The Strange Connection Between Mono and M.S.

Denis Burkitt, an Irish surgeon, traveled Africa during World War II as a member of the Royal Army Medical Corps and later settled in Uganda to practice medicine. There he noticed that a surprising number of children developed strange jaw tumors, cancer that would become known as Burkitt’s lymphoma. Burkitt eventually sent samples of the tumor cells to the Middlesex Hospital School of Medicine in London, where pathologist Michael Anthony Epstein and his colleagues Yvonne Barr and Bert Achong examined them under an electron microscope.

Their results – they noticed particles similar to the herpes virus, only smaller were published in an important article in Lancet in 1964 and prompted the realization that this newly identified member of the herpes virus family, later named the Epstein-Barr virus, was the cause of Burkitt’s lymphoma. This was the first evidence that a viral infection could lead to cancer. The virus has since been shown to increase the risk of Hodgkin’s lymphoma, as well as cancers of the nasopharynx and stomach. It is also the most common cause of infectious mononucleosis, a disease typically characterized by extreme fatigue, sore throat, fever, and swollen lymph nodes in the neck. These symptoms may persist for several weeks, and in chronic cases, recur for years.

We now know that over 90 percent of adults are infected with the Epstein-Barr virus. As with other herpes viruses, once infected, the virus stays with you forever—it deposits its DNA along with yours in the nuclei of many of your cells. (RNA viruses such as SARS-CoV-2 can be cleared from the body.) Most people become infected with the Epstein-Barr virus during childhood: it is spread through bodily fluids, usually saliva; kissing is a common route of transmission (as is sharing utensils). Young children, if they become ill at all, usually develop symptoms that are indistinguishable from those of a cold or flu; mono is more common when the first infection occurs after puberty. “Most people will never know they’re infected,” says Jeffrey Cohen, director of the infectious disease laboratory at the National Institute of Allergy and Infectious Diseases.

The virus enters the cells in the back of the throat and travels from there to B cells, a type of white blood cell that produces antibodies. In some B cells, the virus replicates, creating proteins that the immune system can recognize and suppress. However, in other cells, it remains dormant. “He’s very inconspicuous,” says Cohen. Eventually, as these infected B cells circulate throughout the body, they reach the back of the throat again. The virus awakens and begins to produce proteins that its host loses, potentially spreading the pathogen to others, probably for several days a month. “The vast majority of infected people pass it on,” says Cohen. “It’s spilled in our saliva for the rest of our lives.”

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