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1.
Detailed questionnaires were completed in 1978–79 by 23 of the 28 then known resident Faroese multiple sclerosis (MS) patients and 127 controls. These controls were divided into 69 Group A (patient sibs and other relatives), 37 Group B (matched neighbor controls, their spouses and sibs, plus patient's spouse), and 21 Group C (distant matched controls, spouses, relatives living where MS patients never resided and British troops were not encamped during the war). No differences between cases and controls were found for education, occupation, types of residence, bathing, sanitary or drinking facilities, and nature of house construction or heating. Detailed dietary histories, available for half the subjects, revealed no difference, cases versus controls, for four age periods between age 0 and 30 years, and for 16 specified foodstuffs. Animal exposures showed overall no consistent differences by location or type of animal. There was a tendency to greater exposure to British troops during the war for cases versus Groups A and B, but this did not attain statistical significance. Vaccinations for smallpox, tetanus and diphtheria were less common in the MS; no difference was found for other vaccinations. Except for a relative deficit in the cases for rubella and (insignificantly) for measles, mumps and chicken pox, reported illnesses were equally common among all groups. Operations, hospitalizations and injuries did not differentiate the groups, nor did age at menarche for women. Neurologic symptoms were significantly more common in the cases than in the controls.  相似文献   

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Wallin MT, Heltberg A, Kurtzke JF. Multiple sclerosis in the Faroe Islands. 8. Notifiable diseases.
Acta Neurol Scand: 2010: 122: 102–109.
© 2009 The Authors Journal compilation © 2009 Blackwell Munksgaard. Objective – To seek evidence for a possible infectious origin of the type 1 epidemic of multiple sclerosis (MS) in the Faroe Islands. This began in 1943 coincident with their British military occupation throughout World War II. Materials and methods – Data obtained from the Danish National Health Service were assessed for all notifiable diseases in the Faroe Islands reported from 1900 to 1977. Results – Among 38 disorders, selective increases were found for acute infectious gastroenteritis (AIGE) and paradysentery, with outbreaks in late 1940 and in 1943 shortly after the introduction and later marked influx, respectively, of British troops. Five other infections showed elevated numbers in 1941 and 1942. Conclusions – There is a temporal association of AIGE and paradysentery in the Faroe Islands with the first arrival and later marked augmentation of British forces stationed there during the war. Rises in the incidence of other diseases in 1941–1942 seem more likely a consequence of increased foreign commercial travel by Faroese at that time.  相似文献   

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As of 1991 we had ascertained 42 native resident Faroese plus 12 non-resident "migrant" Faroese with clinical onset of MS in this century. The resident series comprised four successive epidemics beginning in 1943 and then at 13-year intervals thereafter, a separation of very high statistical significance (p < 0.00001). We concluded that the first epidemic in the Faroes resulted from the introduction of a specific but unknown infection which we call the "primary MS affection" (PMSA) by occupying British troops during World War II. Clinical neurologic MS (CNMS) is then the rare late sequel of infection with PMSA. The first epidemic defined age of susceptibility to PMSA as age 11 to 45 at onset of exposure. Models of transmission used for the first three epidemics included the need for two years of exposure before PMSA acquisition and limitation of transmissibility of PMSA to age 13 to 26. With these conditions successive cohorts of susceptible Faroese were defined to account for the second and third epidemics, and they also predicted the occurrence of the fourth epidemic. Further consideration of these models suggests transmissibility is even more limited, perhaps to age 20 to 26 or so.  相似文献   

