Epstein-Barr Virus

Epstein-Barr Virus is a member of the herpes family

Epstein-Barr virus (EBV) occurs world-wide and infects most people at some point in their lives.

Children are largely immune to its effects, but infection in older people can cause a condition called infectious mononucleosis.

Long-term infection is, in very rare cases, linked to the development of some forms of cancer.

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What is Epstein-Barr virus?

It is a member of the herpes family of human viruses.

Who is at risk?

Young children are usually protected from infection because their immune systems are primed while they are still in the womb.

However, this immunity gradually wears off as they get older.

The vast majority of EBV infections in children either cause no symptoms at all, or very mild symptoms indistinguishable from the other mild, brief illnesses of childhood.

However, when EBV infection occurs during adolescence or young adulthood, it causes infectious mononucleosis in up to 50% of cases.

What are the symptoms of infectious mononucleosis?

They include fever, sore throat, and swollen lymph glands.

Sometimes, the spleen or liver may also begin to swell up.

On very rare occasions it may also cause heart disorders and problems with the central nervous system.

However, infectious mononucleosis is almost never fatal.

Patients usually recover within one to two months. Symptoms seldom last for more than four months.

Are they any long term problems?

EBV remains dormant or latent in a few cells in the throat and blood for the rest of the person's life.

Periodically, the virus can reactivate and is commonly found in the saliva.

This reactivation usually occurs without symptoms of illness.

EBV also establishes a lifelong dormant infection in some cells of the body's immune system.

It is possible, though very unlikely, that this may lead to the development of two very rare cancers - Burkitt's lymphoma and nasopharyngeal carcinoma.

EBV appears to play an important role in these malignancies, but is probably not the sole cause of disease.

Are other people at risk?

Most individuals exposed to people with infectious mononucleosis have previously been infected with EBV and are not at risk.

In addition, transmission of EBV requires intimate contact with the saliva of an infected person.

Transmission of this virus through the air or blood does not normally occur.

Can transmission be prevented?

The virus is also found frequently in the saliva of healthy people.

In fact, many healthy people can carry and spread the virus intermittently for life.

For this reason, transmission of the virus is almost impossible to prevent.

Is there any treatment?

There is no specific treatment for infectious mononucleosis, other than treating the symptoms.

No antiviral drugs or vaccines are available.

Some physicians have prescribed a 5-day course of steroids to control the swelling of the throat and tonsils.

There is some evidence that the use of steroids decreases the overall length and severity of the illness.