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Selective association of multiple sclerosis with infectious mononucleosis

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Author: Zaadstra, B.M. · Chorus, A.M.J. · Buuren, S. van · Kalsbeek, H. · Noort, J.M. van
Institution: TNO Defensie en Veiligheid TNO Kwaliteit van Leven · DenV KvL
Source:Multiple Sclerosis, 3, 14, 307-313
Identifier: 240723
doi: doi:10.1177/1352458507084265
Keywords: Health · Biomedical Research · Immunology · Multiple sclerosis · adolescent · adult · aged · article · chickenpox · childhood disease · clinical feature · comorbidity · controlled study · demography · disease association · Epstein Barr virus · female · human · infectious mononucleosis · major clinical study · male · multiple sclerosis · mumps · Netherlands · onset age · population based case control study · questionnaire · risk assessment · risk factor · rubella · virus infection · Adolescent · Adult · Age Distribution · Aged · Case-Control Studies · Chickenpox · Female · Humans · Infectious Mononucleosis · Male · Measles · Middle Aged · Multiple Sclerosis · Mumps · Prevalence · Risk Factors · Rubella


Previous studies have suggested an association between multiple sclerosis (MS) and infectious mononucleosis (IM) but data on the exact strength of this association or its selectivity have been conflicting. In this study we have evaluated the association between MS and a variety of common childhood infections and afflictions in a large population-based case-control study involving 2877 MS cases and 2673 controls in the Netherlands. We examined the frequency of different common infections and afflictions before the age of 25 and the age at which they occurred, using a self-administered questionnaire. The Odds ratios (ORs) for the occurrence of a variety of clinically manifest common childhood infections including rubella, measles, chicken pox and mumps before the age of 25 for MS cases versus controls ranged between 1.14 and 1.42, values similar to those for irrelevant probe variables used to reveal recall bias. In contrast, the OR for clinically manifest IM in MS cases versus controls, corrected for demographic variables, was 2.22 (95% confidence interval 1.73-2.86; P < 0.001). The average age of onset of IM in the population of MS cases (16.5 years) did not differ from controls (16.8 years). Our data confirm previous much smaller studies to show that the risk for MS is significantly enhanced by prior IM, and extend those previous data by showing that this association is far stronger than with other common childhood infections or afflictions. © 2008 SAGE Publications.