Skip to main content

The role of the early social environment on Epstein Barr virus infection: a prospective observational design using the Millennium Cohort Study

  • V. GARES (a1) (a2), L. PANICO (a3), R. CASTAGNE (a1) (a2), C. DELPIERRE (a1) (a2) and M. KELLY-IRVING (a1) (a2)...

Epstein-Barr virus (EBV) is a highly prevalent herpesvirus linked to infectious mononucleosis and several malignancies. This paper aims to study the association between children's early life social environment at 9 months and EBV infection at 3 years of age.


We used data on children included in the UK Millennium Cohort Study. We described the social environment using area-level and material factors as well as socioeconomic position (SEP) at 9 months. EBV was measured at 3 years of age (n = 12 457).


Lower rates of EBV infection were observed in children living in towns and rural areas compared with those living in cities. Lower SEP and overcrowding in the household increased the odds of being infected. Children whose parents were social tenants were more likely to be infected than homeowners. In the overall model, the strength of the association between material factors and EBV infection weakened.


We showed that early life material deprivation was associated with a higher risk of EBV infection among 3-year-olds. Children living in more deprived social conditions may be more likely to become EBV carriers at an earlier age.

Corresponding author
*Author for correspondence: V. Garès, INSERM, UMR1027, F-31000 Toulouse, France and Université Toulouse III Paul-Sabatier, UMR1027, F-31000 Toulouse, France. (Email:
Hide All

These authors contributed equally to this work.

