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American Journal of Epidemiology Advance Access originally published online on March 27, 2009
American Journal of Epidemiology 2009 169(10):1260-1266; doi:10.1093/aje/kwp039
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American Journal of Epidemiology © The Author 2009. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

ORIGINAL CONTRIBUTIONS

Clinically Observed Chickenpox and the Risk of Childhood-onset Multiple Sclerosis

Yann Mikaeloff, Guillaume Caridade, Samy Suissa, Marc Tardieu on Behalf of the KIDSEP Study Group

Correspondence to Dr. Yann Mikaeloff, Service de Neurologie Pédiatrique, CHU Bicêtre, Assistance publique-Hôpitaux de Paris, 78 avenue du Général Leclerc, 94275 Le Kremlin-Bicêtre Cedex, France (e-mail: yann.mikaeloff{at}bct.aphp.fr).

Received for publication December 10, 2008. Accepted for publication January 27, 2009.

The authors conducted a population-based case-control study to investigate whether clinically observed chickenpox, linked with a level of intensity for clinical expression, increases the risk of multiple sclerosis (MS) in childhood. The cases were MS patients whose disease onset occurred between 1994 and 2003, before age 16 years, in France. Each case was matched for age, sex, and geographic origin with as many as 12 controls randomly selected from the general population. Information about clinically observed chickenpox in cases and controls before the index date regarding onset of MS was collected with a standardized questionnaire and was checked against health certificates. Conditional logistic regression was used to estimate the odds ratio for an association between MS and chickenpox. The 137 MS cases were matched with 1,061 controls. Clinically observed chickenpox had occurred in 76.6% of the cases and 84.9% of their matched controls. The adjusted odds ratio of MS onset associated with chickenpox occurrence was 0.58 (95% confidence interval: 0.36, 0.92). The authors concluded that clinically observed chickenpox was associated with a lower risk of childhood-onset MS in a French population.

case-control studies; chickenpox; child; multiple sclerosis

Abbreviations: EBV, Epstein-Barr virus; KIDSEP, Kid Sclérose en Plaques neuropediatric study; MS, multiple sclerosis; VZV, varicella-zoster virus


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