Rising incidence of multiple sclerosis

This isn’t a coronavirus post, but it is about a virus.

You may have heard of multiple sclerosis. It’s devastating, and the drugs to treat the disease are absurdly expensive (think $6,000 per dose and requiring three per week).

NIH provides a formal definition:

Multiple sclerosis (MS) is a disease of the central nervous system. In MS the body’s immune system attacks myelin, which coats nerve cells. Symptoms of MS include muscle weakness (often in the hands and legs), tingling and burning sensations, numbness, chronic pain, coordination and balance problems, fatigue, vision problems, and difficulty with bladder control. People with MS also may feel depressed and have trouble thinking clearly.

MS is the most common disabling neurological disease affecting young adults. It generally strikes people ages 20 to 40 and more commonly affects women. It affects some 400,000 Americans, and about 2.5 million people worldwide. The most common form of the disease is called relapsing-remitting MS, in which symptoms come and go.

https://www.nccih.nih.gov/health/multiple-sclerosis(1)

While the incidence is in the low single digits, it has been increasing since around 2013.(2) Because of the low incidence, there has been limited funding for research. Further, the incidence is subject to under-counting due to incomplete and in consistent data collection.

A study by the National MS Society argues that official estimates significantly undercount MS cases. This study estimates that roughly 1,000,000 Americans have MS, double the official number.(3)

A new study has identified a link between MS and the Epstein-Barr Virus (EBV). This virus is a type of herpes virus, and is perhaps best known as the cause of infectious mononucleosis, or mono for short. This virus is quite common. Mono is also called the kissing disease as it is spread through saliva, and it’s rife in college dorms.(4)

Now it seems that people with EBV have a much higher than normal risk of developing MS.(6) Some scientists are hypothesizing a cause link between EBV and MS, although if that were true, I would expect the incidence of MS to be much higher than we think it is.

I suspect that telling high school and college students not to kiss is about as effective as using a broom to shovel snow.

The blunt truth is that we don’t have effective tools for controlling the spread of any viruses, or better, eradicating them. Once a virus is inside us, we don’t have tools to assess where the virus has gone or what it is doing to us, much less get rid of it. I suppose we could do a tissue biopsy for every organ in the body, but that’s a hideous idea in terms of risk to the patient and cost.

And it’s not just the coronavirus, SARS-CoV-2, that’s out to get us.

Sources:

  1. https://www.nccih.nih.gov/health/multiple-sclerosis
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7720355/
  3. https://www.nationalmssociety.org/About-the-Society/MS-Prevalence
  4. https://www.cdc.gov/epstein-barr/about-ebv.html
  5. https://www.mayoclinic.org/diseases-conditions/mononucleosis/symptoms-causes/syc-20350328
  6. https://www.nih.gov/news-events/nih-research-matters/study-suggests-epstein-barr-virus-may-cause-multiple-sclerosis

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