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Joensen P. Multiple sclerosis incidence in the Faroe Islands 1986–2007. Acta Neurol Scand: 2010: 121: 348–353.
© 2009 The Author Journal compilation © 2009 Blackwell Munksgaard. Objective – Epidemiological studies of the isolated Faroese population in 1945 identified a high annual incidence of multiple sclerosis (MS) of 10/100,000. At the time, there was speculation that the disease was brought to the country by British occupation forces resident in the islands from 1940 to 1945. The objective of the current study is to determine the incidence of diagnosis of MS in the Faroe Islands during the period 1986–2007. Methods – All patients in the Faroe Islands diagnosed with MS from July 1, 1986 to July 1, 2007 are documented in the current longitudinal, prospective study. The diagnosis is based on clinical observation, magnetic resonance imaging scanning, cerebrospinal fluid tests, and visual evoked potential response testing. Results – The incidence of MS during the period 1986–2007 is 4.5/100,000 annually. This is generally of the same order of magnitude as other research findings in Scandinavia and Iceland. The incidence of MS from 1986 to 2007 is about double the incidence in the Faroe Islands for the period from 1940 to 1986, calculated to be 2.7/100,000 annually. Conclusion – The observed incidence of MS in the Faroe Islands, where the population is genetically homogeneous and where the diet exposes the population to neuro‐toxic contamination, is at the same level as found in other high‐risk regions. The former detected epidemics of MS in Faroe Islands seems apparently to have leveled out and could not be recognized in the recent period covered by the present survey.  相似文献   

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Among 32 resident Faroese, clinical MS began between 1943 and 1973 and comprised 3 epidemics, each one significantly later in time and lower in incidence than the preceding. This is confirmed by the present division of the cases of the epidemics according to the calendar time when the patients attained age 11. The risk of MS for Faroese of Epidemic I, (those who acquired the disease from asymptomatic British troops in the World War II occupation), was 18 per 10,000. Depending on the minimum population number required for transmission, the MS risk for Epidemic II was 15 per 18 per 10,000, and for Epidemic III (under our second model) 9 or 11 per 10,000, none differing significantly from Epidemic I. We conclude that the primary MS affection (PMSA) is a single, widespread, specific, systemic infectious disease whose acquisition in virgin populations follows 2 years of exposure starting between age 11 and 45, which then produces clinical neurologic MS (CNMS) in only a small proportion of the affected after an incubation period of 6 (virgin populace) or 12 (endemic areas) years, and which is transmissible only during part or all of this systemic PMSA phase that ends by age 27 or younger.  相似文献   

10.
K Lauer 《Neuroepidemiology》1988,7(4):228-233
The distribution of MS cases in the Faroe Islands according to place at birth and place at onset was tested for a possible association with differing industries in 1930 and 1960, respectively. The MS patients originated predominantly from communities where commercial fisheries were prominent, whereas a weaker association was found with wood-processing plants. Both associations might, however, be confounded by the factor population as such, since patients were born mostly in the larger communities. No association with any kind of industry was found when residences during World War II were evaluated with respect to industries in 1960. Further studies into the conditions of life, with special reference to the social background of commercial fisheries in the early 20th century in the Faroe Islands, might be useful.  相似文献   

11.
Using data from 32 patients with symptom onset between 1943 and 1973, we described the occurrence of clinical neurologic multiple sclerosis (CNMS) in the Faroe Islands as then constituting three epidemics. We concluded that CNMS is the rare late result of infection with the primary MS affection (PMSA), a state requiring some 2 years of exposure for acquisition by Faroese. Our theses are that PMSA was first transmitted during World War II by affected by asymptomatic British troops to Faroese aged 11-45; that this (F1) cohort of affected asymptomatic Faroese under age 27 in 1945 transmitted PMSA to the next (F2) cohort of Faroese comprising those attaining age 11 each year from 1945 until F1 input ceased; that the F2 cohort similarly transmitted PMSA to the third (F3) cohort of Faroese. Cases of CNMS defining epidemics I-III were members of the respective F1-F3 cohorts. Within the F4 cohort of Faroese there is now a fourth epidemic of CNMS, with 7 patients with symptom onset between 1984 and 1989. Intermittency of the year of birth for CNMS cases is thus a reflection of membership in these separate population cohorts, and does not indicate 'protection' in infancy or childhood. There is no evidence for an extra-Faroese source of MS after the first epidemic. No model of acute infection with short transmissibility fits the data.  相似文献   

