Does Mono (Epstein-Barr Virus) Cause Multiple Sclerosis?

Learn how the Epstein Barr Virus is a risk factor for MS

Woman in bed looking ill
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While experts do not know the precise cause of MS, most believe that MS develops from a unique interplay between a person's genes and their environment. It's thought that environmental factors like sunlight exposure, smoking, and/or exposure to certain infections (especially viruses) may trigger MS in individuals with a certain genetic makeup. EBV is the most notable virus that has been linked to MS.


How EBV is Connected to Multiple Sclerosis

Epstein-Barr virus (EBV) is the most common cause of infectious mononucleosis, more commonly known as "mono" or "glandular fever." Mono is a disease that most commonly affects young adults, especially those in college. But not everyone who is infected with EBV gets mono. According to the Centers for Disease Control and Prevention, or CDC, about one-quarter of young adults who are infected with EBV will develop mono.

Common mono symptoms include severe fatigue, sore throat, body aches, headache, swollen glands, and rash. Less common symptoms include an enlarged spleen (located in the upper left part of your abdomen) and/or a swollen liver (located in the upper right part of your abdomen). 

In terms of how EBV is connected to MS, EBV is more common in people with MS than in people who do not have MS. In addition, having a history of mono is a risk factor for developing MS.

High amounts of EBV antibodies in the blood—proteins made by a person’s immune system to fight viruses—is also a risk factor for MS.

What Does This Mean for Me If I Get Mono?

Just because you are diagnosed with mono does not mean you will develop MS. In fact, you probably will not. Not everyone who has one or more potential risk factors is going to get MS.

But in some instances the right (or wrong) combination occurs and the result is multiple sclerosis.

Think of it this way. There are multiple causes for a flat tire—a nail or big piece of glass gets run over, your tire gets old and wears out, or you hit a really big bump. Often it’s a combination of more than one of these factors that leads to a flat tire. Once you have a flat tire, you have the same problem as everyone else with a flat tire, regardless of the reason. The solution is the same too—fix the hole and put more air in.

Bottom Line

No virus, including Epstein-Barr virus, has been found to cause MS. That being said, the scientific evidence linking EBV to MS is mounting. It appears there is something there, but we just don't know yet how to interpret it. 


Birnbaum, M.D. George. (2013). Multiple Sclerosis: Clinician’s Guide to Diagnosis and Treatment, 2nd Edition. New York, New York. Oxford University Press.

Centers for Disease Control and Prevention. Epstein Barr Virus and Infectious Mononucleosis. Accessed February 3rd 2016. 

Pohl D. Epstein-Barr virus and multiple sclerosis. J Neurol Sci. 2009 Nov 15;286(1-2):62-4.

Serafini B et al. Dysregulated Epstein-Barr virus infection in the multiple sclerosis brain. J Exp Med. 2007 Nov 26;204(12):2899-912.

Tselis A. Epstein-Barr virus cause of multiple sclerosis. Curr Opin Rheumatol. 2012 Jul;24(4):424-8.

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