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Epidemiology of multiple sclerosis in U.S. veterans

1. Race, sex, and geographic distribution

Departments of Neurology and Community Medicine, Georgetown University School of Medicine, and Neurology Service, Veterans Administration Medical Center, Washington, D.C. (Dr. Kurtzke); the Clinical Epidemiology Branch, National Cancer Institute, Bethesda, Maryland (Dr. Beebe); and the Medical Follow-up Agency, National Academy of Sciences-National Research Council, Washington, D.C. (Dr. Norman).

Five thousand three hundred five World War II and Korean conflict veterans who have been compensated by the Veterans Administration for multiple sclerosis (MS) were matched to controls on the basis of age, date of entry into military service, and branch of service. Case/control ratios for white males, white females, and black males were 1.04, 1.86, and 0.45, respectively. The coterminous 48 states, divided into three tiers on the basis of latitude, exhibited the well-known north-south gradient in risk: For all races and both sexes, case/control ratios were 1.41, 1.00, and 0.53 for the North, Middle, and South tiers. Both white females and black males showed this same north-to-south variation in risk. The case/control ratio for males of races other than black or white was 0.23, with possible deficits in risk for American Indians and Japanese-Americans. Filipinos and Hawaiian Japanese were significantly low-risk groups. These findings suggest that both a racial and a possibly genetic predisposition, as well as a geographically determined differential exposure to an environmental agent, are related to the risk of MS.

Address requests for reprints to Dr. Kurtzke, Neurology Service, VA Medical Center, 50 Irving Street N.W., Washington, D.C. 20422.

This work was supported in part by the National Institutes of Health, Contract PH43–64–44, Task Order No. 53, as part of a program of epidemiologic and follow-up studies on veterans developed by the National Research Council at the request of the Veterans Administration, the Department of Defense, and the Public Health Service.

Accepted for publication March 5, 1979.

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