Epstein-Barr Virus Infection, Symptoms, and Possible Treatments
The Epstein-Barr Virus and Its Effects
The Epstein-Barr virus, or EBV, is very common in the human population and infects people of all ages. In the United States, it's estimated that ninety to ninety-five percent of people between the ages of thirty-five and forty have been infected by the virus at some point in their lives. The percentage is believed to be similar in other parts of the world. Once a person has been infected by EBV, it stays in their body.
The Epstein-Barr virus is a member of the herpes family, which is technically known as the herpesvirus family. Like its relatives, such as the cold sore virus, EBV goes through periods of activity and dormancy. When the virus is active it may produce no noticeable effects, produce symptoms that resemble flu, or cause health problems such as infectious mononucleosis and some types of cancer.
Researchers are investigating the factors that activate the virus. Ideally, after the initial infection the virus would remain dormant throughout a person's life and would be unable to cause disease. Although most of us suffer no ill effects from the infection, researchers suspect that EBV may be responsible for more diseases than we realize.
The Epstein-Barr virus was named after Anthony Epstein and Yvonne Barr, two of the scientists in the team that discovered that the virus causes some types of cancer.
Structure of a Virus
Individual virus particles are known as virions. A virion consists of a core of genetic material surrounded by a coat of protein, which is known as a capsid. In the Epstein-Barr virus the genetic material is DNA, as it is in us.
Some viruses are surrounded by a protective envelope, including the Epstein-Barr virus. The envelope of EBV is made of lipid and is covered with spikes made of proteins. These spikes enable the virus to attach to our cells.
Not all biologists consider viruses to be living things because they aren't made of cells and can't reproduce without the aid of a living organism. They send their genetic material into a host cell and then "force" the cell to make new virions.
Life Cycle of the Epstein-Barr Virus
Although almost all of us have the Epstein-Barr virus in our bodies, its behaviour isn't completely understood. The virus infects mainly two types of cells—the epithelial cells of the salivary glands and the B lymphocytes. Epithelial cells line the chambers, or acini, of a salivary gland. Each acinus (singular of acini) makes and secretes saliva. A B lymphocyte is a type of white blood cell that is made in the bone marrow and matures there. When infected saliva enters someone’s body, the virus first infects the tissues of the mouth. It then migrates to the salivary glands and the lymphocytes.
When the Epstein-Barr virus is dormant, it's hiding in an inactive form in the B lymphocytes. The inactive virus is said to be in a “latent” state. The latent virus may be reactivated by conditions such as illness or stress.
Research suggests that many people have low grade infections from active EBV virions. The virions reproduce and enter the person’s saliva, a process known as shedding. They can then be transferred to other people. An active virus doesn't necessarily cause problems in the infected person. The immune system is usually able to keep the infection under control and prevent symptoms of disease.
The Infection Process
EPV is passed from one person to another inside saliva. Saliva can be transferred between people during kissing or by sharing food, drinks, or eating utensils. Touching infected saliva and then touching the mouth or nose can also transmit the virus.
Coughing and sneezing can spread EBV through saliva and mucus droplets, but scientists have found that this is a weak method of infection. Direct saliva contact is far more likely to cause an infection. Tears can sometimes transmit the virus. Rarely, the Epstein-Barr virus can be transmitted from one person to another in blood.
People may not realize that they are carrying EBV in their bodies for several reasons. The virus may be dormant, the active form may cause no symptoms, or the symptoms may resemble those of a cold or influenza.
A Physician's Assistant Describes Mononucleosis
Infectious Mononucleosis or Glandular Fever
When teenagers and young adults are infected by the Epstein-Barr virus they have about a fifty percent chance of developing mononucleosis. The disease is also called infectious mononucleosis, mono, glandular fever, or the kissing disease. Mononucleosis may sometimes develop in people of other ages as well. The term “glandular fever” refers to the fact that the lymph glands under the arms, in the groin, and sometimes in the neck may become swollen and to the fact that the person may develop a high temperature.
Someone suffering from mononucleosis may also experience one or more of the following symptoms. The symptoms could be caused by a different condition, however. A doctor must be consulted for a diagnosis.
- a sore throat
- swollen tonsils
- muscle aches
- loss of appetite
- a spotty rash
- extreme fatigue
- swollen upper eyelids
- photophobia (light sensitivity)
- a general feeling of illness and discomfort, which is known as malaise.
The blood of someone with mononucleosis may contain more white blood cells than normal and the cells may have an unusual appearance. The lymphocytes are often enlarged. In this condition they are said to be reactive.
In about fifty percent of mononucleosis cases, the spleen may become enlarged. The patient may also experience hepatitis (liver inflammation) and jaundice (a yellow colour 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.