Hide All
1. Wolf, H, Bogedain, C, Schwarzmann, F. Epstein-Barr virus and its interaction with the host. Intervirology 1993; 35(1–4): 2639.
2. De-The, G, et al. Sero-epidemiology of the Epstein-Barr virus: preliminary analysis of an international study – a review. IARC Scientific Publications 1975; 11(2): 316.
3. Cohen, JI. Epstein-Barr virus infection. The New England journal of medicine 2000; 343(7): 481492.
4. Evans, AS. The spectrum of infections with Epstein-Barr virus: a hypothesis. The Journal of Infectious Diseases 1971; 124(3): 330337.
5. Hsu, JL, Glaser, SL. Epstein-Barr virus-associated malignancies: epidemiologic patterns and etiologic implications. Critical Reviews in Oncology/Hematology 2000; 34(1): 2753.
6. Zajacova, A, Dowd, JB, Aiello, AE. Socioeconomic and race/ethnic patterns in persistent infection burden among U.S. adults. The Journals of Gerontology Series A, Biological Sciences and Medical Sciences 2009; 64A(2): 272279.
7. Condon, LM, et al. Age-specific prevalence of Epstein-Barr virus infection among Minnesota children: effects of race/ethnicity and family environment. Clinical Infectious Diseases 2014; 59(4): 501508.
8. Piriou, E, et al. Early age at time of primary Epstein-Barr virus infection results in poorly controlled viral infection in infants from Western Kenya: clues to the etiology of endemic Burkitt lymphoma . Journal of Infectious Diseases 2012; 205(6): 906913.
9. Slyker, JA, et al. Clinical and virologic manifestations of primary Epstein-Barr virus (EBV) infection in Kenyan infants born to HIV-infected women. The Journal of Infectious Diseases 2013; 207(12): 17981806.
10. Dowd, JB, Aiello, AE, Alley, D. Socioeconomic disparities in the seroprevalence of cytomegalovirus infection in the US population: NHANES III. Epidemiology and Infection 2009; 137(01): 5865.
11. McQuillan, GM, et al. Racial and ethnic differences in the seroprevalence of 6 infectious diseases in the United States: data from NHANES III, 1988–1994. American Journal of Public Health 2004; 94(11): 19521958.
12. Dowd, JB, et al. Seroprevalence of Epstein-Barr virus infection in U.S. children ages 6–19, 2003–2010. PLoS ONE 2013; 8(5): e64921.
13. Ferres, M, et al. Seroprevalence of Epstein Barr virus infection in a healthy population of Santiago de Chile. Revista medica de Chile 1995; 123(12): 14471452.
14. Jansen, MA, et al. Determinants of ethnic differences in cytomegalovirus, Epstein-Barr virus, and herpes simplex virus type 1 seroprevalence in childhood. The Journal of Infectious Diseases 2016; 170: 126134, e121–e126.
15. Chabay, PA, Preciado, MV. EBV primary infection in childhood and its relation to B-cell lymphoma development: a mini-review from a developing region. International Journal of Cancer 2013; 133(6): 12861292.
16. Kelly-Irving, M, Tophoven, S, Blane, D. Life course research: new opportunities for establishing social and biological plausibility. International Journal of Public Health 2015; 60(6): 629630.
17. Connelly, R, Platt, L. Cohort profile: UK Millennium Cohort Study (MCS). International Journal of Epidemiology 2014; 43(6): 17191725.
18. Anon. University of London. Institute of Education. Centre for Longitudinal Studies. (2012). Millennium Cohort Study: Second Survey, 2003–2005: Oral Fluid Collection Bioassay Data. [data collection]. UK Data Service. SN: 6993,
19. Anon. University of London. Institute of Education. Centre for Longitudinal Studies. (2017). Millennium Cohort Study: First Survey, 2001–2003. [data collection]. 12th Edition. UK Data Service. SN: 4683,
20. Bartington, SE, et al. Feasibility of collecting oral fluid samples in the home setting to determine seroprevalence of infections in a large-scale cohort of preschool-aged children. Epidemiology and Infection 2009; 137(2): 211218.
21. Anon. University of London. Institute of Education. Centre for Longitudinal Studies. (2017). Millennium Cohort Study: Second Survey, 2003–2005. [data collection]. 9th Edition. UK Data Service. SN: 5350,
22. Townsend, C, et al. Technical report on the Millennium Cohort Study biomedical data enhancement study of infections and later allergies. UK Data Service,
23. McLeod, CB, et al. Income inequality, household income, and health status in Canada: a Prospective Cohort Study. American Journal of Public Health 2003; 93(8): 12871293.
24. Hsu, JL, Glaser, SL. Epstein-Barr virus-associated malignancies: epidemiologic patterns and etiologic implications. Critical Reviews in Oncology/Hematology 2000; 34(1): 2753.
25. Plewis, I. Non-response in a birth Cohort study: the case of the Millennium Cohort Study. International Journal of Social Research Methodology 2007; 10(5): 325334.
26. Sumaya, CV, et al. Seroepidemiologic study of Epstein-Barr virus infections in a rural community. The Journal of Infectious Diseases 1975; 131(4): 403408.
27. Crowcroft, NS, et al. Epidemiology of Epstein-Barr virus infection in pre-adolescent children: application of a new salivary method in Edinburgh, Scotland. Journal of Epidemiology and Community Health 1998; 52(2): 101104.
28. Baker, MG, et al. Collaborating with a social housing provider supports a large cohort study of the health effects of housing conditions. BMC Public Health 2016; 16: 159.
29. Gray, A. Definitions of Crowding and the Effects of Crowding on Health. A Literature Review Prepared for the Ministry of Social Policy. 2001.
30. Worthman, CM, Panter-Brick, C. Homeless street children in Nepal: use of allostatic load to assess the burden of childhood adversity. Development and Psychopathology 2008; 20(1): 233255.
31. Dowd, JB, Zajacova, A, Aiello, A. Early origins of health disparities: burden of infection, health, and socioeconomic status in U.S. children. Social Science & Medicine 2009; 68(4): 699707.
32. Schaub, B, Lauener, R, von Mutius, E. The many faces of the hygiene hypothesis. The Journal of Allergy and Clinical Immunology 2006; 117(5): 969977; quiz 978.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
Please enter your name
Please enter a valid email address
Who would you like to send this to? *


Type Description Title
Supplementary materials

Gares et al. supplementary material
Tables S1-S3

 Word (40 KB)
40 KB


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed