Most people associate hearing loss with noise exposure or aging. But did you know that common viral infections can also affect your hearing? From temporary changes in hearing to long-term damage, several viruses have been linked to ear-related complications. Understanding this connection can help you stay vigilant about your hearing health, especially during and after illness.

How Viruses Affect Hearing

Viruses can harm the ear in several ways:

• Directly damaging inner ear structures like the cochlea or auditory nerve

• Triggering inflammation that affects hearing or balance

• Causing secondary infections, such as ear infections, that lead to fluid buildup or pressure

Hearing issues caused by viruses may be temporary or permanent, and may affect one or both ears.

Common Viral Infections Linked to Hearing Problems

Measles

Measles can cause sensorineural hearing loss, which is permanent, by directly damaging the inner ear or auditory nerve. The risk is particularly high in children. Luckily, measles can be prevented with the MMR (measles, mumps, rubella) vaccine.

Mumps

Sudden, often permanent hearing loss may be caused by mumps, usually on one side. The virus that causes mumps may inflame the cochlea and auditory nerve, leading to this hearing loss. Mumps-related hearing loss is rare, but it is one of the better-known viral causes of permanent hearing loss in children.

Rubella (German Measles)

Rubella can cause congenital hearing loss in infants. When a pregnant person contracts rubella, the virus may cross the placenta and harm the developing inner ear of the fetus, leading to the infant being born with permanent hearing loss. Rubella-related hearing loss is largely preventable through vaccination.

Cytomegalovirus (CMV)

Progressive or fluctuating hearing loss, often in children, may be caused as a result of cytomegalovirus (CMV) infection. CMV is a leading non-genetic cause of congenital hearing loss and, like rubella, it can be passed on from a pregnant person to an infant before it is born. Importantly, many CMV infections are asymptomatic, making newborn hearing screening crucial.

Herpes Simplex Virus (HSV)

HSV can cause sudden sensorineural hearing loss via inflammation of the cochlea or auditory nerve. In newborns, HSV can be acquired during birth and may lead to permanent hearing loss if untreated.

Influenza (“The Flu”)

Many people don’t realize that the flu doesn’t just cause fever and chills. Influenza virus may lead to temporary hearing loss, ear pressure, or tinnitus (ringing in the ears). Congestion and secondary ear infections (otitis media) may result from the flu, and these can temporarily affect hearing. Severe cases of these symptoms can lead to inner ear inflammation and more serious damage. Auditory flu symptoms typically resolve on their own, but persistent issues should be evaluated by a health professional.

COVID-19

Emerging evidence shows associations between COVID-19 and sudden hearing loss, tinnitus, and dizziness. This is possibly due to direct viral invasion of inner ear cells or secondary inflammation from the infection affecting the auditory nerve. Research is ongoing, but hearing changes have been reported both during acute infection and in long-COVID cases.

Varicella Zoster Virus (Chickenpox & Shingles)

The virus that causes chickenpox and shingles can cause Ramsay Hunt Syndrome, a condition that includes facial paralysis, ear pain, and hearing loss. This occurs due to reactivation of the virus in the facial nerve, near the ear, and can affect both hearing and balance. Antiviral medication and corticosteroids are typically prescribed for treatment, and early intervention improves outcomes.

What to Watch For

If you or your child has recently had a viral illness and experience any of the following symptoms, it’s important to consult a healthcare provider:

• Sudden hearing loss in one or both ears

• Persistent ear fullness or pressure
  Ringing in the ears (tinnitus)

• Dizziness or balance issues

• Delayed speech or language development in children

Early evaluation can help determine whether the hearing issue is temporary or needs treatment.

Protecting Your Hearing During Illness

Luckily, there are ways to protect your hearing from the impacts of viral infection:

• Vaccinate: Stay up-to-date on routine vaccines like MMR, flu, COVID-19, and varicella.

• Seek early treatment: Don’t delay medical care if hearing changes occur, especially after a viral infection.

• Follow up: If a child has been ill with a virus known to affect hearing, ask your pediatrician about a hearing evaluation.

• Monitor symptoms: Temporary congestion or fluid-related hearing issues may resolve, but persistent symptoms should be assessed.

Hearing health is closely linked to overall health, and viral infections are a surprisingly common cause of auditory issues. While some infections may lead to only temporary hearing changes, others can result in lifelong hearing loss if not identified and managed promptly.

The good news is that many viral-related hearing issues are preventable through vaccination, early diagnosis, and proactive care. If you've recently had a viral illness and notice changes in your hearing or balance, don’t ignore it. Your ears might be telling you something important.

For more articles like this, subscribe to the RestorEar newsletter.