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To the Editor:
In a recent paper, Marrie et al.1 used a case-control methodology to investigate a possible relationship between MS and infectious mononucleosis (IM). The study involved 225 subjects with MS and 900 controls matched for age, sex, and physician practice, with all subjects being from the United Kingdom. Marrie et al., on the basis of a significantly higher rate of IM in cases (5 of 225) than in controls (6 of 900), interpreted that contracting IM is a risk factor for MS.
I believe that their data are not sufficient to draw such a conclusion. Infection with Epstein-Barr virus (EBV), regardless of timing, is a putative risk factor for MS because almost all persons with MS have been previously infected with EBV.2,3⇓ Experimental work has revealed that EBV could theoretically participate in MS etiology …
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