Abstract
Detailed questionnaires were completed in 1978–79 by 23 of the 28 then known resident Faroese multiple sclerosis (MS) patients and 127 controls. These controls were divided into 69 Group A (patient sibs and other relatives), 37 Group B (matched neighbor controls, their spouses and sibs, plus patient's spouse), and 21 Group C (distant matched controls, spouses, relatives living where MS patients never resided and British troops were not encamped during the war). No differences between cases and controls were found for education, occupation, types of residence, bathing, sanitary or drinking facilities, and nature of house construction or heating. Detailed dietary histories, available for half the subjects, revealed no difference, cases versus controls, for four age periods between age 0 and 30 years, and for 16 specified foodstuffs. Animal exposures showed overall no consistent differences by location or type of animal. There was a tendency to greater exposure to British troops during the war for cases versus Groups A and B, but this did not attain statistical significance. Vaccinations for smallpox, tetanus and diphtheria were less common in the MS; no difference was found for other vaccinations. Except for a relative deficit in the cases for rubella and (insignificantly) for measles, mumps and chicken pox, reported illnesses were equally common among all groups. Operations, hospitalizations and injuries did not differentiate the groups, nor did age at menarche for women. Neurologic symptoms were significantly more common in the cases than in the controls.
Keywords: multiple sclerosis, risk factors, case control questionnaires, Faroe Islands
References
- 1. Kurtzke JF, Hyllested K. Multiple sclerosis in the Faroe Islands: 1. Clinical and epidemiological features. Ann Neurol 1979: 5: 6–21. [DOI] [PubMed] [Google Scholar]
- 2. Kurtzke JF, Hyllested K. Multiple sclerosis in the Faroe Islands: II. Clinical update, transmission and the nature of MS. Neurology 1986: 36: 307–28. [DOI] [PubMed] [Google Scholar]
- 3. Kurtzke JF, Hyllested K. Multiple sclerosis in the Faroe Islands: III. An alternative assessment of the three epidemics. Acta Neurol Scand 1987: 76: 317–39. [DOI] [PubMed] [Google Scholar]
- 4. Kurtzke JF, Hyllested K, Heltberg A, Olsen A. Multiple sclerosis in the Faroe Islands: V. The occurrence of the fourth epidemic as validation of transmission. Acta Neurol Scand 1993: 88: 161–73. [PubMed] [Google Scholar]
- 5. Jersild C, Kurtzke JF, Riisom K, Heltberg A, Arbuckle J, Hyllested K. Multiple sclerosis in the Faroe Islands: VI. Studies of HLA markers. Tissue Antigens 1993:42:105–10. [DOI] [PubMed] [Google Scholar]
- 6. Kurtzke JF, Hyllested K, Arbuckle JD et al. Multiple sclerosis in the Faroe Islands: IV The lack of a relationship between canine distemper and the epidemics of MS. Acta Neurol Scand 1988: 78: 484–500. [DOI] [PubMed] [Google Scholar]
- 7. Kurtzke JF, Hyllested K, Heltberg A. Multiple Sclerosis in the Faroes In: Firnhaber W, LAUER K. eds. Multiple Sclerosis in Europe. An Epidemiological Update. Darmstadt, Germany , LTV Press; 1994: 51–61. [Google Scholar]
- 8. Kurtzke JF, Hyllested K. Multiple Sclerosis in the Faroe Islands and the lack of protection by exposure in infancy. Neuroepidemiology 1992: 11: 90–9. [DOI] [PubMed] [Google Scholar]
- 9. Kurtzke JF, Beebe GW, Norman JE Jr. Epidemiology of multiple sclerosis in United States veterans: III. Migration and the risk of MS. Neurology 1985: 35: 672–8. [DOI] [PubMed] [Google Scholar]
- 10. Kurtzke JF, Kurland LT, Goldberg ID. Mortality and migration in multiple sclerosis. Neurology 1971: 21: 1186–97. [DOI] [PubMed] [Google Scholar]
- 11. Delasnerie‐Laupretre N, Alperovitch A. Migration and age at onset of multiple sclerosis: some pitfalls of migrant studies. Acta Neurol Scand 1992: 85: 408–11. [DOI] [PubMed] [Google Scholar]
- 12. Kurtzke JF. Epidemiologic evidence for multiple sclerosis as an infection. Clin Microbiol Reviews 1993: 6: 382–427. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 13. Sadovnick AD, Armstrong H, Rice GP et al. A population‐based study of multiple sclerosis in twins: Update. Ann Neurol 1993: 33: 281–5. [DOI] [PubMed] [Google Scholar]
