Flu season is here, and the Centers for Disease Control and Prevention is urging everyone age 6 months or older to get the flu vaccine. Doctors say the need for a flu shot is especially important for people with multiple sclerosis, the autoimmune disease that damages the central nervous system. “The flu infection may stimulate the immune system, which may in turn trigger an MS attack,” says Dr. Robert Shin, director of the Georgetown Multiple Sclerosis and Neuroimmunology Center, which is part of Georgetown University Medical Center.
Waves of Attacks
MS is characterized by T cells in the immune system that mistakenly attack the brain, spinal column and optic nerves. That damage can lead to physical, cognitive and emotional problems, such as vision loss, slowed thinking, trouble walking, extreme fatigue, neuropathy (burning, tingling, numbness or pain) and depression.
According to the National Multiple Sclerosis Society, these attacks come in waves known exacerbations or relapses for 80 percent of MS patients. While it’s unclear exactly what causes relapses, Shin says that any infection, illness or stressor may increase the risk of an MS attack or may make MS symptoms worse.
[Read: What Symptoms Suggest I Might Have MS?]
The Flu and MS
One potential infection associated with triggering MS relapses is the flu, the contagious respiratory illness caused by a number of influenza viruses, including influenza A or B. Flu symptoms include fever, aches, chills, cough, sore throat, head congestion, headaches, fatigue and sometimes vomiting and diarrhea.
Flu bugs are in circulation year-round, but they are especially prevalent in the U.S. during fall and winter. “When you see flu outbreaks, you see MS relapses,” says Dr. Amesh Adalja, an infectious disease specialist with the Johns Hopkins University Center for Health Security.
Adalja points to several studies that have explored the association between flu and MS relapses, such as a 2011 Finnish study that suggests a higher occurrence of exacerbations in MS patients during outbreaks of influenza A or Epstein-Barr virus (a member of the herpes virus family and a common cause of infectious mononucleosis).
What’s the Link?
Scientists have known for years that the flu can stir up the immune system and cause an MS relapse. “The immune system fends off whatever causes the infection. For people with MS, the immune activation spills into the central nervous system,” Adalja explains. “So all T cells, even the ones not related to infection, may be activated. It’s like there’s an alarm bell.”
But it was only recently that researchers began identifying the mechanism for this activation. A study in mouse models published in August suggested that influenza trips some sort of “on” switch in the body. “Certain genes are turned on that allow more immune cells to make it from other parts of the body into the central nervous system and cause damage characteristic of MS,” Adalja says.
[See: 9 Ways to Boost Your Immune System.]
Protecting Against the Flu
Because of the link between influenza and relapses, doctors recommend that MS patients take extra precautions to prevent getting the flu. Protection is crucial, since the virus can spread easily when someone with the flu coughs, sneezes or talks. Flu droplets can travel as far as 6 feet in the air, according to the CDC.
The first line of defense, say the experts, is the flu shot. “This can help keep you from getting influenza and from getting relapses of MS, which can have deleterious effects on their quality of life,” Adalja says.
There are several types of flu shots. Adalja recommends that MS patients get one that covers four different strains of the flu, called a quadrivalent vaccine. And a particular type of quadrivalent vaccine may be the most effective, he says. “There’s emerging data that the recombinant quadrivalent vaccine called Flublok has more protection.” You may need to ask your doctor or pharmacy to order Flublok if you decide you want it.
Adalja explains that most flu vaccines are made in chicken eggs, which causes the vaccine virus to adapt to chickens and can limit effectiveness in humans. But recombinant vaccines (formed by recombining DNA and injecting it into insect cells in a lab) are identical to the original vaccine virus that’s used to make the flu vaccine.
What about the notion that getting a flu shot causes you to get sick? Shin says it’s a myth. “Sometimes people blame vaccinations for making them ill, but remember that the flu shot does not contain any live flu virus, so infection really is impossible,” Shin says. “I do recommend that MS patients avoid the nasal spray form of the vaccine, however, because it contains live virus.”
And the flu shot is not a guarantee that you won’t get the flu. However, doctors say the vaccine reduces the risk of complications from flu, such as pneumonia and hospitalization.
[Read: Who Are the Kinds of People Who Get MS?]
Other Ways to Protect Yourself
In addition to getting a flu shot, doctors recommend that you take other steps to ward off germs. ” Wash your hands frequently, preferably with soap and water, and avoid other people who are sick,” Shin advises. Adults with the flu may be contagious as much as a week after becoming sick, and children can be contagious even longer, according to the CDC.
If you suspect that you’ve contracted a flu bug, report your symptoms to your doctor as soon as possible. Try to get to your doctor within 48 hours of the start of flu symptoms, so you will be eligible to take an antiviral medication to help reduce the length of symptoms. “MS patients can take antiviral medications, if recommended by their health care provider. In fact, one anti-flu medication, amantadine [Symadine and Symmetrel], is often prescribed to MS patients to help with MS-related fatigue,” Shin says.
And if you feel you’re experiencing a relapse after getting the flu, contact your doctor. Flu is uncomfortable for everyone, but it’s temporary. MS exacerbations, which are also temporary, can cause nerve damage that has lasting MS side effects.
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What’s the Link Between Flu and MS Relapses? originally appeared on usnews.com