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Epidemiological studies of multiple sclerosis (MS) conducted in the Faroe Islands identified 10 annual incidences per 100,000 in 1945 and 4.5 in the period 1986-2007. The aim of this study was to estimate the annual incidence of onset of MS in the Faroe Islands in the six decades from 1943 to 2002 and during the period 2003-7.All patients diagnosed with MS between 1943 and 2007 were documented. The incidence of MS before 1943 was around 0.2 per 100,000 annually. During the period 1943-62, an annual incidence rate of 4.4 [confidence interval (CI) 2.9-6.1] per 100,000 was observed. During the 20-year period 1963-82, the level declined significantly (p < 0.001) to around 0.6 (0.3-1.5). Thereafter, an increase was seen during the period 1983-2002, evidencing a significant (p < 0.001) sevenfold increase in the annual incidence to 4.6 (3.2-6.2) per 100,000. Subsequently, for the period 2003-7, there was again a decline to 2.4 (2.1-3.3) (p = 0.003). This study confirms that significant variation in the incidence of MS has occurred in the Faroes over time. Because the rate of genetic change within the Faroese population is relatively slow, the study suggests environmental factors as a contributing cause of MS. If only genetic factors for susceptibility were important, the incidence rate should not wax and wane over time, as is observed.  相似文献   

13.
Joensen P. Incidence of amyotrophic lateral sclerosis in the Faroe Islands.
Acta Neurol Scand: 2012: 126: 62–66.
© 2011 John Wiley & Sons A/S. Objectives – The establishment of variations in the incidence of amyotrophic lateral sclerosis (ALS) in the Faroese population from that found in other general populations may point to risk factors for the development of this disease among the Faroese. The aim of this study was to estimate the annual incidence of ALS during the period 1987–2009 and to compare the occurrence of ALS in the Faroe Islands with data from three European countries. Method – All Faroese patients diagnosed with ALS in this period are documented in the current longitudinal prospective study. Results – The incidence of ALS in the Faroe Islands during the period 1987–2009 is 2.6 (1.7–3.7) per 100,000 annually. The results yielded no strong evidence of a difference (P = 0.09) in the incidence of ALS between Faroe Islands and Europe. The sample population is small, and this, of course, impacts the statistical precision of the findings. Conclusion – The data clearly suggest, however, that the Faroese population is probably not subject to an increased risk of ALS, even though certain risk factors are present in the general population: (i) a fish‐based diet contaminated with mercury and polychlorinated biphenyl; (ii) the high occurrence of the recessive carnitine transporter genetic defect; and (iii) the anticipated high degree of inbreeding at the fifth generation.  相似文献   

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J F Kurtzke  K Hyllested 《Neurology》1986,36(3):307-328
In this century, 41 Faroese with MS were ascertained. One subset, after living in Denmark for 2 years between ages 11 and 31, had MS onset an average of 6 years later. In the Faroes, MS occurred as three separate and decreasing epidemics beginning in 1943 and ending in 1973. We believe that asymptomatic British troops introduced the first epidemic during 1941 to 1942, with the later epidemics resulting from transmission by affected but asymptomatic Faroese. We conclude that "MS" is a widespread, systemic, specific infectious disease only rarely causing neurologic symptoms and transmissible at most from ages 13 to 26.  相似文献   

