Is the Flu Connected to Multiple Sclerosis Relapses?

Sometimes the most seemingly disparate of conditions can actually be intrinsically connected to one another. Experts are now beginning to suspect the influenza may affect the immune system in a way that heightened one's risk for a flare up of multiple sclerosis.

The importance of flu vaccines

The flu has been particularly vicious and unforgiving this year. Everyone over the age of six months has been recommended to get a flu shot. And this is particularly crucial for those who have multiple sclerosis.

Dr. Robert Shin is the director of the Georgetown Multiple Sclerosis and Neuroimmunology Center, part of Georgetown University Medical Center, and he explains why those with multiple sclerosis have to be especially diligent in fighting against the virus: "The flu infection may stimulate the immune system, which may in turn trigger an MS attack."

While those with MS usually stay on top of their medications, those without it sometimes fail to be vaccinated, sometimes deciding they would prefer to have the flu for a few days than take the time to go get a shot. The problem with that mentality is that they themselves are not the only people affected. Without vaccinations, the viruses spread more widely and quickly. As such, they are placing those with MS at higher risk than if fewer people were exposing them to the virus.

Any infection can spark a flare-up

Multiple sclerosis is characterized by the T cells within the immune system that, unfortunately, misunderstand certain signals and then decide to attack the brain, optic nerves, and spinal column.

The result is significant damage, including physical, emotional, and cognitive problems. Some of the most common are slowed thinking, vision loss, difficulty walking, intense fatigue, depression, and neuropathy.

Flare ups come in what the Multiple Sclerosis Society refers to exacerbations or relapses for the vast majority of multiple sclerosis patients, around 80 percent to be exact. These flare ups come in waves; but it is not entirely certain why they occur. Shin says that it is possible for any illness, infection, or stressor of any kind to potentially spark an attack or intensified symptoms.

Why the flu is particularly dangerous for MS

As any other illness or stressor, the flu is capable of triggering MS relapses. It can be caused by a variation of viruses, which makes it a particularly large threat. These causes include influenza A or B, and the resulting symptoms can be minor to debilitating. Such symptoms include chills, fever, aches, sore throat, cough, headaches, head congestion, vomiting, diarrhea, and fatigue.

Many don't realize, but the flu is not necessarily condensed to flu season. People can be affected all year. However, fall and winter are certainly when the most cases occur.

Dr. Amesh Adalja is an infectious disease specialist with the Johns Hopkins University Center for Health Security, and comments, "when you see flu outbreaks, you see MS relapses." Adalja references multiple studies that have analyzed this connection, including a 2011 Finnish study that found higher rates of occurrence of exacerbations in those with MS during outbreaks of either influenza A or the Epstein-Barr virus, which is a member of the herpes virus family, as well as a particularly frequent cause of infectious mononucleosis.