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In a group of 901 people in Germany who were studied at early stages of MS, every individual exhibited evidence of the Epstein-Barr virus (EBV) in blood samples, using several means of detection. These findings add strong evidence to an association between Epstein-Barr virus and MS, although they do not show that this virus actually causes the disease.

• To date, researchers have not been able to identify a single virus as the trigger for MS. Several viruses have been studied, with Epstein-Barr Virus showing the most evidence thus far, but multiple steps are required to show that a particular virus is an actual cause of MS. Researchers must prove that: the virus is in the body before MS develops, and that the virus actually causes the disease and is not just happening alongside the disease.
• Researchers have raised the possibility that MS is a rare complication of EBV infection. It is also possible that EBV infection may be required to develop MS, but that it does not act alone, and one or more other risk factors are needed to trigger MS.
• The German National MS cohort enrolled a total of 1212 participants from multiple centers in Germany between August 2010 and December 2014. It includes people diagnosed with MS at early stages – that is, in the previous six months with clinically isolated syndrome, or in the past two years with relapsing-remitting MS. People in this early cohort had not yet been treated with any disease-modifying therapy for MS (except for short-term treatment for relapses).
• The investigators tested blood samples that had been collected from the early cohort, and identified EBV in 100% of the samples. They also tested blood samples from more than 16,000 people in the general hospital population. The prevalence of EBV was high in the hospital population, reaching 95%, but never 100%.
• The team suggested that if a person with MS-like symptoms does not show signs of EBV exposure, then it may be prudent to consider a diagnosis other than MS.
• Read more about viruses implicated in MS, and learn more on the complex picture of MS risk factors in a RealTalkMS podcast. 

“Complete Epstein-Barr virus seropositivity in a large cohort of patients with early multiple sclerosis” by Drs. Sargis Abrahamyan, Klemens Ruprecht, and colleagues on behalf of the German Competence Network Multiple Sclerosis, is published in the Journal of Neurology Neurosurgery and Psychiatry.