16.
Validity of the epidemics of multiple sclerosis in the Faroe Islands   总被引:3,自引:0,他引:3  
Concerns have been raised as to our diagnoses, exclusions, case ascertainment, definition of epidemics, and the role of the British occupation in the occurrence of multiple sclerosis among Faroese. We believe none of these points are substantiated, but rather that there did occur three consecutive and decreasing epidemics of clinical neurologic MS (CNMS) among native resident Faroese between 1943 and 1973, with no cases before or (so far) since. We have attributed these occurrences to the introduction into the Faroe islands of what we have called the primary MS affection (PMSA) by the British troops who occupied the islands in World War II. The first Faroese population cohort of PMSA-affected, which included the epidemic I cases, transmitted PMSA to the next cohort of Faroese comprising those attaining age 11 in 1945-1956, and they included the epidemic II cases. The second cohort thereafter similarly transmitted PMSA to the third Faroese cohort with its epidemic III cases. We conclude that PMSA is a single, widespread, specific, systemic infectious disease whose acquisition in virgin populations follows 2 years of exposure starting between age 11 and 45, which then produces CNMS in only a small proportion of the affected after a 6-year incubation period, and which is transmissible only during part or all of this systemic PMSA phase that ends before the usual age of CNMS onset. In endemic MS areas both the exposure and incubation periods may be twice as long, but otherwise PMSA may have there the same characteristics as inferred for the Faroes.  相似文献   

17.
Clinical onset of multiple sclerosis (MS) occurred in 32 native resident Faroese between 1943 and 1973, comprising 3 consecutive epidemics of decreasing frequency. Relationship of MS with the appearance of canine distemper (CD) was explored by serologic studies, questionnaires, and veterinarian reports. Tested were sera from 12 MS patients and 112 controls among the 22 patients and 192 controls with questionnaires in 1978-1979. The daily treatment ledgers of the Veterinarian of the Faroes 1940-1961 were also reviewed and additional Faroese interviewed 1987-1988 as to CD. History of CD was determined for residence of all 32 MS. There was no evidence of elevated CD antibody titers in MS vs controls for neutralizing titers or ELISA values, nor to ELISA for measles. In the questionnaires only one patient and 2 of his sibs reported owning (the same) dog(s) with CD during the war. One other patient reported a possibly sick dog but not CD. CD occurred in one southern village 1941-1942, was present on Vágar from 1941-1950, and was epidemic on Streymoy 1944-1945 with scattered cases there and elsewhere through 1950. There was no significant correlation between villages with CD and MS residents. We conclude that the occurrence of multiple sclerosis was not related to the presence of canine distemper or sick dogs in the Faroe Islands.  相似文献   

18.
A series of biostatistical tests were applied to the data upon which the Faroe epidemic hypothesis was constructed. Temporal, cluster analysis using three commonly applied methods were unsuitable because of the very small size of the sample (32 cases of MS). Methods to detect non-random clusters of disease identified a cluster of 16 cases with date of onset between 1941-1950 (p less than 0.05). However, when 1 questionable case of MS was excluded, the resulting cluster did not support the epidemic hypothesis. The overlapping 95% confidence limits of 5- and 10-year based incidence rates of MS, by date of onset (Poisson distribution) argues against the presence of an epidemic. Analysis of the exposure data, i.e. contacts between the Faroese and the British troops, yielded only borderline statistical significance but changing a single case of MS from the exposed to the unexposed category failed to support the exposure theory. All calculations were also carried out using the probable date of acquisition of the disease, between the ages of 5 and 14 years; these also failed to substantiate the hypotheses of epidemic and transmissibility. Since the validity of statistical analysis to test for the presence of epidemics with small sample sizes is not well established, the lack of concordance between the results of the various approaches leads to the conclusion that there was no epidemic of MS in the Faroes.  相似文献   

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Summary Some factors which might be related to the marked increase in multiple sclerosis in the Faroe Islands in mid-century were studied. Of these, only the occupation by British troops in World War II was found to be significant. A vague relationship with industrial changes earlier in the century was also found. These findings are discussed with caution with respect to the close association between population on the one hand and all features tested as well as multiple sclerosis on the other.Supported by the Hermann and Lilly-Schilling foundation in the Stifterverband für die Deutsche Wissenschaft, Essen, Federal Republic of Germany  相似文献   

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