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Epstein-Barr Virus: Symptoms, Diagnosis and Treatment

The Epstein-Barr virus (EBV), also called human gammaherpesvirus 4 is a member of the herpes virus family [1] . EBV is one of the most common types of human herpesvirus types in the herpes family. EBV causes mononucleosis, or the commonly known "mono". It is also known as the kissing disease, as saliva is one of the means through which the EBV spreads. The virus is found in all corners of the world and can affect people of any age. However, it is mostly reported in young adults [2] .

EBV is contagious, that is, it can spread from one individual to the other. The virus affects or more likely, infects the human B cells and eventually spreads throughout the reticuloendothelial system or RES. The reticuloendothelial system consists of the liver, spleen, and peripheral lymph nodes [3] .

Studies have revealed that about 50 per cent of the population will develop antibodies against the virus by the age of 5. In the case of adolescents, about 12 per cent can develop antibodies later in life. The EBV is linked with fever, sore throat, swollen lymph nodes in the neck, and sometimes an enlarged spleen. However, it does not state that everyone with EBV will develop mononucleosis [4] .

Although the signs and symptoms caused by the virus will not be essentially severe or fatal, it will be present in your body throughout your life. As most people will not have any visible symptoms, they will not even be aware of the presence of the virus in their system [5] .

Diseases Caused By Epstein-Barr Virus

The virus is associated with various diseases such as [6] [7] [8]

  • infectious mononucleosis,
  • Burkitt's lymphoma,
  • Hodgkin's lymphoma,
  • stomach cancer,
  • multiple sclerosis,
  • lymphomatoid granulomatosis,
  • African Burkitt's lymphoma,
  • nasopharyngeal carcinoma
  • Gianotti-Crosti syndrome,
  • erythema multiforme,
  • acute genital ulcers,
  • oral hairy leukoplakia,
  • Parkinson's disease,
  • dementia with Lewy bodies, and
  • multiple system atrophy.

Symptoms Of Epstein-Barr Virus

Once the EBV infects an individual, it will take around four to six weeks for the symptoms to show up. The symptoms are mostly mild, especially in young children, as adults tend to show the symptoms at one point [9] .

In the case of kids, the symptoms will that of a cold or the flu. It will be more severe and obvious in teenagers and adolescents [10] .

You will have the following symptoms if you are affected by the Epstein-Barr virus [11] .

  • Fever
  • Fatigue
  • Weakness and sore muscles
  • Lack of appetite
  • Sore throat
  • Rash
  • Liver swelling
  • Swollen glands in the neck
  • Spleen swelling
  • Lymph node swelling
  • Headaches
  • Malaise
  • Chills
  • Bloating
  • Excessive sweating
  • Dizziness

How Does It Spread?

As the EBV is contagious, it can spread from one individual to the other when you come in close contact. The virus is found in the saliva [12] .

  • You can get the virus from kissing someone who is infected.
  • You can contract it from drinking from the same glass like that of an infected individual.
  • Using the same toothbrush is also a cause of the disease.
  • The virus can spread through a blood transfusion or an organ transplant.
  • It can also spread through unprotected sex.

It is not necessary that one will become sick if the EBV is present in your system. Likewise, the virus will stay in your system even after you get better and can re-activate in a period of months or even years [13] .

When To See A Doctor

EBV does not pose complications that usually. However, if a child shows the following signs, it is required that you go to a doctor immediately[14] .

  • Trouble breathing or swallowing
  • Very little urine, which is a sign of dehydration
  • Sudden, sharp pain on the left side of the belly (this is an indication of a problem with the spleen)

Complications Of Epstein-Barr Virus

There are possibilities of the following complications arising with the onset of the viral infection [15] [16] .

  • Anaemia
  • Breathing difficulties, usually due to swollen throat tissue
  • Enlarged spleen
  • Red spots or rashes
  • Severely swollen tonsils
  • Irregular heartbeat
  • Liver inflammation or swelling
  • Jaundice
  • Splenic rupture
  • Possible increased risk for cancer such as lymphomas

Diagnosis Of Epstein-Barr Virus

It is difficult to understand whether you are affected by the EBV. As the symptoms such as fever, fatigue, sore throat etc., can be the symptoms of a cold or the flu [17] [18] .

If the symptoms are causing severe discomfort, go to a doctor and he will check for the EBV.

In order to understand the possibility of EBV, the doctor will examine whether you have an enlarged spleen, swollen liver or white patches on your tonsils.

You will be required to take some blood tests. The tests will analyse and examine the presence of antibodies in your blood. The antibodies will indicate the presence of EBV in your body. Blood tests will be conducted to examine whether your body has a certain type of white blood cell, which will help in fighting against the virus [19] .

Treatment For Epstein-Barr Virus

Like other viral infections, the EBV cannot be treated with the help of antibiotics. There is no specific treatment method that can be applied to cure the virus. The virus and the symptoms caused will subside by itself in a few weeks' time.

However, you can adopt the following home remedies to manage the symptoms [20] [21] .

Home remedies

  • Drink a lot of water and other liquids so as to keep yourself hydrated.
  • Get plenty of rest.
  • Use lozenges or ice pops to get rid of the irritation caused by a sore throat.
  • You can also gargle with warm salt water.
  • Take painkillers like ibuprofen or acetaminophen to bring down fever.
  • The painkillers can be used to relieve body aches as well.

Do not give the painkillers to children under the age of 19.

