In the fall and winter of 1948 and 1949 an outbreak of an illness swept through the town of Akureyri, northern Iceland, causing muscle weakness and paralysis as well as pain and mild fever. The illness affected 6-7% of the town’s population of 6900, and was assumed at first to be polio.
The outbreak was studied by Dr Björn Sigurdsson, the director of the Institute for Experimental Pathology at the University of Iceland. It was thought to be caused by a virus, but tests for poliovirus and Coxsackie virus came up negative. The unknown virus seemed to have an incubation period of about seven days.
There were no deaths, but some patients took a surprisingly long time to recover, so much so that Siggurdsson decided to do a follow-up study six years later. He found that many of the patients were still living with symptoms of “nervousness, tender muscles, pains, and tiredness”.
In a 1956 paper, Sigurdsson noted that outbreaks of a similar illness had occurred all over the world in the past seven years. He suggested that the illness be called ‘Akureyri disease’. Researchers struggled to agree on a name; other proposed names included ‘benign myalgic encephalomyelitis’ and ‘epidemic neuromyasthenia’.
In 1988 Dr Byron Hyde spoke with ten survivors of the outbreak. Of the ten, two had made a full recovery, while the other eight ranged from mildly to severely disabled.
References and further reading
SIGURDSSON B, SIGURJONSSON J, SIGURDSSON JH, THORKELSSON J, GUDMUNDSSON KR. A disease epidemic in Iceland simulating poliomyelitis. Am J Hyg. 1950 Sep;52(2):222-38. doi: 10.1093/oxfordjournals.aje.a119421. PMID: 14771044.
SIGURDSSON B. Clinical findings six years after outbreak of Akureyri disease. Lancet. 1956 May 26;270(6926):766-7. doi: 10.1016/s0140-6736(56)91236-3. PMID: 13320872.
Hyde B, Bergmann S. Akureyri disease (myalgic encephalomyelitis), forty years later. Lancet. 1988 Nov 19;2(8621):1191-2. doi: 10.1016/s0140-6736(88)90255-3. PMID: 2903396.
The unique epidemiological pattern of the Royal Free Hospital blazing through the hospital complex in such a short time, hitting nurses and doctors but not patients. People in the prime of life but not children was part of Acheson, Ramsay, Dowsett's reasoning for creating a new name of Benign Myalgic Encephalomyelitis.
The hospital sickness looked similar to Iceland disease but the strange demographic of the Royal Free outbreak was so unusual that Melvin Ramsay, in particular, wanted to find an agent that could explain this bizarre profile.
The Royal Free nurses called it "The Royal Freaks disease"
Melvin Ramsay wasn't happy with the ME name but believed it could serve to describe the Royal Free disease until more was known about the etiology.