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Epidemiologic evidence for multiple sclerosis as an infection
1Neurology Service and Neuroepidemiology Research Program, Veterans Affairs Medical Center, Washington, D.C. 20422.
Clinical Microbiology Reviews
|October 1, 1993
Summary
Multiple sclerosis (MS) risk is influenced by geography and migration, suggesting an environmental trigger acquired in adolescence. This rare disease may stem from a widespread, possibly asymptomatic, infectious agent.
Area of Science:
- Epidemiology
- Neurology
- Infectious Disease
Background:
- Multiple sclerosis (MS) exhibits distinct worldwide geographic distribution patterns, with higher prevalence in certain regions.
- MS disproportionately affects women and individuals of white ethnicity.
- Migration studies indicate environmental factors play a role in MS risk acquisition.
Purpose of the Study:
- To investigate the epidemiological patterns of multiple sclerosis (MS).
- To explore the hypothesis that MS is linked to an infectious agent acquired during specific age windows.
Main Methods:
- Analysis of global MS prevalence data and migration studies.
- Examination of MS epidemic patterns, such as those observed on the Faroe Islands.
Main Results:
- MS risk varies significantly by geographic zone and is influenced by residence.
- Evidence suggests MS susceptibility is age-limited, acquired around adolescence (ages 11-45).
- The Faroe Islands experienced successive MS epidemics, suggesting introduction and transmission of an infectious agent.
Conclusions:
- Clinical multiple sclerosis (MS) is proposed to be a rare outcome of a systemic infectious disease, termed primary MS affection (PMSA).
- PMSA likely requires prolonged exposure, has a limited age of susceptibility, and a long incubation period.
- The causative agent of PMSA is hypothesized to be an unidentified (retro)virus, potentially spread asymptomatically.