View Article References
  1. [1] Cohen, J. I. (2000). Epstein–Barr virus infection. New England Journal of Medicine, 343(7), 481-492.
  2. [2] r, R., Bankier, A. T., Biggin, M. D., Deininger, P. L., Farrell, P. J., Gibson, T. J., ... & Tuffnell, P. S. (1984). DNA sequence and expression of the B95-8 Epstein—Barr virus genome. Nature, 310(5974), 207.
  3. [3] Young, L. S., & Rickinson, A. B. (2004). Epstein–Barr virus: 40 years on. Nature Reviews Cancer, 4(10), 757.
  4. [4] Thorley-Lawson, D. A. (2001). Epstein-Barr virus: exploiting the immune system. Nature Reviews Immunology, 1(1), 75.
  5. [5] Farrell, P. J. (2019). Epstein–Barr Virus and Cancer. Annual Review of Pathology: Mechanisms of Disease, 14, 29-53.
  6. [6] Slots, J., Saygun, I., Sabeti, M., & Kubar, A. (2006). Epstein–Barr virus in oral diseases. Journal of periodontal research, 41(4), 235-244.
  7. [7] Jenson, H. B. (2011). Epstein-Barr virus. Pediatrics in Review-Elk Grove, 32(9), 375.
  8. [8] Holmes, G. P., Kaplan, J. E., Stewart, J. A., Hunt, B., Pinsky, P. F., & Schonberger, L. B. (1987). A cluster of patients with a chronic mononucleosis-like syndrome: is Epstein-Barr virus the cause?. Jama, 257(17), 2297-2302.
  9. [9] Martyn, C. N., Cruddas, M., & Compston, D. A. (1993). Symptomatic Epstein-Barr virus infection and multiple sclerosis. Journal of Neurology, Neurosurgery & Psychiatry, 56(2), 167-168.
  10. [10] Kottanattu, L., Lava, S. A., Helbling, R., Simonetti, G. D., Bianchetti, M. G., & Milani, G. P. (2016). Pancreatitis and cholecystitis in primary acute symptomatic Epstein-Barr virus infection–Systematic review of the literature. Journal of Clinical Virology, 82, 51-55.
  11. [11] Nanishi, E., Hoshina, T., Ohga, S., Nishio, H., & Hara, T. (2015). Drug reaction with eosinophilia and systemic symptoms during primary Epstein–Barr virus infection. Journal of Microbiology, Immunology and Infection, 48(1), 109-112.
  12. [12] Hutt-Fletcher, L. M. (2017). The long and complicated relationship between Epstein-Barr virus and epithelial cells. Journal of Virology, 91(1), e01677-16.
  13. [13] Sullivan, J. L. (2016). Clinical manifestations and treatment of Epstein-Barr virus infection. Доступно по URL http://www. uptodate. com/contents/clinical-manifestations-and-treatment-of-epstein-barr-virus-infection.
  14. [14] Goetgebuer, R. L., van der Woude, C. J., de Ridder, L., Doukas, M., & de Vries, A. C. (2019). Clinical and endoscopic complications of Epstein-Barr virus in inflammatory bowel disease: an illustrative case series. International Journal of Colorectal Disease, 1-4.
  15. [15] McLaughlin, L. P., Bollard, C. M., & Keller, M. D. (2018). Adoptive T Cell Therapy for Epstein–Barr Virus Complications in Patients With Primary Immunodeficiency Disorders. Frontiers in immunology, 9, 556.
  16. [16] Mazur-Melewska, K., Breńska, I., Jończyk-Potoczna, K., Kemnitz, P., Pieczonka-Ruszkowska, I., Mania, A., ... & Figlerowicz, M. (2016). Neurologic complications caused by Epstein-Barr virus in pediatric patients. Journal of child neurology, 31(6), 700-708.
  17. [17] Chan, K. A., Woo, J. K., King, A., Zee, B. C., Lam, W. J., Chan, S. L., ... & Chan, G. (2017). Analysis of plasma Epstein–Barr virus DNA to screen for nasopharyngeal cancer. New England Journal of Medicine, 377(6), 513-522.
  18. [18] Chawla, J. P. S., Iyer, N., Soodan, K. S., Sharma, A., Khurana, S. K., & Priyadarshni, P. (2015). Role of miRNA in cancer diagnosis, prognosis, therapy and regulation of its expression by Epstein–Barr virus and human papillomaviruses: with special reference to oral cancer. Oral Oncology, 51(8), 731-737.
  19. [19] zannou, I., Papadopoulou, A., Naik, S., Leung, K., Martinez, C. A., Ramos, C. A., ... & Kuvalekar, M. (2017). Off-the-shelf virus-specific T cells to treat BK virus, human herpesvirus 6, cytomegalovirus, Epstein-Barr virus, and adenovirus infections after allogeneic hematopoietic stem-cell transplantation. Journal of clinical oncology: official journal of the American Society of Clinical Oncology, 35(31), 3547-3557.
  20. [20] Peng, H., Guo, R., Chen, L., Zhang, Y., Li, W. F., Mao, Y. P., ... & Ma, J. (2016). Prognostic impact of plasma Epstein-Barr virus DNA in patients with nasopharyngeal carcinoma treated using intensity-modulated radiation therapy. Scientific reports, 6, 22000.
  21. [21] Sawada, A., Inoue, M., & Kawa, K. (2017). How we treat chronic active Epstein–Barr virus infection. International journal of hematology, 105(4), 406-418.
Story first published: Sunday, March 3, 2019, 11:00 [IST]
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