Skip to main content
PMC home page
Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 2004 Dec;58(12):1032–1035. doi: 10.1136/jech.2003.018366

Multiple sclerosis after infectious mononucleosis: record linkage study

M Goldacre 1, C Wotton 1, V Seagroatt 1, D Yeates 1
PMCID: PMC1732628  PMID: 15547068

Abstract

Objective: To ascertain if infectious mononucleosis is a risk factor for the development of multiple sclerosis (MS); and, if it is, whether its effect is close to or remote in time from the onset of MS.

Design: Analysis of database of linked abstracts of records of hospital admission and death.

Setting: Health region in central southern England.

Main outcome measure: Ratio of rate of MS in a cohort of people admitted to hospital with infectious mononucleosis to the rate in a comparison cohort.

Results: Considering all time intervals from admission with infection to admission with MS, there was a non-significant increase of risk of MS in the infectious mononucleosis cohort (rate ratio 2.17, 95% confidence intervals 0.79 to 4.77). At the interval of 10 years or more, there was a significant increase in risk of MS (rate ratio 4.01, 1.48 to 8.93). The mean time from infectious mononucleosis to first admission with MS was 14 years.

Conclusion: This study adds support to the evidence that Epstein-Barr virus, the cause of infectious mononucleosis, is associated with MS. Its role is probably as an initiator of the disease process of MS, or as a contributor to its early development, rather than as an activator of latent, existing disease.

Full Text

The Full Text of this article is available as a PDF (60.9 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ascherio A., Munch M. Epstein-Barr virus and multiple sclerosis. Epidemiology. 2000 Mar;11(2):220–224. doi: 10.1097/00001648-200003000-00023. [DOI] [PubMed] [Google Scholar]
  2. Ascherio A., Munger K. L., Lennette E. T., Spiegelman D., Hernán M. A., Olek M. J., Hankinson S. E., Hunter D. J. Epstein-Barr virus antibodies and risk of multiple sclerosis: a prospective study. JAMA. 2001 Dec 26;286(24):3083–3088. doi: 10.1001/jama.286.24.3083. [DOI] [PubMed] [Google Scholar]
  3. Ben-Shlomo Y., Davey Smith G., Marmot M. G. Dietary fat in the epidemiology of multiple sclerosis: has the situation been adequately assessed? Neuroepidemiology. 1992;11(4-6):214–225. doi: 10.1159/000110934. [DOI] [PubMed] [Google Scholar]
  4. Dean G. Annual incidence, prevalence, and mortality of multiple sclerosis in white South-African-born and in white immigrants to South Africa. Br Med J. 1967 Jun 17;2(5554):724–730. doi: 10.1136/bmj.2.5554.724. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Goldacre M. J., Seagroatt V., Yeates D., Acheson E. D. Skin cancer in people with multiple sclerosis: a record linkage study. J Epidemiol Community Health. 2004 Feb;58(2):142–144. doi: 10.1136/jech.58.2.142. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Goldacre M., Kurina L., Yeates D., Seagroatt V., Gill L. Use of large medical databases to study associations between diseases. QJM. 2000 Oct;93(10):669–675. doi: 10.1093/qjmed/93.10.669. [DOI] [PubMed] [Google Scholar]
  7. Hayes C. E. Vitamin D: a natural inhibitor of multiple sclerosis. Proc Nutr Soc. 2000 Nov;59(4):531–535. doi: 10.1017/s0029665100000768. [DOI] [PubMed] [Google Scholar]
  8. Holman C. D., Bass A. J., Rouse I. L., Hobbs M. S. Population-based linkage of health records in Western Australia: development of a health services research linked database. Aust N Z J Public Health. 1999 Oct;23(5):453–459. doi: 10.1111/j.1467-842x.1999.tb01297.x. [DOI] [PubMed] [Google Scholar]
  9. Kendrick S., Clarke J. The Scottish Record Linkage System. Health Bull (Edinb) 1993 Mar;51(2):72–79. [PubMed] [Google Scholar]
  10. Levin Lynn I., Munger Kassandra L., Rubertone Mark V., Peck Charles A., Lennette Evelyne T., Spiegelman Donna, Ascherio Alberto. Multiple sclerosis and Epstein-Barr virus. JAMA. 2003 Mar 26;289(12):1533–1536. doi: 10.1001/jama.289.12.1533. [DOI] [PubMed] [Google Scholar]
  11. Lindberg C., Andersen O., Vahlne A., Dalton M., Runmarker B. Epidemiological investigation of the association between infectious mononucleosis and multiple sclerosis. Neuroepidemiology. 1991;10(2):62–65. doi: 10.1159/000110248. [DOI] [PubMed] [Google Scholar]
  12. Marrie R. A., Wolfson C., Sturkenboom M. C., Gout O., Heinzlef O., Roullet E., Abenhaim L. Multiple sclerosis and antecedent infections: a case-control study. Neurology. 2000 Jun 27;54(12):2307–2310. doi: 10.1212/wnl.54.12.2307. [DOI] [PubMed] [Google Scholar]
  13. Wandinger K., Jabs W., Siekhaus A., Bubel S., Trillenberg P., Wagner H., Wessel K., Kirchner H., Hennig H. Association between clinical disease activity and Epstein-Barr virus reactivation in MS. Neurology. 2000 Jul 25;55(2):178–184. doi: 10.1212/wnl.55.2.178. [DOI] [PubMed] [Google Scholar]
  14. Warner H. B., Carp R. I. Multiple sclerosis and Epstein-Barr virus. Lancet. 1981 Dec 5;2(8258):1290–1290. doi: 10.1016/s0140-6736(81)91527-0. [DOI] [PubMed] [Google Scholar]
  15. van der Mei I. A. F., Ponsonby A-L, Dwyer T., Blizzard L., Simmons R., Taylor B. V., Butzkueven H., Kilpatrick T. Past exposure to sun, skin phenotype, and risk of multiple sclerosis: case-control study. BMJ. 2003 Aug 9;327(7410):316–316. doi: 10.1136/bmj.327.7410.316. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Journal of Epidemiology and Community Health are provided here courtesy of BMJ Publishing Group

RESOURCES