Epstein-Barr Virus Infection, Symptoms and Treatment

The Epstein-Barr virus (EBV) is very common in the human population. In the United States, ninety to ninety five percent of people between the ages of thirty five and forty have been infected by the virus. Once a person has been infected, the virus stays in their body for the rest of their life. It may produce no noticeable effects, may produce symptoms that resemble flu, or may cause health problems such as mononucleosis and some types of cancer.

The Epstein-Barr virus is a member of the herpes family of viruses, and like its relatives, such as the cold sore virus, goes through periods of activity and dormancy. When the virus is active, it may make the infected person ill or may produce no symptoms. Even if someone is experiencing no problems from the EBV activity in their bodies, they are infectious. The active virus reproduces and enters the person’s saliva, a process known as “shedding.” The virus can then be transferred to other people. When the virus is dormant, it is hiding in an inactive form in B lymphocytes, which are a kind of white blood cell, and is said to be in a “latent” state. The latent virus can be reactivated by illness or by stress.

The virus is passed from one person to another inside saliva. The saliva can be transferred during kissing or by sharing food, drinks or eating utensils with an infected person. Touching infected saliva and then touching the mouth or nose can also transmit the virus. Coughing and sneezing can spread the virus through saliva and mucus droplets, but scientists have found that this is a weak method of virus transfer. Direct saliva contact is far more likely to cause an EBV infection. Tears can sometimes transmit the virus. Very rarely, the Epstein-Barr virus can be transmitted from one person to another in blood.

When infected saliva enters someone’s body, the virus first infects the tissues of the mouth and nose. The virus then reproduces, enters the salivary glands and spreads to other areas of the body.

People may not realize that they are carrying the Epstein-Barr virus in their bodies because the active virus may cause no symptoms, the virus may be dormant or people may think that they are suffering from a cold or influenza when the Epstein-Barr virus is making them ill.

When teenagers and young adults are infected by the Epstein-Barr virus they have a thirty five to fifty percent chance of developing mononucleosis, which is also called mono, glandular fever or the kissing disease. Mononucleosis may sometimes develop in people of other ages. The term “glandular fever” refers to the fact that the lymph glands under the arms, in the groin and especially in the neck become swollen, and to the fact that the person develops a high temperature. Someone suffering from mononucleosis may also experience a sore throat, swollen tonsils, headache, chills, muscle aches, loss of appetite, a spotty rash, extreme fatigue and a general feeling of illness and discomfort, which is known as “malaise.” There may also be swelling of the eyelids. The blood usually contains more white blood cells than normal, and they may have an unusual appearance.

In about fifty percent of mononucleosis cases, the spleen may become enlarged. There may also be hepatitis and jaundice (a yellow color to the skin and the white part of the eyes). Very rarely, the heart, lungs or nervous system may be affected.

Mononucleosis symptoms develop about four to six weeks after the initial infection by EBV. Acute mononucleosis symptoms last for around two to four weeks, but the fatigue may be experienced for several months. Mononucleosis may sometimes occur in a chronic state that lasts for much longer or that reappears at intervals for years.

The Epstein-Barr virus causes or contributes to some kinds of cancer, including Burkitt’s lymphoma, nasopharyngeal carcinoma and some cases of Hodgkin (or Hodgkin's) lymphoma. It may also cause some cases of chronic fatigue syndrome and multiple sclerosis, although this is less certain.

Rest and plenty of fluids are usually prescribed for an active Epstein-Barr infection that is producing mononucleosis or flu-like symptoms. Pain and fever reducers like aspirin, ibuprofen and acetaminophen should help. Children shouldn’t be give aspirin since they may develop Reye’s syndrome, a very dangerous condition involving swelling of the brain. Antibiotics don’t affect viruses, but may be prescribed if the person’s weakened body has developed a bacterial infection as well as an EBV infection.

If the spleen is swollen there is a possibility that it could rupture. Corticosteroids may be prescribed to reduce swelling in the spleen and in the throat. Precautions need to be taken to avoid spleen rupture during exercise.

Scientists are continuing to study the Epstein-Barr virus and are learning more about it. Recent research had discovered that the virus can infect more areas of the body than was previously thought and that it may cause or contribute to more disorders than we previously realized.

Since most of us have already been infected by the Epstein-Barr virus, we need to do what we can to help our immune systems control the virus. Usually when the virus is reactivated after the initial infection no symptoms are produced, but this is not always the case. Eating a nutritious diet will strengthen the immune system. We should avoid habits known to weaken the immune system, like eating too much sugar, fat and alcohol. We do need to eat some fats, but these should be healthy fats, like omega-3 and monounsaturated fats. Smoking suppresses the immune system so should be avoided.

We should try to maintain a healthy weight, since being very overweight has been shown to lower immunity to diseases. Regular exercise boosts the activity of the immune system and reduces emotional stress. Activities such as yoga and tai chi can also help reduce emotional stress. To decrease physical stress, we should get an adequate amount of sleep and try to avoid other infections. Although exercise is important, very intense exercise or exercising for too long or too often without giving the body a chance to recover will contribute to physical stress within the body and should be avoided.