Makhani, et al. AIMS: This study analysed Epstein-Barr virus (EBV), cytomegalovirus (CMV), varicella-zoster virus (VZV), and herpes simplex virus (HSV) in children with a first attack of central nervous system demyelination (ADS). RESULTS: Children diagnosed with MS were more likely than those with monophasic ADS, i.e. non-MS, to be seropositive for remote EBV infection (37/49 vs 82/185, p<0.001) but not for CMV (7/33 vs 37/97, p=0.09), HSV (6/36 vs 26/110, p=0.48) or VZV (30/33 vs 83/97, p=0.55) exposure. CONCLUSIONS: Although the majority of children with MS are seropositive for remote EBV exposure, EBV is not obligatory for MS development in children.
“I am not convinced; the diagnosis of MS in children is not easy. It will be very important to follow the children with MS that are EBV negative to make sure they have typical MS and not another disease. The corollary to this is that if children can develop MS without antecedent EBV infection the association between EBV infection and MS is unlikely to be causal; it will also question the EBV vaccination strategy that is being promoted as a prevention strategy for MS.”