Part 3 - Vaccinations and Infections

     The National Fibromyalgia Association’s 2006 Internet survey of 2596 individuals found that 26.7% of those who could trace the origin of their FMS to a specific event reported that event to be an illness and 45% felt that infections worsened their FMS symptoms.  However, the reports in the scientific literature are conflicting.

     Only one study has been reported showing that chronic hepatitis B infection may increase the risk of FMS. In this study 25% of patients who had antibodies that were positive for Hepatitis B also had FMS.  Two studies with a total of 202 FMS patients have reported an association of hepatitis C virus infection and FMS.  Conversely, two studies with 267 FMS patients found no association to hepatitis C.  If such an association does exist, one possible pathological mechanism may involve hepatitis C induced changes in cytokines which affect the hypothalamic-pituitary-adrenal axis. 

     If you’re wondering just what are cytokines, then be sure to read the two short reports on cytokines and neuroendocrinology. Until you do here is an introduction to cytokines. They are cellular molecular messengers that the body uses primarily to regulate inflammatory responses. When you hear about cytokines, it will usually be in regard to arthritis but they will also appear in discussions about inflammatory bowel disease and interstitial cystitis – two other conditions that occur in FMS. Cytokines can be released by different types of cells into the circulation or into tissue and they will then bind to specific receptors on other cells and trigger responses in these cells – hence the messenger function. 

     HIV is another infection that has caught the attention of FMS researchers. Dr. Buskila, who is a dedicated Israeli FMS researcher, has found 15 of 51 patients (29%) diagnosed with HIV to also have FMS which was not associated with duration or stage of HIV infection. FMS has been found in 11% and 17% of HIV patients in two other studies.

     Everyone has heard about Lyme disease and it has generated some interesting findings in regard to FMS. A study in the Annuals of Internal Medicine published in 1992 suggested that Lyme disease may trigger FMS but antibiotic treatment was not effective in resolving symtptoms. The confusion of Lyme disease and fibromyalgia was, in part, responsible for one physician stating that approximately half of the 91 courses of antibiotics provided to 100 patients first seen at the Lyme Disease Center at the Robert Wood John Medical School were “probably unwarranted.”  This was most likely due to the infectious organism causing Lyme disease, Mycoplasma, creating symptoms similar to FMS. However, to date, no definitive association exists between FMS and Mycoplasma infection.

     So far, as in most other studies on the causative factors for FMS, there are no clear-cut answers regarding infection or vaccination and FMS. More evidence that work still needs to be done.