MS is on the increase. It is showing an Environmental Issue.


Walton C, King R, Rechtman L, Kaye W, Leray E, Marrie RA, Robertson N, La Rocca N, Uitdehaag B, van der Mei I, Wallin M, Helme A, Angood Napier C, Rijke N, Baneke P. Rising prevalence of multiple sclerosis worldwide: Insights from the Atlas of MS, third edition. Mult Scler. 2020 Nov 11:1352458520970841. doi: 10.1177/1352458520970841. Epub ahead of print. PMID: 33174475.

What is the cause of MS. Genetics? But this study shows that environmental influences are equally if not more important. It says disease is modifyable if we change the environmental triggers, but at the moment we are clearly doing the opposite. MS is on the increase in all parts of the globe….Have our genes changed that much is the past few decades.

Background: High-quality epidemiologic data worldwide are needed to improve our understanding of disease risk, support health policy to meet the diverse needs of people with multiple sclerosis (MS) and support advocacy efforts.

Objectives: The Atlas of MS is an open-source global compendium of data regarding the epidemiology of MS and the availability of resources for people with MS reported at country, regional and global levels.

Methods: Country representatives reported epidemiologic data and their sources via survey between September 2019 and March 2020, covering prevalence and incidence in males, females and children, and age and MS type at diagnosis. Regional analyses and comparisons with 2013 data were conducted.

Results: A total of 2.8 million people are estimated to live with MS worldwide (35.9 per 100,000 population). MS prevalence has increased in every world region since 2013 but gaps in prevalence estimates persist. The pooled incidence rate across 75 reporting countries is 2.1 per 100,000 persons/year, and the mean age of diagnosis is 32 years. Females are twice as likely to live with MS as males.

Conclusions: The global prevalence of MS has risen since 2013, but good surveillance data is not universal. Action is needed by multiple stakeholders to close knowledge gaps.

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  • Epigenetic? Genes loading the gun and environment pulling the trigger? And environment being any number of external forces – EBV, Head injury, stress/trauma. Fascinating!

  • I wonder why it is on the increase? Smoking rates are going down in the developed world. Is it increasing vitamin d deficiency rates? Epstein Barr virus is just really common anyway. I would love to get to the bottom of this mystery to prevent this affliction on other people!

    • Probably Life style changes, maybe the infection rate of childhood EBV is dropping and you are getting it later in life

  • How much of the ‘higher prevalence’, if any, could be attributed to greater awareness and diagnosis? MS surely have existed before it had a name? Maybe possible that way back people who had MS were ‘diagnosed’ with something else? Or is that completely crazy?

    • Not crazy….but historically we would die earlier and young men would be out fighting and historically we may have got EBV in childhood and our immune response would be shaped differently…but the truth is I don’t know.

  • We need antiretroviral trials that target EBV both in central nervous system and in the blood stream to see the day of light in multiple sclerosis. Also hopefully after this coronavirus pandemic I hope vaccine development will be faster for an EBV vaccine.

  • I use a builder of Iranian origin. A heavy smoker and sure is indulging in multiple partners behind his wife’s back. He started to tell me he couldn’t see from his left and the same side was numb. My First thought was covid attacking his nerve. Then 2nd thought MS. His had multiple MRI and he confirmed that he had MS. I wanted to share with my MS Journey but thought he might blame me for catching MS. Given none knows for definite what causes ms thought instay stem.

  • Is incidence increasing with change of dietary habits? I remember I looked at the increase in MS cases in Japan and meat consumption. There are generic reports talking about westernization of lifestyle. I remember also that age of puberty is decreasing in developing country with improved and increased protein intake so this could add to increase the build up of the environmental factor.

    I did this search while looking for something that is highly expressed in the brain, that can come from dietary habits and that could trigger immunity. So I thought that Neu5Gc that is immunogenic, found in animal meat (increased consumption) and can replace neu5ac in brain glycoproteins could have some role. It is not possible to find a person that is completely Neu5Gc free as it is unlikely that someone from birth to death never eat this sugar. If the mother eats meat Neu5Gc it will pass to the baby via breastfeeding. So going vegan won’t solve the point as once you had it it stays where it is. Going vegan should be done for generations before seeing any effect.

    And another point that I thought had some additional connection with this is that monkeys (callytrix) that lack the same gene human lacks (CMAH) can develop MS like disease after viral infection. That gene turns neu5ac into neu5gc. Other monkeys that have a functioning copy of the gene do not develop the disease… or maybe they are resistant to the virus?

    Of course this is not sufficient to explain because other factors need to play a role otherwise everyone would get MS, so EBV, immune response out of control and probably something else maybe genetic.

    And finally correlation does not mean causality… but maybe it could be something interesting to be studied.

  • ” all parts of the globe”

    What about the “farther away from the equator the more risk you sustain for develop ms” hyphotesis?

    Does still holds?

  • Is there anywhere where the rate is dropping? As the saying goes, on average I am comfortable with my head in the freezer and my feet in the oven. Where the extremes occur is more important.

  • So what happens as you cross the Straights of Gibraltar? It goes from 100-200 per 100,000 to 0-25 per 100,000. I notice that living at the equator helps.

  • The latitude thing has always puzzled me. As the son of a meteorologist I grew up around weather maps and climate tables. I absorbed enough to know that in theory, if there were no cloud cover, everywhere on earth would the same number of potential sunlight hours in a year. On the equator, 12 hours per day x 365. At the poles, 24 hours (summer) or 0 hours (winter) at the solstices, increasing or decreasing over the six months between them. (It turns out that this isn’t quite accurate: because of atmospheric refraction, annual potential sunshine hours are higher at the North Pole than at the South.) The daily amount of potential UV radiation varies at the poles but not at the equator.

    However, cloud cover does block sunlight, and it’s distributed all over the earth’s atmosphere. There’s no precipitation without clouds, and the wettest places on earth lie between the Tropics of Cancer and Capricorn, many of them along the equator – in Colombia, Brazil, Cameroon, Congo, India and Indonesia. Stations in Colombia’s Chocó province average more than 10,000 mm of rain per year, with rainfall recorded on 20 days in most months and year-round humidity of 90%. I have not heard of high MS prevalence in these cloudy equatorial regions.

    Sunshine data reveals that the sunniest places in the world lie between 25 and 40 degrees north and south latitude. In the United States, the well-documented south-to-north gradient of increasing MS prevalence
    does not correlate with annual sunshine data except perhaps on the Atlantic and Pacific coasts. Canada and northern Europe, lying north of 40 degrees north latitude, receive less sunshine, broadly speaking according to latitude. They have high MS prevalence; even so, the intra-regional prevalence does not correlate perfectly with annual sunlight, as Saskatchewan and Italy demonstrate. In the Southern Hemisphere, Argentina, South Africa and Australia have reasonably high MS prevalence along with better-than-average annual sunshine figures.

    Of course, it doesn’t matter how much sunshine a point on the sphere receives if no one lives there, so population density is a factor. So is life expectancy. So is the likelihood that MS will be suspected or diagnosed.

    At bottom, serum Vitamin D3 levels and their global distribution are the markers of interest in MS theory-building. It’s not at all evident that latitude per se is a factor in their development.

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