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Coxsackie B virus
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====Blood testing==== Elevated Coxsackie B antibodies have been found in patients in at least two ME outbreaks.<ref name="Fegan1983" /><ref name="Calder1984" /> In a retrospective cohort study<ref name="Dowsett1990" /> by [[Melvin Ramsay]] and [[Elizabeth Dowsett]], 31% of the patients were found to have elevated enteroviral IgM antibody levels. Sixteen of these patients were retested annually over three years and all showed persistently elevated Coxsackie B neutralizing antibody levels and intermittently positive enteroviral IgM, suggesting a persistent infection was present. Similarly, a study of of 76 patients with [[postviral fatigue syndrome]] (PVFS) found that 76% had detectible [[IgM]] responses to enteroviruses. 22% had positive cultures (compared to 7% controls) and [[VP1 antigen]] was detected in 51%, all pointing to a chronic infection in many post-viral patients.<ref>{{Cite journal | last = Yousef|first = G.E. | date = January 1988 | title = CHRONIC ENTEROVIRUS INFECTION IN PATIENTS WITH POSTVIRAL FATIGUE SYNDROME | url = https://www.sciencedirect.com/science/article/pii/S0140673688927225|journal=The Lancet|volume=| pages=|via=}}</ref> However, a larger study in Scotland of 243 PVFS patients and matched controls found no difference in IgM and IgG positivity between patients and controls.<ref>{{Cite journal | last = Miller | first = N A | date = 1991 | title = Antibody to Coxsackie B virus in diagnosing postviral fatigue syndrome | url =https://www.bmj.com/content/302/6769/140.short|journal=The British Medical Journal|volume=| pages=|via=}}</ref>
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