NEW DELHI: Next time you wake up with extreme fatigue, high fever, sore throat and swollen glands, take note. The trigger behind it could be a simple kiss.Infectious mononucleosis or “kissing disease” is caused by Epstein-Barr virus (EBV) and is one of the most common human infections worldwide. It is spread through saliva, not just kissing, but daily close contact.A US study using records from the Rochester Epidemiology Project, led by the Mayo Clinic, which tracked nearly 19,000 people, found that people with mononucleosis were more than three times more likely to later develop multiple sclerosis (MS). The risk is still small — 0.17 percent in people with mononucleosis and 0.07 percent in people without mononucleosis — but the disease also appears earlier in infected people.Multiple sclerosis is a chronic disease in which the immune system attacks the protective covering of nerves, disrupting signals between the brain and body. It may begin with fatigue, vision problems, numbness, and imbalance, and may worsen over time.Experts say the link is strong but not causative. Dr. Sudhir Kumar, a neurologist at Apollo Hospitals in Hyderabad, said the apparent increase in multiple sclerosis cases in younger people may reflect better awareness and earlier MRI-based diagnosis rather than a true shift in incidence. Although EBV is closely related to multiple sclerosis, which infects most people, the disease remains uncommon. “EBV may act as a trigger in genetically susceptible individuals, but it is not sufficient by itself to cause multiple sclerosis,” he said, adding that it’s unclear whether early infection causes early disease.He warned against routine long-term monitoring after mononucleosis, noting that the absolute risk is low and over-testing may cause unnecessary anxiety. Rather, awareness is key. Early symptoms—such as blurred vision or pain, tingling or numbness, unexplained fatigue, brief weakness, imbalance, or a shock-like sensation in the spine—are often overlooked as they come and go, but any neurological symptoms that persist for more than 24 hours should be evaluated.Professor Manjari Tripathi, director of the neurology department at AIIMS, Delhi, said Epstein-Barr virus is common in India, especially among children and adolescents. She said, “Multiple sclerosis is a complex disease with multiple risk factors – genetic, environmental and immune. EBV may be a trigger, but it is not the only cause, and most people infected will never develop MS.”Scientists say the findings strengthen the case for prevention strategies, including a potential Epstein-Barr virus vaccine.
