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

Journal article
Authors Cecilia Ahlgren
Kjell Torén
Anders Odén
Oluf Andersen
Published in European journal of epidemiology
Volume 24
Issue 9
Pages 541-52
ISSN 1573-7284
Publication year 2009
Published at Institute of Medicine, School of Public Health and Community Medicine
Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation
Department of Mathematical Sciences, Mathematical Statistics
Institute of Medicine, Department of Internal Medicine
Pages 541-52
Language en
Links dx.doi.org/10.1007/s10654-009-9367-...
Keywords Case-control study; Gender; Multiple sclerosis; Vaccinations; Viral infections
Subject categories Internal medicine

Abstract

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.

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