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70 m a s s a g e & b o d y wo r k s e p te m b e r/o c to b e r 2 0 2 2 Multiple Sclerosis: A Viral Complication? New Ways to Think About a Familiar Disease By Ruth Werner essential skills | PATHOLOGY PERSPECTIVES Alarmist alert: The following statements are all true. But the consequences are not always as dire as portrayed here. SCENARIO 1 Picture a virus that moves easily from human to human through saliva and respiratory secretions, sexual activity, and contaminated skin-breaking gear like needles or tattoo equipment. It can also be shared indirectly via fomites like toothbrushes or drinking glasses. This virus can cause infections that are completely silent, but when symptoms are present, they often involve a sore throat, debilitating fatigue, a risk of splenic rupture, dangerous reactions to antibiotics, and a post-viral syndrome with possible life-changing, long-term consequences. This virus evades the immune system by hiding in its target cells after the infection subsides. From there, it can reactivate to cause repeated, silent outbreaks, during which it can spread to other hosts. But that's just the beginning. In addition to causing an acute infection, this virus can also cause pneumonia, pancreatitis, hepatitis, myocarditis, and various inflammations of the central nervous system. And it is one of the few pathogens directly associated with a variety of cancers: Burkitt's lymphoma, Hodgkin's and non- Hodgkin's lymphoma, nasopharyngeal cancer, and others. And it is everywhere. It is virtually inescapable. We have no strategies to prevent transmission, no vaccine, and no protective measures. Consequently, about 95 percent of adults have it. You, dear reader, almost certainly harbor colonies of this pathogen, even if you have no memory of symptoms or an infection. SCENARIO 2 Imagine a disease. It's been in the medical literature for about 150 years, but has been present for much longer. We don't know everything about it, but we know a lot, and we're learning more all the time. This disease causes scattered patches of damaged tissue and scarring to appear throughout the brain and spinal cord. These lesions interfere with nerve transmission, so both sensation and motor control in the rest of the body are affected. Symptoms of this disease may vary from one episode to the next, and might include brain fog, fatigue, vision disturbances, painful muscle spasms, weakness, loss of balance, and gastrointestinal dysfunction, among many other possibilities. It is often progressive, and patients may accrue permanent damage to both glial cells and axons in the central nervous system (CNS). This disease is not necessarily terminal, but it is associated with loss of ambulation and diminished bowel and bladder control, among many other problems. Complications related to lost function shorten the lifespan of people with this condition by an average of 5–10 years.

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