- 14. Cook SD, Rohowsky‐Kochan C, Bansil S, Dowling PC. Evidence for multiple sclerosis as an infectious disease. Acta Neurol Scand 1995: 91 (Suppl. 161): 34–42. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 15. Lauer K. Environmental associations with the risk of multiple sclerosis: the contribution of ecological studies. Acta Neurol Scand 1995: 91 (Suppl. 161): 77–88. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 16. Boiko A, Deomina T, Favorova O, Gusev E, Sudomoina M, Turetskaya R. Epidemiology of multiple sclerosis in Russia and other countries in the former Soviet Union: investigations of environmental and genetic factors. Acta Neurol Scand 1995: 91 (Suppl. 161): 71–6. [DOI] [PubMed] [Google Scholar]
- 17. Beebe GW, Kurtzke JF, Kurland LT, Auth TL, Nagler B. Studies on the natural history of multiple sclerosis: 3. Epidemiologic analysis of the Army experience in World War II. Neurology 1967: 17: 1–17. [DOI] [PubMed] [Google Scholar]
- 18. Kurtzke JF, Page WF. Epidemiology of multiple sclerosis in US veterans: VII. Risk factors for MS. Neurology. 1997: 48: 204–13. [DOI] [PubMed] [Google Scholar]
- 19. Kelsey JL, Githens PB, Walter SD et al. An epidemiological study of acute prolapsed cervical intervertebral disc. J Bone Joint Surg 1984: 66A: 907–14. [DOI] [PubMed] [Google Scholar]
- 20. Poser CM. Trauma and multiple sclerosis. An hypothesis. J Neurol 1987: 234: 155–9. [DOI] [PubMed] [Google Scholar]
- 21. Lauer K. The risk of multiple sclerosis in the USA in relation to sociogeographic features: a factor‐analytic study. J Clin Epidemiol 1994: 47: 43–8. [DOI] [PubMed] [Google Scholar]
- 22. Swingler RJ, Compston DA. Demographic characteristics of multiple sclerosis in south east Wales. Neuroepidemiology 1990: 9: 68–77. [DOI] [PubMed] [Google Scholar]
- 23. Lauer K. A factor‐analytical study of the multiple‐sclerosis mortality in Hesse and Baden‐Wuerttemberg, Germany. J Publ Health (Weinheim) 1993: 1: 319–27. [Google Scholar]
- 24. Irvine DG, Schieffer HB, Hader WJ. Geotoxicology of multiple sclerosis: the Henribourgh, Saskatchewan, Cluster Focus I: The water. Sci Total Environ 1989: 84: 45–59. [DOI] [PubMed] [Google Scholar]
- 25. Swank R, Lerstad O, Strom A, Backer J. Multiple sclerosis in rural Norway. Its geographic and occupational incidence in relation to nutrition. New Engl J Med 1952: 246: 721–8. [DOI] [PubMed] [Google Scholar]
- 26. Lauer K. Dietary changes in temporal relation to multiple sclerosis in the Faroe Islands: An evaluation of literary sources. Neuroepidemiology 1989: 8: 200–6. [DOI] [PubMed] [Google Scholar]
- 27. Norman JE, Cook SD, Dowling PC. House‐hold pets among veterans with multiple sclerosis and age‐matched controls. Pilot survey. Arch Neurol 1983: 40: 213–14. [DOI] [PubMed] [Google Scholar]
- 28. Cook SD, Natelson BH, Levin BE et al. Further evidence of a possible association between house dogs and multiple sclerosis. Ann Neurol 1978: 3: 141–3. [DOI] [PubMed] [Google Scholar]
- 29. Warren SA, Warren KG, Greenhill S, Paterson M. How multiple sclerosis is related to animal illness, stress, and diabetes. Can Med Assoc J 1982: 126: 377–82, 385. [PMC free article] [PubMed] [Google Scholar]
- 30. Cook SD, Dowling PC, Russell WC. Multiple sclerosis and canine distemper. Lancet 1978: 1: 605–6. [DOI] [PubMed] [Google Scholar]
- 31. Kurtzke JF, Hyllested K. Validity of the epidemics of multiple sclerosis in the Faroe Islands. Neuroepidemiology 1988: 7: 190–227. [DOI] [PubMed] [Google Scholar]
- 32. Alter M, Cendrowski W. Multiple sclerosis and childhood infections. Neurology 1976: 26: 201–4. [DOI] [PubMed] [Google Scholar]
- 33. Alvord EC Jr, Jahnke U, Fischer EH, Kies MW, Driscoll BF, Compston DA. The multiple causes of multiple sclerosis: the importance of infections in childhood. J Child Neurol 1987: 2: 313–21. [DOI] [PubMed] [Google Scholar]
- 34. Haile R, Smith P, Read D, Nassim D, Warlow C, Russell WC. A study of measles virus and canine distemper virus antibodies, and of childhood infections in multiple sclerosis patients and controls. J Neurol Sci 1982: 56: 1–10. [DOI] [PubMed] [Google Scholar]
- 35. Sullivan CB, Visscher BR, Detels R. Multiple sclerosis and age at exposure to childhood diseases and animals: Cases and their friends. Neurology 1984: 34: 1144–8. [DOI] [PubMed] [Google Scholar]
- 36. Poskanzer DC, Sheridan JL, Prenny LB, Walker AM. Multiple sclerosis in the Orkney and Shetland Islands II. The search for an exogenous aetiology. J Epidemiol Community Health 1980: 34: 240–52. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 37. Cook SD, Dowling PC. Multiple sclerosis and viruses: an overview. Neurology 1980: 30: 80–91. [DOI] [PubMed] [Google Scholar]
- 38. Kurtzke JF, Bui QH. Multiple sclerosis in a migrant population: 2. Half‐Orientals immigrating in childhood. Ann Neurol 1980: 8: 256–60. [DOI] [PubMed] [Google Scholar]