June 8, 2011 – Shingles (herpes zoster), a painful
disease that primarily attacks senior citizens, has also been found to
significantly increase – by almost four times - the risk of multiple
sclerosis (MS) occurring in the year following the shingles attack,
according to a massive study from Taiwan.
The findings, which also support a long-held view
on how MS may develop, are published in The Journal of Infectious
While shingles occurs in people of all ages, it is
most common in 60- to 80-year-olds. Fifty percent of all Americans will
have had shingles by the time they are 80. Shingles is a
disease caused by the varicella-zoster virus - the same virus that
After you have chickenpox, the virus stays in your
body. It may not cause problems for many years. As you get older, the
virus may reappear as shingles. There is a vaccine for people aged 60 or
MS is an autoimmune disease that affects the brain
and spinal cord, leading to inflammation and nerve damage as the body's
immune cells attack the nervous system. Possible causes that may trigger
the inflammation include environmental, genetic, and viral factors. One
virus that has been associated with MS is varicella zoster virus, the
cause of herpes zoster (shingles).
In a study conducted by Herng-Ching Lin, PhD, and
colleagues at Taipei Medical University in Taiwan, 315,550 adults with
herpes zoster and a control group of 946,650 subjects were tracked and
then evaluated for MS occurrence during a one-year follow-up period.
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The control group was selected randomly from a pool
of subjects who had not been diagnosed with herpes zoster or other viral
After adjusting for monthly income and geographic
region, the authors found that the group with herpes zoster had a 3.96
times higher risk of developing MS than the control group.
The authors noted that this risk, although
increased, was still low, as is the frequency of MS in general.
The study also noted an interval of approximately
100 days between a herpes zoster event and occurrence of MS.
Although the study was limited almost entirely to
Han Chinese adults, the large scope of this nationwide case-controlled
study, 1.26 million sampled patients, provides strong epidemiological
evidence for a possible role for herpes zoster in the development of MS.
The authors also point out that MS has a lower
prevalence in Asian compared to Western populations and, thus, it may be
difficult to project their findings to other populations.
In an accompanying editorial, Teresa Corona, MD,
and Jose Flores, MD, of the National Institute of Neurology and
Neurosurgery in Mexico noted that "The evidence provided in this
study…allows us to better understand the role of these viral factors as
an MS risk among certain genetically susceptible individuals," and that
the study should be corroborated in other parts of the world to help
clarify the role of this and other viruses in MS.
● There is epidemiological evidence that some
herpes viruses may contribute to multiple sclerosis (MS) occurrence.
● The rate of MS prevalence varies by
geographical location and income.
● In this study, investigators found a
significantly higher—but still low—risk for MS occurring in the year
following a shingles, or herpes zoster, attack compared to a control
● There is evidence that 30 percent of relapses
in MS patients may be associated with an infectious disease.
Founded in 1904, The Journal of Infectious Diseases
is the premier publication in the Western Hemisphere for original
research on the pathogenesis, diagnosis, and treatment of infectious
diseases; on the microbes that cause them; and on disorders of host
immune mechanisms. Articles in JID include research results from
microbiology, immunology, epidemiology, and related disciplines. JID is
published under the auspices of the Infectious Diseases Society of
America (IDSA). Based in Arlington, Va., IDSA is a professional society
representing more than 9,000 physicians and scientists who specialize in
infectious diseases. For more information, visit
>> The Journal of Infectious Diseases
with this study is available online –
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