who catch it. That is to say, many infectees complain of symptoms like: mildly increased fatigue, mild short-term/working memory deficits and problems recalling words or names (word recall problems is a very common symptom), increased sensitivities to environmental sounds and noise. All of these symptoms are relatively mild, but they do fit into the general pattern of a very mild, subclinical chronic fatigue syndrome (“ME/CFS-lite” you might call it). This demonstrates that enteroviruses such as the one described by this website can cause very mild ME/CFS symptoms in pretty much everyone who contracts them.
To read more about the symptoms, diagnosis and treatments of chronic fatigue syndrome, see the ME/CFS Info page.
Many of the symptoms caused by this virus resemble peripheral neuropathy. Peripheral neuropathy is a disorder in which the body’s peripheral nervous system sustains damage. Symptoms of peripheral neuropathy may include: muscle weakness, muscle twitching, muscle cramps, walking gait abnormalities, blurred vision, slow processing of visual information (you see things with your eyes, but not with your brain), hearing loss, tinnitus, balance and coordination problems, dizziness or fainting, loss of smell, dry mouth, unusual sweating or inability to sweat normally (which may lead to heat intolerance), paresthesias, skin numbness, slow wound healing, bladder control changes, dysautonomia (autonomic dysfunction), cold hands and feet, and sometimes nose (Raynaud’s syndrome) due to reduced blood flow to the the extremities, abnormalities in blood pressure or heart rate, postural orthostatic tachycardia syndrome (which is where you get a substantial increase in heart rate when suddenly moving from a seated to a standing position), and impotence in men (erectile dysfunction). The symptoms listed in this paragraph are those typically found in peripheral neuropathy; the symptoms highlighted in bold are the ones I experienced myself as result of this viral infection. Thus it would seem that this virus might cause peripheral neuropathy.
It is interesting that an epidemic of neuropathy in Cuba in 1991 to 1993 was triggered by a virus that was found to be antigenic ally related to coxsackievirus A9 and coxsackievirus B4. 1
Polymyositis or Dermatomyositis
This virus seems to have caused mild muscle weakness in the pelvic girdle and the upper legs (thighs) of several people including myself. The muscles in this area are known as the lower proximal muscles (the proximal muscles are those in the central portion of the body, the zone from shoulders to thighs). Now proximal muscle weakness is a characteristic of the diseases polymyositis and dermatomyositis, and these two chronic inflammatory myopathy diseases have been linked to group B coxsackieviruses 1 (as well as parvovirus B19 infections, HIV and HTLV-I). Polymyositis and dermatomyositis generally affect the thighs and hips to begin with, but then progress to all the proximal muscles. However, those infected with this virus who developed this mild lower proximal muscle weakness have not had any further disease progression over the years, so if this is polymyositis or dermatomyositis, it is certainly a mild, benign and non-progressing form of this disease.
Dermatomyositis is characterized not only by proximal muscle weakness, but also by a heliotrope rash on the upper chest area just under the neck, corresponding to the area exposed in a V-neck jumper (the so-called V-sign of dermatomyositis), a symptom myself and several other people with this virus displayed. Thus along with my muscle weakness, my V-sign heliotrope rash tends to support the idea that the virus described on this website is causing something akin to a mild, benign version dermatomyositis.
Polymyositis and dermatomyositis are diseases in which T cells attack the muscle tissue; 1 2 in other words, these are autoimmune conditions, precipitated by viral infection.
Generalized Anxiety Disorder
This virus rapidly precipitates generalized anxiety disorder (GAD) in a small subset of people who catch it. GAD is characterized by chronic excessive worrying, nervousness and tension. In GAD, this anxiety is uncontrollable, and not connected to specific events or situations. GAD is likely driven by biochemical abnormalities (a chemical imbalance) in the brain. GAD makes life difficult, and makes relaxation completely out of the question.
This virus seems to cause anhedonia and emotional flatness to varying degrees in people. Anhedonia is the loss of the ability to experience pleasure from enjoyable activities.
In this section, by examining the symptoms manifested by my virus, we confirm that this virus is most likely an enterovirus, such as a coxsackievirus B or echovirus. Coxsackievirus B and echovirus are two species of enterovirus known to cause chronic infections. Coxsackievirus B can cause most, if not all, of the symptoms I experienced.
However, be aware that other infectious microbes can cause approximately similar symptoms. So if you have slightly different symptoms to me, have a look at the other microbes detailed on the ME/CFS Info page, as one of those may be the culprit in your case.
We now examine each of the major symptoms produced by my virus, and we find that all these major symptoms strongly match the symptoms known to be produced by enteroviruses.
Herpangina symptom: strong match. An initial characteristic symptom of my virus is a sore throat looking like herpangina (an inflamed red throat at the back of the soft palette). In my case, the herpangina was without any pain, and without blisters or ulcers, but with a cluster of small papules (raised pimples not producing pus) in the pharynx, these papules being a slightly whiter shade of the red/pink color of the throat itself. The name lymphonodular pharyngitis is given to a herpangina-type sore throat where there are only papules, but no blisters or ulcers; so lymphonodular pharyngitis may be a better description of my sore throat.
