{
  "schema_version": "2.0.0",
  "id": "white-1998-glandular-fever",
  "name": "London post-glandular-fever fatigue cohort (White)",
  "aliases": [
    "St Bartholomew's glandular fever cohort"
  ],
  "outbreak_event": null,
  "pathogen_id": "epstein-barr-virus",
  "pathogen_class": "virus",
  "exposure_ascertainment": "serology",
  "design": "prospective_inception",
  "denominator_defined": "yes",
  "denominator_method": "Consecutive patients presenting with glandular fever (EBV) or an ordinary upper respiratory tract infection, enrolled at acute presentation and followed prospectively; the URTI group serves as the comparison.",
  "recruitment_source": "community",
  "time_zero_definition": "Acute glandular fever (or comparison upper respiratory tract infection)",
  "time_zero_precision": "month",
  "control_group": "other_disease",
  "control_matching_variables": [],
  "n_source_population": null,
  "n_enrolled": 250,
  "n_analysed": 250,
  "followups": [
    {
      "months": 2,
      "n_assessed": null,
      "n_lost": null
    },
    {
      "months": 6,
      "n_assessed": null,
      "n_lost": null
    }
  ],
  "max_followup_months": 6,
  "instruments": [
    "somatic-symptom-self-report"
  ],
  "case_definition": "author_defined",
  "pem_assessed": "no",
  "objective_measures": [
    "none"
  ],
  "specimens_collected": true,
  "specimen_types": [
    "serum"
  ],
  "acute_phase_specimens": "yes",
  "storage": null,
  "biobank_status": "unknown",
  "consent_future_use": "unknown",
  "external_access": "unknown",
  "contact": null,
  "registration_id": null,
  "funders": [
    "Wellcome Trust"
  ],
  "conflicts": null,
  "data_availability": null,
  "notes": "Landmark prospective inception cohort with an active comparison group (ordinary URTI), showing that an acute post-infective fatigue syndrome is markedly more common after glandular fever than after a routine URTI. A chronic fatigue syndrome persisted in a minority (~9-10%) at 6 months. Establishes specificity of the trigger, not just occurrence.",
  "publications": [
    {
      "id": "white-1998",
      "title": "Incidence, risk and prognosis of acute and chronic fatigue syndromes and psychiatric disorders after glandular fever",
      "authors": "White PD, Thomas JM, Amess J, Crawford DH, Grover SA, et al.",
      "year": 1998,
      "journal": "British Journal of Psychiatry",
      "doi": "10.1192/bjp.173.6.475",
      "pmid": "9926075",
      "url": "https://pubmed.ncbi.nlm.nih.gov/9926075/",
      "open_access": false,
      "is_primary_cohort_paper": true
    }
  ],
  "symptom_inventory_scope": "single_domain",
  "n_symptoms_queried": null,
  "symptom_instrument_note": null,
  "related_cohorts": [],
  "last_verified": "2026-07-20",
  "verified_by": "OSMF research-tracker (web-verified against source)",
  "harmonisation_ruleset": "pais-harmony-v1",
  "observations": [
    {
      "id": "white-acute-fatigue",
      "cohort_id": "white-1998-glandular-fever",
      "publication_id": "white-1998",
      "schema_version": "2.0.0",
      "measure_id": "sym:fatigue",
      "measure_verbatim": "acute fatigue syndrome at onset after glandular fever (47%) vs after ordinary upper respiratory tract infection (20%)",
      "population": {
        "scope": "whole_cohort",
        "stratum": null,
        "denominator_basis": "unclear",
        "n_assessed": {
          "status": "measured_not_reported"
        }
      },
      "timing": {
        "timepoint_months": 0,
        "timepoint_band": "acute",
        "reference_period": "not_reported",
        "is_cumulative": false
      },
      "method": {
        "ascertainment": "unclear",
        "instrument_id": "somatic-symptom-self-report",
        "severity_threshold": null,
        "blinded_assessment": "not_reported"
      },
      "value": {
        "type": "proportion",
        "numerator": {
          "status": "measured_not_reported"
        },
        "denominator": {
          "status": "measured_not_reported"
        },
        "percent": 47,
        "ci": null,
        "precision": "approximate"
      },
      "comparator": {
        "group": "other_disease",
        "value": {
          "type": "proportion",
          "percent": 20,
          "precision": "exact"
        },
        "effect": null
      },
      "harmonised": null,
      "provenance": {
        "source_locator": "Results/Abstract (acute fatigue syndrome 47% GF vs 20% URTI)",
        "extracted_by": null,
        "extracted_on": null,
        "verified_by": "OSMF research-tracker (web-verified against source)",
        "verified_on": "2026-07-20",
        "extraction_method": "manual"
      }
    }
  ]
}