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Migration and multiple sclerosis in Alaskan military veterans

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Abstract

The objective is to provide the first estimates of the prevalence of multiple sclerosis (MS) in Alaskan white males including those migrant to and from the state. A case–control cohort design was utilized with a nationwide series of United States (US) veterans service-connected for MS and matched to pre-illness controls who had entered military service between 1960 and 1994. Among 3,758 white male MS cases and their 7,426 controls were 7 MS and 28 controls resident in Alaska at service entry, who provided an adjusted case/control (C/C) risk ratio for developing MS of 0.47 and an estimated prevalence rate of 22/100,000 population, but only 1 of the 7 had also been born in Alaska, for an estimated prevalence rate of 3.2 per 100,000 (95% confidence interval (CI): 0.08–17.80). The other 6 MS patients and their 26 controls, who migrated from another state to Alaska before onset, had an adjusted C/C ratio of 0.44 for a prevalence rate of 20.6 (95% CI: 7.56–44.90), significantly lower than the reported rate of 45.23 per 100,000 for all US white males in 1976. Another 9 MS patients and 7 controls born in Alaska, who had migrated to another state before entering service, provided an adjusted C/C risk ratio for developing MS of 2.44, with a highly significant elevated prevalence rate of 115 per 100,000 (95% CI: 52.6–218.1). In conclusion, these data suggest that Alaska is not a high-risk area for MS and indicate that migration before onset to Alaska from the high-risk coterminous US decreases the risk of MS and the opposite migration increases it. A formal prevalence survey of MS in Alaska is needed to support or refute these findings.

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Acknowledgments

This work was supported by Veterans Affairs Merit Review Grants (V688-1532 and V688P-1997, John F. Kurtzke, Principal investigator), which provided contracts for services to the Medical Follow-up Agency, National Academy of Sciences, Washington, DC (William F. Page, Principal Scientist).

Presented at the world congress on treatment and research in multiple sclerosis, Montreal, Canada, on September 19, 2008.

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Authors and Affiliations

  1. Neuroepidemiology Section, Neurology Service, Veterans Affairs Medical Center and MS Center of Excellence-East, #127, 50 Irving Street, NW, Washington, DC, 20422, USA

    Mitchell T. Wallin & John F. Kurtzke

  2. Department of Neurology, Georgetown University Medical School, Washington, DC, USA

    Mitchell T. Wallin & John F. Kurtzke

  3. Medical Follow-up Agency, National Academy of Sciences, 500 5th Street, NW, Washington, DC, 20001, USA

    William F. Page

Authors
  1. Mitchell T. Wallin
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  2. William F. Page
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  3. John F. Kurtzke
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Correspondence to Mitchell T. Wallin.

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Wallin, M.T., Page, W.F. & Kurtzke, J.F. Migration and multiple sclerosis in Alaskan military veterans. J Neurol 256, 1413–1417 (2009). https://doi.org/10.1007/s00415-009-5123-5

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  • DOI: https://doi.org/10.1007/s00415-009-5123-5

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