Clustering in any disease seems to happen, but in he large picture, ends up being coincidence. This is the same thing that happens when every kid gets vaccinated and some kids develop Autism Spectrum Disorders. Once biostatisticians began looking at the data, the small clusters fell out as coincidence.
Disease clusters happen. The Love Canal Chemical Dump in NY is a great example. To date, the epidemiology doesn't support chemical exposures or statistically significant clustering in MS.
There was a published study Int. J. Epidemiol. (1992) 21 (3): 528-532. doi: 10.1093/ije/21.3.528
"A previous study of 381 multiple sclerosis (MS) patients from Norway has shown significant clustering of residence in adolescence among contemporaneous patients. Using a regression model with individual degree of clustering determined by Monte Carlo methods, this study utilizes the same data and shows a significant correlation (P = 0.002) between the degree of clustering and age at clinical onset of disease. A high degree of clustering in adolescence indicated a low age at clinical onset. This association was also verified independently of the regression model. The finding supports the theory of a common viral agent acting epidemically among nonpre-exposed individuals during adolescence, with MS developing in individuals with other necessary factors, such as a genetic predisposition. "
So a combination of an HLA predisposition and a common viral trigger may be involved in these cluster events. This seems to be one of the things that keeps bringing EBV and other adolescent viral exposures back into the picture. The cluster may appear related to geography of environment, but is actually related to exposure to a shared viral trigger.
Bob
I don't have a theory but in school 3 of us girls were inseparable best friends and all ended up with ms. Sadly I am the only one left as they both progressed rapidly. I can't help but believe there's a connection.
Even when the WHO looked, they have problems finding MS complaints in the equatorial zone. Much of this has lead to the "Vitamin D" theories (more sun light.) There is a pretty high incidence of Asian Variant MS (Opticospinal Multiple Sclerosis) in specific Asian populations. This appears to be related to specific HLA sequences and may be a separate disease rather than a variant. There is also the problem that many cases of Opticospinal Multiple Sclerosis are diagnosed as Neuromyelitis Optica without testing for the anti-aquaporin-4 antibody.
Bob
I have never liked the equator theory. That would make the Asians have the highest rates of MS in the World. I think it is either Northern European Genetics and/or simply that many countries near the equator do not have the health systems to diagnose MS that makes that theory.
Alex
The one environmental factor that has the strongest correlation to the incidence of MS is the distance from the equator.
Bob
Hi Jean,
Alex says it best - you could have a genetic predispostion (parent), but also geographical info regarding instances of MS suggest environment can play a factor, and then there are those virals that could have made us succeptible.
Hardest part about all of this, and pinpointing that one solid source of information is that none of these factors exclusively cause MS, but a lot of uncredible sources of information leads one to believe it could be.
So, we know what it does, just not the exact exclusive cause. If you would like some reliable reading on this, you can visit any top hospital, neurology department website, particularly the research hospitals like Johns Hopkins, or Mt. Sinai, etc.
If everyone dx'd with MS had the same biology and environmental conditions we'd certainly know the culprit by now.
Good luck with your searches - hope you turn up something solid.
-Shell
The only idea researchers have is that you have the genetic predisposition and then something in your environment kicks it off. No one really knows what MS is yet. So there is no clear link.
Years ago a Miami journalist did a story on the high rate of people on the Island of Key West having MS, my brother pointed this out to me and is convinced this is how I got MS. That is where my first attack happened. I then lived on Lejuene Marine Base in NC where the water supply was polluted with dry cleaning fluid for over thirty years and there is a high rate of Cancer and autoimmune diseases. That is where my symptoms became permanent. May be a coincidence may be not.
I could never link my MS to living on either military base even though The Navy had me fill out a survey about Lejuene. They are running it against those living on a Marine Base in California at the same time to see if there is the same rate of Cancer and Autoimmune.
The problem is there are so many toxins in the environment it would be impossible to tell or for that matter get away from them.
I really do not worry about how I got MS because it is like a cucumber turning into a pickle there is no going back.
I suspect another issue is the under reporting of the rates of MS in this country. I think it is just more prevalent than we know.
Alex