population-based case-control study on viral infections and vaccinations and subsequent multiple sclerosis risk

• Published in: European journal of epidemiology Vol. 24; no. 9; pp. 541 - 552
• Main Authors: Ahlgren, Cecilia, Torén, Kjell, Odén, Anders, Andersen, Oluf
• Format: Journal Article
• Language: English
• Published: Dordrecht Dordrecht : Springer Netherlands 2009; Springer; Springer Netherlands; Springer Nature B.V
• Subjects: Adolescent; Adult; Age Factors; Autoimmune diseases; Biological and medical sciences; Cardiology; Case studies; Case-Control Studies; Case-control study; Child; Children; Clinical Medicine; Cohort Studies; Epidemiology; Female; Gender; General aspects; Health risk assessment; Humans; Immunization; Infections; Infectious Diseases; Infectious Mononucleosis - epidemiology; Klinisk medicin; Male; Measels mumps rubella vaccine; Measles; Measles-Mumps-Rubella Vaccine - adverse effects; Medical sciences; Medicine; Medicine & Public Health; Miscellaneous; Multiple sclerosis; Multiple Sclerosis - epidemiology; Multiple Sclerosis - etiology; Mumps; Neuro-Epidemiology; Oncology; Public Health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Questionnaires; Risk Factors; Rubella; School health; Sex Factors; Surveys and Questionnaires; Sweden - epidemiology; Vaccination; Vaccination - statistics & numerical data; Vaccinations; Varicella-zoster virus; Viral diseases; Viral infections; Virus Diseases - complications; Virus Diseases - epidemiology; Viruses; Young Adult; Sweden; Gothenburg Sweden; Multiple sclerosis; Vaccinations; Gender; Case–control study; Viral infections; Human; Nervous system diseases; Vaccination; Sex; Risk; Case-control study; Case control study; Epidemiology; Statistical study; Inflammatory disease; Infection; Prevention; Immunoprophylaxis; Viral disease; Central nervous system disease; Risk factor; Evolution; Public health
• ISSN: 0393-2990; 1573-7284; 1573-7284
• DOI: 10.1007/s10654-009-9367-2

Viral infections are probably involved in the pathogenesis of multiple sclerosis (MS). A recent cohort study in the Gothenburg population revealed no change in MS incidence associated with the introduction of the Swedish measles, mumps and rubella vaccination programmes. The aim of the present study was to clarify whether these infections or vaccinations, and two other infections, varicella and infectious mononucleosis, influence MS risk. We performed a population-based case-control study in Gothenburg that included 509 MS cases and 2,067 controls, born 1959-1986. Data on infections and vaccinations were obtained from questionnaires and from child health and school health records. We found no significant associations between measles, mumps, rubella or varicella and MS risk. These results were consistent between the two source materials. Infectious mononucleosis was associated with significantly higher MS risk (odds ratio 2.03, 95% CI 1.52-2.73). Overall, there was no significant association between measles-mumps-rubella (MMR) vaccination and MS risk, while those MMR vaccinated before age ten only were at significantly higher MS risk (odds ratio 4.92, 95% CI 1.97-12.20). Those MMR vaccinated both before and after age ten had intermediate MS risk. Infection with measles, mumps, rubella and varicella did not influence MS risk in contrast to infectious mononucleosis which conferred doubled MS risk. The association with 'early' MMR vaccination only was an isolated finding, limited by a small number of subjects and multiple testing. Most likely this was a chance finding. Future studies could investigate it on an a priori basis.