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MS research may change direction if researchers take up the challenge of testing the hypothesis that a recent review proposes—namely, that MS is a sexually transmitted infection (STI). The author emphasises that this may be just one way in which the disease occurs but maintains that there is sufficient evidence to suggest that it is spread sexually, manifesting itself in those who are genetically susceptible.
MS is generally assumed to have a genetic or immune basis, but it shares parallels with STIs—not least tropical spastic paraplegia—an STI whose similarity to primary progressive MS is striking.
Historically, clusters or epidemics of MS recorded after an influx of troops in communities with a previously low incidence of the disease—for example, Allied troops sent to Iceland, Shetland, and the Faroes in World War II—are consistent with the spread of an STI. MS is initially more prevalent in females, and is passed on more efficiently from men to women. Migration at a young age from low risk to high risk areas for MS rapidly increases risk status. Prevalence mirrors social and cultural norms: MS is most prevalent in permissive societies and least so in Moslem Arab countries, in ethnic populations living apart from white populations— Aborigines, Maoris—and in closed white communities with strict moral attitudes. It also mirrors changing social norms: the Danish MS Registry, with records from 1949, reported a significant increase in MS in women when oral contraceptives became available and use of barrier methods offering more protection against STIs declined.
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