From the Guidelines
Multiple sclerosis (MS) can significantly increase the risk of complications from influenza, making it crucial for MS patients to take preventive measures and seek early treatment if infected. People with MS may experience longer and more severe flu symptoms due to their compromised immune system, which can be further affected by immunosuppressive medications used to treat MS 1. Common MS treatments like interferon beta, glatiramer acetate, natalizumab, fingolimod, and ocrelizumab can impact immune function, potentially prolonging flu recovery. Additionally, MS symptoms often temporarily worsen during infections (called pseudoexacerbations), making it seem like both the MS and flu are worse simultaneously.
To manage flu recovery with MS, it is essential to:
- Stay hydrated
- Rest adequately
- Take fever reducers like acetaminophen (avoiding ibuprofen if on certain MS medications)
- Contact your neurologist if symptoms persist beyond 7-10 days or if MS symptoms significantly worsen Getting an annual flu vaccine is especially important for MS patients to prevent infection in the first place, as prevention is easier than managing the flu with MS. Most MS medications are compatible with the standard flu vaccine, though timing may need adjustment for some treatments 1. According to the Centers for Disease Control and Prevention, people with neurologic and neurodevelopment conditions, including MS, are at higher risk for influenza complications and should be prioritized for antiviral treatment 1.
Some key points to consider:
- MS patients are at higher risk for influenza complications due to their compromised immune system
- Early antiviral treatment can reduce the risk of complications from influenza
- Annual flu vaccination is crucial for MS patients to prevent infection
- MS medications can affect immune function, potentially prolonging flu recovery
- It is essential to consult with a neurologist for personalized advice on managing flu recovery with MS.
From the Research
MS and Immune Response
- Multiple sclerosis (MS) is a chronic autoimmune disease that affects the central nervous system (CNS) 2
- MS is characterized by immune dysregulation, resulting in the infiltration of the CNS by immune cells, triggering demyelination, axonal damage, and neurodegeneration 2
- The exact causes of MS are not fully understood, but genetic and environmental factors are thought to control MS onset and progression 2
MS and Infections
- There is no direct evidence to suggest that MS causes difficulty in getting over the flu 3, 4, 5, 6, 2
- However, people with MS may be more susceptible to infections due to their compromised immune system 3, 6, 2
- Treatment with disease-modifying therapies (DMTs) can reduce the annual relapse rate by 29% to 68% compared with placebo or active comparator, but may also increase the risk of infections 3
Treatment of Influenza
- Neuraminidase inhibitors (NAIs) such as oseltamivir, zanamivir, laninamivir, and peramivir are available for the treatment of influenza 4, 5
- These drugs can decrease the median duration of influenza-related symptoms by approximately 1 day if initiated within 48 hours of the onset of symptoms of influenza 5
- The appropriate use of NAIs requires further study, and their efficacy and tolerability in patients with MS are not well established 4, 5