Herpangina sore throats are usually only caused by certain viruses of the Enterovirus genus, namely enterovirus 71, coxsackievirus A16, and coxsackievirus B species. Lymphonodular pharyngitis is normally caused by coxsackievirus A10 only (but this virus does not produce chronic infections, so we can rule this out). So regarding the herpangina (or lymphonodular pharyngitis) sore throat symptoms, we have strong match between the symptoms produced by my virus, and the symptoms that enteroviruses precipitate. Note that more rarely, herpangina can be caused by echovirus (also from the Enterovirus genus), parechovirus, adenovirus, and herpes simplex virus.
Incubation period: possible match. I happen to know exact time I was exposed to this virus; so the fact that its first symptoms appeared 12 hours after this exposure shows that this virus has a very fast incubation period. This rapid 12 hour incubation period was also noted in several other people who were infected by this virus, and an incubation period of 8 hours was actually observed in one individual. This is an extremely fast incubation period, and should be of scientific note just in itself. Using this very valuable incubation period information, we can rule out a whole range of infectious microbial pathogens that have much longer incubation periods. Thus for example, the virus I caught could not possibly be Epstein-Barr virus (EBV), as EBV has an incubation period of 4 to 6 weeks, which considerably longer that the roughly 12 hour incubation period of my virus. Similarly, we can rule out nearly all other viruses and other microbes, as the incubations for most microbes tend to be much longer than 12 hours.
Figures quoted for coxsackievirus B incubation periods are 3 to 5 days, 1 and echovirus incubation periods are 2 to 14 days. 1 By contrast, the virus that I caught has a more rapid incubation period of around 12 hours (and I have noted my virus incubate in precisely 8 hours in one individual who caught it). So on first analysis, it might seem that the incubation period of my virus is too fast to make it a coxsackievirus B or echovirus. However, there are some enteroviruses which can incubate in 24 hours, such as enterovirus 70. 1 Might the virus described on this website be a newly-emerging recombinant enterovirus, combining the genes of say coxsackievirus B with a more rapidly incubating enterovirus? Research indicates that recombination events are common in the coxsackievirus B group. 1 Such a recombination could help explain why the incubation period of the virus described on this website is so remarkably fast.
Contagiousness: possible match. My virus is mildly contagious, and is transmitted from person-to-person via normal household or social contact, taking many months to a year before it transmits to everyone in the household. It will generally transmit when there is close contact such as kissing (especially French kissing), or when eating or drinking together (where spittle ejected from an infected person’s mouth may fall on another person’s food). The enteroviruses are generally easily passed from person-to-person via normal household contact, as they are spread by saliva and nasal secretions.
Organs and areas affected: strong match. Out of the various enteroviruses, a virus in the Coxsackie B group fits my symptoms particularly well, as coxsackievirus B often causes upper respiratory tract infection, gastrointestinal symptoms, significant neurological disease, persistent long-term infection, heart conditions, and systemic spread throughout the body — all of which have be precipitated by my virus. So regarding the organs and areas affected, we have strong match between the my virus, and enteroviruses. There are six serotypes within this coxsackievirus B group; these are coxsackievirus B1, B2, B3, B4, B5 and B6.
Muscle weakness in pelvic girdle: strong match. The virus described on this website can cause muscle weakness in the pelvic girdle and thighs (the lower proximal muscles). Proximal muscle weakness is the characteristic of the diseases of dermatomyositis and polymyositis, and these two chronic inflammatory myopathy diseases have been linked to group B coxsackieviruses (as well as parvovirus B19 infections, HIV and HTLV-I). Polymyositis and dermatomyositis generally affect the thighs and hips to begin with, but then progress to all the proximal muscles. So these pelvic and thigh muscle weakness symptoms may strongly match the symptoms known to be caused by enteroviruses such as coxsackievirus B.
Dermatomyositis is characterized by a heliotrope rash, a symptom myself and several other people with this virus display on the upper chest; thus along with my pelvic muscle weakness, my heliotrope rash tends to support the idea that the virus described on this website is causing something akin to a mild, benign version dermatomyositis.
Hearing loss and increased tinnitus: strong match. Quite a few elderly people (aged 70+) that caught my virus soon (within year or so) experienced sensorineural hearing loss, increased tinnitus, and sometimes even a mild loss of balance or dizzy spells. This little cluster of symptoms is actually a well-known syndrome called Meniere’s disease. Studies have found that coxsackievirus B5, influenza B virus, varicella zoster virus and herpes simplex virus are associated with these type of ear symptoms. 1 2 I myself noticed a loss in hearing acuity, after catching this virus. Greater age seems to predispose an individual to greater aural damage from this virus. So regarding the hearing loss and increased tinnitus symptoms, we have match between the symptoms produced by my virus and those produced by enteroviruses.
