by Kimberly Allen, RN
The Epstein-Barr virus (EBV) is also known as human herpesvirus 4 (HH4) is a member of the herpes family. It is also one of the most common viruses found in humans infecting over 95% of the worlds adult population. In addition to the 95% of adults that have been infectfed with EBV, in the US approximately half of all children 5 years of age have antibodies against EBV indicating a previous infection. Once the maternal antibody protection ears off infants become vulnerable to EBV. In the US most people don’t become infected during childhood, it usually occurs during their teens.
The EBV is mostly known for causing infectious mononucleosis, however, it has been linked to numerous other conditions including certain cancers like Hodgkin’s lymphoma, nasopharengieal cancer and Burkitt’s lymphoma. EBV has also been linked to an increased risk of some autoimmune diseases, though dermatomuositis is the most common it has also been linked to rheumatoid arthritis and systemic lupus errythematous as well as multiple sclerosis and Sjogrens syndrome. It is a highly contagious virus that is spread from person to person through saliva and/or genital secretions. It is most commonly spread through kissing or sharing utensils, and glasses as well as food. That’s why infectious mononucleosis is frequently called the “kissing” disease. The EBV has DNA that is double stranded and multiplies easily in a type of white blood cell called lymphocytes as well as cells that live in your mouth, including the tongue, and your nose. In most cases your immune system is able to control and contain the virus, however, it does not eradicate it from your body. There will remain a few living EBV in your lymphocytes for the rest of your life. this makes it possible for the virus to reactivate later in life, which is called a “latent” infection. In most cases if the virus reactivates you won’t experience any symptoms.
Symptoms of EBV usually don’t manifest for 4-6 weeks after becoming infected. Children tend to have mild non-specific symptoms that resemble other childhood infections or no symptoms at all. However, in rare cases children can develop low white blood cell counts and pneumonia as well as rashes. On the other hand teens and young adults tend to develop symptoms related to infectious mononucleosis. Symptoms of acute infectious mononucleosis include a fever ans swollen lymph glands as well as a sore throat. The sore throat tends to be very painful which is usually what causes the person to see their doctor. In most people infected their tonsils tend to become inflamed and they also experience other symptoms like weakness and fatigue and a poor appetite as well as headaches and bloating. Chills and sweats are not uncommon either.
There is no “cure” for EBV and viruses do not respond to antibiotics. The goal of treatment for EBV is to manage and relieve the symptoms and to maintain your body’s strength while the infection runs it’s course. Supportive care it the best way to accomplish this task. That means lots of rest and fluids as well as over the counter medications to relieve your fever as well as your aches and pains. Occasionally if the inflammation is severe your doctor may prescribe cortico steroids.
Like other viruses the best way to prevent becoming infected with EBV is practicing good hygiene, especially hand washing. Don’t share glasses and utensils with others. Remember a person has been infected and is contagious for 4-6 weeks before symptoms appear, so a person may appear healthy and still transmit the EBV.