Is MS sexually-transmitted?

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If MS is due to EBV infection, it may be sexually transmitted, as EBV can be transmitted sexually. #MSBlog #MSResearch


EBV infection is not necessarily sexually transmitted. You can exchange saliva and virus in other ways. #MSBlog #MSResearch

In response to the comment: “…… I notice that your collaborator Prof Hawkes believes that MS is caused by child abuse…..”


“This comment, which I don’t agree with, is based on a statement from the following hypothesis article of Chris Hawkes’.”


C Hawkes. Is multiple sclerosis a sexually transmitted infection? J Neurol Neurosurg Psychiatry. 2002 October; 73(4): 439–443.

“It may be worth reading the paper. Any theory about causation needs to be read in the context of causation theory. Unfortunately, Dr Hawkes did not do this when he framed his hypothesis; if he did he may have come to an alternative explanation regarding the cause of MS. You need  to remember that there is a  science behind causation. It started way back in the later 1800’s when Robert Koch formulated his postulates to persuade his contemporaries that the he had found the cause of tuberculosis.” 


Koch’s postulates are:


1. The specific organism should be shown to be present in all cases of animals suffering from a specific disease but should not be found in healthy animals.

2. The specific microorganism should be isolated from the diseased animal and grown in pure culture on artificial laboratory media.

3. This freshly isolated microorganism, when inoculated into a healthy laboratory animal, should cause the same disease seen in the original animal.

4. The microorganism should be reisolated in pure culture from the experimental infection. 


Kochs’s postulates served us well, but broke down when we tried to apply them to viruses that only have one host. It then fell to the British Statistician, Sir Austin Bradford-Hill, to formulate more general and appropriate criteria of causation; the following are the Bradford-Hill criteria:



1. CONSISTENCY AND UNBIASEDNESS OF FINDINGS

2. STRENGTH OF ASSOCIATION

3. TEMPORAL SEQUENCE

4. BIOLOGICAL GRADIENT (DOSE-RESPONSE RELATIONSHIP)

5. SPECIFICITY

6. COHERENCE WITH BIOLOGICAL BACKGROUND AND PREVIOUS KNOWLEDGE

7. BIOLOGICAL PLAUSABILITY

8. REASONING BY ANALOGY

9. EXPERIMENTAL EVIDENCE

If you are interested in reading about these criteria I suggest the following references:

Bradford-Hill A. The environment and disease: association or causation? Proc Royal Soc Med 1965; 58:295-300.

Bradford-Hills Criteria

Bradford-Hill’s criteria have also been modified to apply them to the problem of MS:

Giovannoni et al. Infectious causes of multiple sclerosis.Lancet Neurol. 2006 Oct;5(10):887-94.

“When you apply Bradford-Hill’s criteria to MS as being a caused by EBV several of the Bradford-Hill criteria can be ticked. When you apply these criteria to MS being a sexually transmitted disease, a few if any can be ticked and, finally, in relation to MS being caused by child abuse you can’t tick any of the boxes. So in summary, I don’t think MS is caused by child abuse; there is simply no evidence to support this hypothesis. However, the jury is still out on MS being possibly sexually transmitted. I am convinced that EBV is involved in the causal pathway of MS. EBV is transmitted by saliva. The process of exchanging saliva, particularity after childhood, usually requires intimate contact and hence the pattern of infection of EBV in relation to infectious mononucleosis looks similar to a sexually transmitted disease. In fact Dorothy Crawford, an EBV expert from Edinburgh, claims that EBV infection may be sexually transmitted in ~15% of cases. The following paper puts her claim into context.”


Dorothy et al. Sexual History and Epstein-Barr Virus Infection. The Journal of Infectious Diseases. 2002; 186:731-736.

To determine the role of sexual contact in transmission of Epstein-Barr virus (EBV) and occurrence of infectious mononucleosis (IM), a cross-sectional study was undertaken of EBV serologic testing and histories of IM and sexual behavior among 1006 new students at Edinburgh University. Prevalence of EBV seropositivity was significantly greater among women (79.2%) than among men (67.4%; P <.001) and among those who had ever been sexually active (82.7%) than among those who had not (63.7%; P <.OOl). Having a greater number of sex partners was a highly significant risk factor for EBV seropositivity. Two thirds of IM cases, but only a tenth of asymptomatic primary EBV infections, were statistically attributable to sexual intercourse. The findings suggest that EBV transmission occurs during sexual intercourse or closely associated behaviors. Transmission in this way appears to account for most cases of IM but for only a minority of cases of asymptomatic EBV infection, which mainly occur at younger ages.

About the author

Prof G

Professor of Neurology, Barts & The London. MS & Preventive Neurology thinker, blogger, runner, vegetable gardener, husband, father, cook and wine & food lover.

33 comments

    • No different to the general population. A strong argument against the STD hypothesis. George Ebers has published a lot on this.

    • The child abuse and/or STD hypotheses don't tick the BH criteria. In fact it is difficult to apply BH criteria to these issues as they are very non-specific categories.

