I certainly believe it played a part in my case. I was under tremendous mental and physical stress for over 56 weeks without break, working over 100hrs per emergency, in 90 degree heat and 80% humidity, as a federal emergency responder in Puerto Rico. My work involved recurring contact with corpse fluids, wearing minimal PPE. I experienced a number ear and respiratory infections over my time there, culminating in my first NMOSD attack, which occurred as I waited to board a plane. Are there any definitive studies that make the case for infection as a catalyst?