Tuesday, 15 September 2015

Upper respiratory Tract Infections not related to MS activity

Kneider et al. Upper Respiratory Infections and MRI Activity in Relapsing-Remitting Multiple Sclerosis. Neuroepidemiology. 2015;45:83-89.

BACKGROUND: Although clinical reports have suggested a relationship between systemic infections and multiple sclerosis (MS) relapses, MRI evidence supporting an association is conflicting. Here we evaluated the temporal relationship between upper respiratory infections (URIs) and MRI activity in relapsing-remitting (RR) MS.
METHODS: We combined individual data on URI with data on active lesions in pre-scheduled MRI examinations performed every 4 weeks for 28 weeks in 69 patients. A 4-week at-risk (AR) period started, by definition, 1 week before the onset of a URI. We recorded the relationship between the number of active lesions in each MRI with (1) the number of days of AR time in the immediately preceding 4-week period and (2) the number of days passed since the onset of a preceding URI.
RESULTS: Average MRI lesions/day showed no difference between AR (0.0764) and not-AR (0.0774) periods. The number of lesions in 483 pre-scheduled MRI examinations did not correlate with the AR proportion in the prior 4-week period, and time from URI onset did not correlate with lesion number on the next MRI examination.
CONCLUSION: The occurrence of a URI did not increase the risk of MRI activity evaluated in an adjacent 4-week window in RRMS. 


For many years we have been told that relapses can occur shortly after an chest infection, but this study argues against this. Lets  wait until there is more confirmation. 

However, there may be many triggers for relapses. Yesterday the news was aglow that the MS Society suggested that people (about 48%) required to undergo an assessment to claim disability benefits felt that their health was damaged and that their condition deteriorated or they relapsed.Just over a third who had a face-to-face assessment for Personal Independence Payment (PIP) said the same.

As well as the detrimental impact on health recorded by the survey, a number of respondents said the changes to the benefits system had forced them to spend less, including on treatment. About a third said they were spending less on food, 28% on transport and 41% on socialising with family and friends.

The charity says the disability benefits system fails to take adequate account of the fluctuating and hidden symptoms of MS, or the extent of their impact and launched a campaign on Monday, MS: Enough: Make welfare make sense, calling for a number of reforms to the benefits system, including assessments that take proper account of evidence provided by professionals who understand the condition. It also wants the government to carry out a full impact assessment of any further changes to disability benefits, including the effects on other areas of public spending such as health and social care.

Have a read and if you think they are making sense sign up to their petition.

You have been posting about this and maybe ProfG will post his views. However have your say.

Maybe Mister Angry will return and Dr Dre will take them to task.

12 comments:

  1. The paper by Kneider I'm not sure I agree with.
    I have MS and had a very nasty infection over a year ago. It gave me very heavy legs, like weights around my ankles, painful when standing and I had to crawl around my home. On day two had urine test done, GP surgery sent it off to lab. Then had bladder issues from day four. Then on day six I got a sore throat.
    Kept chasing test results and then I got a phone call to say yes infection in urine but I got antibiotics way too late on day seven or eight.
    My legs are still in pain when standing up and I have not fully recovered. I bypass the GP surgery now and go to hospital out of hours GP instead. I did not have an MRI scan done so I can't say if there was MRI activity.

    https://en.wikipedia.org/wiki/Upper_respiratory_tract_infection
    Wikipedia:
    Acute upper respiratory tract infections include rhinitis, pharyngitis/tonsillitis and laryngitis often referred to as a common cold, and their complications: sinusitis, ear infection and sometimes bronchitis (though bronchi are generally classified as part of the lower respiratory tract.) Symptoms of URTIs commonly include cough, sore throat, runny nose, nasal congestion, headache, low grade fever, facial pressure and sneezing. Onset of symptoms usually begins 1–3 days after exposure. The illness usually lasts 7–10 days.

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  2. Is an ear infection counted as a URI? I had a relapse trigger by an ear infection. I had an MRI scan at the time and there was lots of activity.

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  3. Re. "MS Society suggested that people (about 48%) required to undergo an assessment to claim disability benefits felt that their health was damaged and that their condition deteriorated or they relapsed."

    These asessments do cause worry, anxiety and can be stressful. Some MSers are being refused ESA or PIP benefits and are having to ask for mandatory reconsideration. If they get turned down again they take it to a tribunal.

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  4. All of my relapses have been connected to viral activities. I'd need a much more convincing paper than this.

    Frankly. really unimpressed by the research that the NMSS chooses to fund. So much nonsense about exercising and supplements and VitD and all of it is nonsense that won't lead to.a cure. Charity runs for people who can barely walk and spaghetti dinners hosted by big pharma trying to push new formulations of the same crap meds. What a fucking useless group. Wish I could give directly to scientists doing.good work.

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    Replies
    1. If you contact the group that takes your fancy, I'm sure they'd be glad of any contributions.

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  5. Given the complexity of MS I see the "triggers" for activity of the lesions vary from carrier to carrier, clear that there are triggers "general" but there are variations of each. I for one so far has not "succumb" to go through stress but infections knock me out, so that the trigger that made me discover MS was through a throat infection, which then I find out it was mononucleosis ...

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    Replies
    1. That seems an unusual path to MS to have mono as your first relapse trigger, if I have understood correctly. But what do I know.
      I had mono in my early teens and then my first MS relapse aged 38.

      Delete
  6. Either stress is a relapse trigger for me or it is a severe driver of a relapse once it has started. Being unwell can be stressful in itself.

    I guess it depends on what the MSer is informed about by medical professionals when MS is first suspected. If those suspected of having MS are advised stress might aggravate symptoms then at least they can adapt their lifestyle in a positive way. Also if the MSer already has some knowledge of MS and possible relapse triggers then they are one step ahead.

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  7. There are some experienced and understanding neurologists (I don't know if this is a few or several in numbers) who advise patients suspected of having MS "don't get stressed". I have not been told this although about two years after my MS diagnosis my MS nurse mentioned about stress and MS.

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    Replies
    1. Team G we MSers have been telling neurologists for years stress will impact on MS. Yet very few medical professionals warn those suspected of having MS about stress. If they do it's often too late.

      The survey by the MS Society confirms this yet again. We can only lead a horse to water but we can't make the horse drink it.

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    2. Thanks I'm aware of the importance of stress

      Delete

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