Chronic fatigue syndrome: strong match. What about the fact I developed chronic fatigue syndrome (ME/CFS) from my virus? The enteroviruses coxsackievirus B and echovirus have been strongly linked to chronic fatigue syndrome, 1 2 3 so the ME/CFS precipitated by my virus is a typical characteristic of enteroviruses.
Myocarditis, pericarditis and sudden heart attacks: strong match. In terms of the people who manifested myocarditis, pericarditis and sudden heart attacks after catching my virus, it is known that coxsackievirus B is a very common cause of all these conditions. So regarding these cardiological events precipitated by my virus, these strongly match the characteristic diseases caused by enteroviruses such as coxsackievirus B.
Immunosuppression: strong match. For the first two years after catching the virus described on this website, people tend to get more infections, such as fungal skin infections, urinary tract infections, ear infections, tooth infections, all generally requiring antibiotics or antimicrobials to clear. Now enteroviruses are known to cause immune suppression in the first two months after catching them: in the first two months CD8 cell counts can drop well below the normal range (down to around 100 per mm3, when the normal range is 150 to around 800), and there can sometimes also be significant decreases in CD3 and CD4 cell counts during these first two months. 1
So transient immunosuppression is normal for enteroviruses. In the case of the virus described on this website, judging by the increased number of mild opportunistic infections it gives rise to during the first two years of infection in many people, this immunosuppression may last longer than two months before it eases off; but nevertheless, this is more or less in keeping with the effects of enteroviruses.
In conclusion: nearly all clinical signs and symptoms of my virus closely match those produced by enteroviruses, strongly suggesting that my virus is an enterovirus of some type. Dr John Chia (a highly regarded infectious disease specialist and expert in enterovirus and chronic fatigue syndrome) has very generously taken the time to read my symptoms listed on this web site, and said my symptoms are consistent with a chronic enterovirus infection.
There are a number of difficulties in testing for the presence of enteroviruses in the body in the case of chronic infections. This is because in chronic enterovirus infections, very few viral particles are present in the blood or tissues, and so only very sensitive laboratory tests are able to detect these infections.
ARUP Lab micro-neutralization tests are the only blood tests that are sensitive enough to be able to detect the very low levels of enterovirus antibodies typically found in chronic, long-term infections. If you suspect you may have the virus described on this website, these ARUP Lab micro-neutralization tests are probably the best ones to take.
Dr John Chia found that this ARUP Lab micro-neutralization antibody test is highly sensitive and specific: the test is able to detect the very small quantities of enterovirus antibodies that are present in the blood in chronic enterovirus infections, and furthermore, this test will determine which specific coxsackievirus B serotypes you have (it tests for all 6 Coxsackie B viruses), and which specific echovirus serotypes you have (out of the 5 echoviruses tested). These tests can be ordered directly from ARUP or ordered through Labcorp (if ordered through Labcorp, write on the form to specifically send this test to ARUP). The ARUP Lab coxsackievirus B1 to B6 antibody test is here, and the ARUP Lab echovirus antibody test is here. These tests are expensive though, around $500 each.
The immunohistochemistry enterovirus test is a more sensitive (but unfortunately less specific) way of detecting chronic enterovirus infections. The immunohistochemistry test is more complicated, as it requires you to visit a gastroenterologist, who will place an endoscope down your throat to obtain a tissue sample from your stomach. The tissue sample is then tested for the presence of enterovirus VP1 protein. Dr John Chia has pioneered this approach for detecting chronic enterovirus infections in ME/CFS patients, and with this technique he has demonstrated the presence enteroviruses in the stomach tissues of 82% of ME/CFS patients (versus 20% of healthy subjects). This immunohistochemistry test can detect most types of enterovirus, and it is the most sensitive test of all, but it unfortunately does not determine the specific types of enteroviruses you have (whereas the ARUP micro-neutralization test does determine the specific types of enterovirus). The stomach biopsy immunohistochemistry enterovirus test provided by Dr Chia’s lab costs $250 (this excludes the fees of the gastroenterologist).
Polymerase Chain Reaction (PCR) is NOT sensitive enough to detect chronic enteroviral infections. Echoviruses are cleared quickly from the blood stream, so after the acute infection, there is not much chance of finding enteroviral RNA in the blood.
Taking an enterovirus CFT test (Complement Fixation Test) for chronic enterovirus infection is NOT appropriate. The enterovirus CFT test is fine for testing acute enterovirus infections (in the first 10 days of infections), but it is of no use whatsoever for chronic enterovirus infections, which are low level, hard-to-detect infections.
More details on the ARUP micro-neutralization test and the immunohistochemistry test can be found on the Enterovirus Foundation web site.
Details of possible antiviral treatments for enterovirus infections are given on the Treatments page. Unfortunately, though, enterovirus infections are very hard to treat, as there is a lack of good antiviral drugs for enteroviruses.