Paget's disease of bone (PDB) is a common skeletal disorder characterised by 
focal abnormalities of increased and disorganised bone turnover. Genetic factors 
play a central role in the pathogenesis of PDB but environmental factors also 
contribute. Measles virus (MV), respiratory syncytial virus (RSV) and canine 
distemper virus (CDV) have all been implicated as potential disease triggers but 
the data are conflicting. Since chronic paramyxovirus infection with measles is 
known to be accompanied by increased production of antiviral antibodies, we have 
analysed circulating concentrations of antibodies to MV, CDV, and RSV as well as 
mumps, rubella and varicella zoster virus (VZV) in 463 patients with PDB and 220 
aged and gender-matched controls. We also studied the relation between viral 
antibody concentrations and various markers of disease severity and extent in 
460 PDB patients. A high proportion of cases and controls tested positive for 
antiviral antibodies but there was no significant difference in circulating 
antibody concentrations between PDB cases and controls for MV, CDV, RSV, rubella 
or VZV. However, mumps virus antibody levels were significantly higher in the 
PDB cases (mean ± SD = 3.1 ± 0.84 vs. 2.62 ± 0.86. p < 0.001). There was no 
association between disease severity and circulating antibody concentrations to 
any of the viruses. In conclusion, we found no evidence to suggest that PDB is 
associated with abnormalities of immune response to measles or other 
paramyxoviruses, although there was evidence of a greater antibody response to 
mumps. The results do not support that hypothesis that PDB is associated with a 
persistent infection with measles or other paramyxoviruses.