Most people will have the Epstein-Barr virus (EBV) at some point, usually in early childhood. EBV may lay dormant in the body for years. Recently, researchers have found a link between EBV and multiple sclerosis (MS).

Epstein-Barr virus (EBV) is a common virus that is part of the herpesvirus family. Up to 90% of the world population has contracted EBV, and multiple research groups have discovered a link between EBV and the autoimmune disease multiple sclerosis (MS).

Here’s more about EBV, what symptoms you may experience, and how the infection may trigger MS.

Many people with EBV may be asymptomatic, meaning that they don’t have symptoms. Others may have only vague symptoms that don’t seem to indicate any particular illness.

EBV causes several types of infection, including mononucleosis (mono). These infections have similar symptoms.

People with an EBV infection may have symptoms for an extended period of time.

Early indications of an EBV infection include:

Symptoms may linger for as long as several months. Fatigue may last the longest.

Researchers don’t know the exact cause of MS. Some theories point to viral infections acting as a trigger. Some viruses, like EBV, remain in the body after infection. Later on, the infection can become reactivated and cause new health issues.

The link between how EBV might affect MS isn’t clear yet. Reactivation is one theory, and another is that the immune reaction to the virus, even the first time and not as reactivation, could cause an immune reaction against myelin.

Researchers examined 10 million active-duty military personnel between the years 1993 and 2013. They found that there was a higher rate of recent infection with EBV among people who developed MS. In fact, of the 801 individuals with MS identified in the study, just one person didn’t have a previously documented EBV infection.

This same link wasn’t observed with other common viruses.

Understanding this association

Another recent study expands on these findings. The researchers found that a part of EBV (a protein called EBNA1) resembles a protein made in the brain and spinal cord (called GlialCAM). When the immune system fights the virus, it also ends up attacking the GlialCAM in the protective layer around the nerve cells (myelin).

When the myelin is damaged, it impacts the nerve cells and their ability to send electrical signals between neurons in the brain and spinal cord. The lack of myelin causes muscle weakness, numbness, fatigue, and other symptoms of MS.

The researchers estimate that 20% to 25% of people who develop MS have antibodies in the blood that bind to both EBNA1 and GlialCAM. So, during the initial infection or if the virus becomes reactivated later, the immune system in these people attacks both the virus protein and the naturally occurring one, leading to MS.

These studies don’t specify the type of MS that may be caused by EBV.

There are four main types of MS:

A person with MS may move between these types. The main difference is that with relapsing-remitting, you’ll have clear periods of remission (times with few or no symptoms). With the progressive forms, you may have remissions, but your overall function generally gets worse with time.

There’s no standard treatment for EBV infection. Since it’s a virus, it doesn’t respond to antibiotic treatment.

Treatment addresses symptoms:

There’s no vaccine for EBV.

You may prevent infection by practicing good hygiene habits, like washing your hands. You should also avoid close contact with people who have EBV infection. This includes not sharing drinks or utensils, kissing, or sharing other personal items, like toothbrushes.

However, it might not be possible to prevent getting EBV since the virus is so common and prevalent in the community.

There’s no specific advice for people looking to prevent MS related to EBV. While most people get EBV, MS is much less common. However, there are some things you can do to lower your risk of developing MS:

Who is at the highest risk of developing MS?

MS can affect people of any sex, but it’s twice as common in people assigned female at birth. The disease tends to start sometime between the ages of 20 and 40 years, with the average age of onset being 32 years.

Smoking is another major risk factor and can increase a person’s risk by as much as 50%.

What is my chance of developing MS if I’ve had an EBV infection?

Researchers in one study found that the risk of developing MS was 32 times higher after arecent EBV infection among the study participants.

What are the earliest symptoms of MS?

Symptoms of MS can vary by person and change over time. Common symptoms include fatigue and trouble with movement, like walking. Vision and speech issues are also early signs.

How is MS treated?

There’s no cure for MS. Treatment for MS includes disease-modifying therapy to reduce the frequency and severity of relapses as well as treatment to help improve symptoms.

EBV is a common virus that most people contract during their lifetimes. MS affects some 2.8 million people worldwide. Researchers have identified a link between EBV and MS, but the connection isn’t a straight line. More factors are at play, like a person’s sex, smoking status, and other environmental factors.

If you have concerns about symptoms you are experiencing or previous EBV infection, make an appointment with your doctor.