Summary about Disease
Epstein-Barr virus (EBV) infection is a common viral infection belonging to the herpesvirus family. It's best known for causing infectious mononucleosis (mono), also known as glandular fever or the "kissing disease." However, many people are infected with EBV in childhood and experience mild or no symptoms. Once infected, the virus remains dormant in the body for life. In some cases, EBV can be associated with certain cancers and autoimmune diseases.
Symptoms
Symptoms vary depending on age and individual immune response. In young children, infection is often asymptomatic or causes mild, cold-like symptoms. In adolescents and adults, common symptoms include:
Fatigue (extreme tiredness)
Fever
Sore throat
Swollen lymph nodes, especially in the neck and armpits
Enlarged spleen
Enlarged liver
Headache
Skin rash
Causes
EBV is primarily spread through saliva. Common modes of transmission include:
Kissing
Sharing drinks, food, or utensils
Coughing or sneezing
Blood transfusions (rare)
Organ transplantation (rare)
Medicine Used
There is no specific antiviral medication to cure EBV infection. Treatment focuses on managing symptoms:
Rest: Essential for recovery.
Pain relievers: Over-the-counter medications like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can help with fever, headache, and sore throat.
Sore throat remedies: Gargling with salt water, throat lozenges.
Corticosteroids: In severe cases, corticosteroids (e.g., prednisone) may be prescribed to reduce inflammation, especially if there is airway obstruction or significant swelling of the tonsils.
Is Communicable
Yes, EBV is communicable, especially during the acute phase of the infection when symptoms are present. The virus can be shed in saliva even after symptoms have resolved, although the risk of transmission is lower. People can also shed the virus intermittently throughout their lives, even without symptoms.
Precautions
Avoid kissing or sharing drinks, food, or utensils with others, especially when symptomatic.
Wash hands frequently with soap and water.
Cover coughs and sneezes.
Avoid strenuous activities, especially contact sports, if you have an enlarged spleen to prevent rupture.
How long does an outbreak last?
The acute phase of infectious mononucleosis typically lasts 2-4 weeks, but fatigue can persist for several weeks or even months. The sore throat and fever usually resolve within 1-2 weeks. Lymph node swelling may take longer to subside.
How is it diagnosed?
Diagnosis is typically made based on:
Physical exam: Assessing symptoms like sore throat, swollen lymph nodes, and enlarged spleen.
Blood tests:
Monospot test: Detects heterophile antibodies, which are often present in people with mono.
EBV-specific antibody tests: Detects antibodies to various EBV proteins, which can help determine if it is a recent or past infection.
Complete blood count (CBC): May show elevated white blood cell count (lymphocytes).
Timeline of Symptoms
Incubation period: 4-6 weeks between infection and the onset of symptoms.
Prodromal period: Gradual onset of fatigue, malaise, and muscle aches for a few days to a week.
Acute phase: Development of classic mono symptoms (sore throat, fever, swollen lymph nodes, fatigue), lasting 2-4 weeks.
Convalescence: Gradual improvement of symptoms, but fatigue may persist for weeks to months.
Important Considerations
Splenic rupture: Avoid contact sports or heavy lifting for several weeks after diagnosis due to the risk of splenic rupture. Consult your doctor for guidance.
Rare complications: EBV infection can sometimes lead to complications such as hepatitis, myocarditis, neurological problems (e.g., encephalitis, meningitis), and hemolytic anemia.
Association with certain cancers: EBV is associated with an increased risk of certain cancers, including Burkitt's lymphoma, Hodgkin's lymphoma, and nasopharyngeal carcinoma.
Autoimmune diseases: There is some evidence suggesting a link between EBV infection and autoimmune diseases like multiple sclerosis.
Chronic EBV infection: Rarely, EBV infection can become chronic, leading to persistent or recurrent symptoms. This is more common in individuals with weakened immune systems.