Infection risk and MS is higher


Infections in patients with multiple sclerosis: A national cohort study in Sweden.Castelo-Branco A, Chiesa F, Conte S, Bengtsson C, Lee S, Minton N, Niemcryk S, Lindholm A, Rosenlund M, Piehl F, Montgomery S.Mult Scler Relat Disord. 2020 Jul 23;45:102420

Multiple sclerosis (MS) patients have an increased risk of infections, but few population-based studies have reported infections occurring in MS in the years immediately after diagnosis.

To explore incident infections in MS, stratified by age and sex.

In a Swedish population-based cohort study 6602 incident MS patients (aged ≥18 years), matched at diagnosis with 61828 matched MS-free individuals were identified between 1st January 2008 and 31st December 2016, using national registers. Incidence rates (IR) and incidence rate ratios (IRR) with 95% CI were calculated for each outcome.

The IRRs were 2.54 (95% CI 2.28-2.83) for first serious infection and 1.61 (1.52-1.71) for first non-serious infection. Compared with MS-free individuals, MS patients had higher IRs for skin, respiratory/throat infections, pneumonia/influenza, bacterial, viral, and fungal infections, with the highest IRR observed for urinary tract/kidney infections (2.44; 2.24-2.66). The cumulative incidence for most of these infections was higher among MS patients than MS-free individuals, both 0 to <5 and 5 to <9 years after index date.

The burden of infections around the time of MS diagnosis and subsequent infection risk, underscore the need for careful considerations regarding the risk-benefit across different disease-modifying therapies.

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  • I should probably know this, so sorry for the daft question, but why do we get more infections? The more I learn about this bloody disease the more my ironic humour kicks in as a defence mechanism. “That’s mint” is probably not an appropriate first reaction but there you go…

  • Is it to do with going on a DMT? I never got sick before diagnosis. After, I got every seasonal cold going. Which has also exposed me to the risk of “helpful” suggestions from my boss on “boosting your immune system”. Yes he knows I have MS, but he still thinks it’s a mental illness. Actually I think COVID has cured him of that as now I’m being treated as “vulnerable”. My whole team are WFH for the time being but I’ll need an individual risk assessment before I can go back to the office.

    I have a minor skin complaint that predates diagnosis – which I’ve only recently self-diagnosed as pitiriasis versicolor. Which explains why Lamasil works on it I guess!

  • Is there a link between gum disease and MS relapses or disability progression?
    Gum disease can be the result of bacteria infection in the gum.
    There is research that indicates those with gum disease may suffer worse Covid outcomes. Also heart issues can be worse for those with gum disease.

    • Sure there are links ProfG may do a post about dental hygiene but in the covid era dentists arent doing anything and I had a broken touch since the first week of lock down

  • Funny, I never really got sick before or after diagnosis (one of those annoying people who never get sick) even after IRT I still don’t get regular colds/flu etc (well I didn’t last year, but there really isn’t much around due to social distancing and hand hygiene). The last thing I really remember having was glandular fever about 30 years ago.

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