      However, EBV infection ticks most of BH criteria to a greater or lesser extent. The issue is that EBV, in addition to being spread by saliva, may be sexually transmitted as well. Hence for me to dismiss the STD theory would seem at odds with position of being in the EBV camp. The issue re it being an STD or not is irrelevant, what is important is knowing that the virus is linked to the cause of MS in some way. Knowing what we know about EBV cannot be ignored, which is why I am so determined to take the EBV hypothesis forward.

    • Greetings from across the pond. I have MS and have never had unprotected sex without a barrier, and one partner. I am negative for common background viruses like CMV, HPV, and JC and all STDs. Maybe I shared a straw with someone at one point in my life. I would be interested if I had EBV, but if it is spread by saliva I wouldn't pejoratively call it an "STD."

    • I have MS and HIV. Could MS be a result of homosexual intercourse? I noticed a lot of things about MS and HIV on this blog.

    • In response to your question I doubt it. There is interest on the blog because of the Charcot project where the plan is that a drug used to treat HIV infection is aimed to control MS

    • Sirs, is it because you have multiple secure partners? I was very carefree in my youth… Is this the reason why I got MS?

    • Re: "I was very carefree in my youth… Is this the reason why I got MS?"

      No. MS is not a sexually transmitted disease. There is no evidence that being carefree in your youth causes MS. The only factors that have been identified are infectious mononucleosis and smoking.

    • I also have aids and MS. My parents think it is my punishment for being gay- is that what the research shows?

    • Re: "HIV & MS"

      We have found the opposite; people who are HIV+ve have a lower chance of getting MS. Why and how this occurs is unknown, but a subject of intense speculation within our group.

    • I'm glad we're having this conversation because I was diagnosed two years ago. My boyfriend for the past 8 years was married to a woman who had MS. She's in a nursing home now. What a coincidence, huh?

      I kind of knew it wasn't contagious, but it was always in the back of my mind a little. On the other hand, I see it as relationship security. I mean, what other woman would sleep with him now with his track record? Think I'll post this as Anonymous….

    • Really? I know numerous gay HIV+ve MSers. ARTs doesn't stop MS for us by the way.

      Interesting is the writing on the wall for the charcot project. ProfG down under has searched the UK data base for all MSers who are also MSers.

    • My friend and I I were both virgins when we were diagnosed at a very young age. Maybe it was something to do with the guy I snogged who had toothache. Come on scientists, please find the true cause.

    • Without data it is not possible to ascertain risk although one hazard a guess., where does this stop.

      Is having red hair a risk factor, ice cream etc etc

    • Prof G – I don't understand – are you saying you support the sexual transmission story? I think I would be a good case for you. I had an affair with someone who had MS and then my wife developed it.

  • Is there a single virgin out there with MS?. If there is, which there will be lots of them at the time of diagnosis, then the idea is blown out of the water.

    Transfer of a bit of saliva is not the same as intercourse, unless I have been doing it differently, and Dr. Hawkes suggestions caused deep, deep offense at the time they were made.

    Obviously the more people you snog the chances you have of getting some saliva increase.
    Wonder what the incidence of MS in continental footballers was, as they used to have a habit of gobbing on their opponents:-)
    However, can we apply the same question. Is MS related to ice cream consumption? If you look hard enough you could find a link. How many people have taken a lick at a kids ice cream, when it was melting in the sun. Transfer of saliva?

  • This paper was a classic example of, sit down and think about the implications before you hit the submit manuscript button.

  • I object to the description in the paper of IM (glandular fever) as a benign disease, they has obviously never had it. That virus has made a number of attempts at trying to kill me.

  • "1. The specific organism should be shown to be present in all cases of animals suffering from a specific disease but should not be found in healthy animals."

    Clearly you cannot think that EBV is the cause of MS since almost all Hunan adults have the virus. A more logical thing to say is that people with MS may have an abnormal reaction to EBV such as a problem with their immune system. The vast majority of scientists would agree with the latter, but the former is unreasonable.

  • I just found out that I have Epstein Barr virus. I had been totally healthy and not very sexually active–never had any infections from anyone. Then I get this test result of my exposure….I haven't even kissed anyone since my last clean tests from all viruses. BUT, my co-worker has MS and she has drink cans sitting around all the time that I moved one time recently. Did she give it to me???…I'm around her all week and I understand that the virus is synonymous with MS. I wish someone had warned me!! 🙁 I'm miffed. There should be warnings about these transmissions, especially if her immune system is out of control. 🙁 Is this the likelihood for me??…

    • Chances are you picked up the virus when you were a child; about 30-40% of conversions are asymptomatic in childhood. The latter are often vertical transmissions from mother or grandmother to children. Horizontal transmission via saliva typically occur in adolescence and early adulthood. I would be surprised if you picked it up from you colleague.

    • >Have you actually ever thought of how many people touch that can before you actually drink it? To actually think that MS can be transmitted by your colleague leaving a coke can around…well, it probably explains why people arent pushing for the discovery of the real cause of MS.

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