Anybody who has unexplained symptoms of ill health or who suspects that the Epstein-Barr virus is making them ill should visit a doctor for a diagnosis and treatment suggestions.
Possible Treatments for an Epstein-Barr Virus Infection
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 may help, but their use must be recommended by a doctor. Children and teenagers shouldn’t be given 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. Corticosteroids may be prescribed if the tonsils are very swollen.
If the spleen is swollen, there is a possibility that it could rupture if it isn't treated gently. A ruptured spleen is a medical emergency. It's important to follow a doctor's instructions in order to avoid damaging the organ. Exercise and contact sports must be avoided for as long as recommended by the doctor.
The Epstein-Barr Virus and Cancer
Diseases Linked to EBV
The Epstein-Barr virus causes or contributes to some kinds of cancer, including Burkitt (or Burkitt's) lymphoma, nasopharyngeal carcinoma, and some cases of Hodgkin (or Hodgkin's) lymphoma and stomach cancer. In addition, it may be linked to some cases of multiple sclerosis, although this is less certain. Various sources claim that the virus is also linked to chronic fatigue syndrome and fibromyalgia, but the scientific evidence for this is scant.
A possible connection between EBV and fibromyalgia is especially interesting to me. My sister has suffered from fibromyalgia, chronic fatigue, and migraines for many years. The three conditions often accompany one another. The cause of fibromyalgia is unknown, although there are a variety of theories to explain its origin. One of them is that the Epstein Barr virus causes or contributes to the disease.
In fibromyalgia, a person experiences chronic and widespread body pain for no obvious reason. Many patients experience periods called flare-ups when symptoms are worse than normal. Chronic fatigue is a condition that often involves periods of debilitating tiredness. Migraines may be debilitating, too. They are more than just a bad headache. A migraine is actually a syndrome involving a range of symptoms.
Determining the cause of my sister's health problems would be great, whether or not EBV is involved; finding a treatment would be even better. The problems seriously interfere with her life and with the lives of many other sufferers.
Gene regulation refers to the mechanisms that act to induce or repress the expression (activity) of a gene.— Springer Nature
A Genetic Discovery
In April 2018, scientists associated with the Cincinnati Children’s Hospital Medical Center made an interesting announcement. The researchers have discovered that a protein made by the Epstein-Barr virus called EBNA2 binds to sites on our genome associated with seven diseases. These diseases are:
- multiple sclerosis, or MS
- rheumatoid arthritis, or RA
- juvenile idiopathic arthritis, or JIA
- systemic lupus erythematosus, or SLE
- inflammatory bowel disease, or IBD
- celiac disease, or CD
- type 1 diabetes
The EBNA2 protein acts as a transcription factor, which regulates the action of genes. By regulating particular genes, the protein may be causing specific diseases. If this is the case, finding a way to treat an EBV infection could also treat the other diseases. More research is needed, but the idea that the virus harms us by influencing our genes is intriguing.
Following general good-health guidelines is the single best step you can take toward naturally keeping your immune system strong and healthy— Harvard Health Publishing
Strengthening the Immune System
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.
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 it. Usually when the virus is reactivated after the initial infection no symptoms are produced, but this isn't always the case.
Studies related to strengthening the immune system are continuing. The evidence obtained so far suggests that eating a healthy and nutritious diet helps the immune system to function efficiently. The evidence also suggests that we should limit the amount of alcohol that we drink and avoid smoking. We should also try to maintain a healthy weight, since being very overweight has been shown to lower immunity to disease.
Regular exercise appears to boost the activity of the immune system and often reduces emotional stress. Exercise has many benefits. Very intense exercise or exercising for too long or too often may contribute to physical stress within the body and should probably be avoided, however. Getting an adequate amount of sleep and avoiding other infections should help to reduce physical stress. Steps to avoid infections, such as washing hands frequently, are important.
Questions About the Virus
There are many unanswered questions about the Epstein-Barr virus and its behaviour. Researchers are exploring the reasons why many of us are apparently not harmed by the EBV in our body while others are. They are also investigating the possibility of using a vaccine to prevent EBV infections.
For now, it seems as though the Epstein-Barr virus is our partner in life. We need to do what we can to make this relationship an unequal partnership and to prevent the virus from getting the upper hand.
Mononucleosis information from the CDC (Centers for Disease Control and Prevention)
Facts about mononucleosis from the Mayo Clinic
The Epstein-Barr Virus and Cancer from Cancer Research UK
Multiple Sclerosis and EBV from the National Multiple Sclerosis Society
Evaluation of Antiviral Antibodies Against EBV and Neurotransmitters in Patients With Fibromyalia from the Journal of Neurology and Neuroscience
Cincinnati Children's Hospital Medical Center. (2018, April 16). 'Mono' virus linked to seven serious diseases: Epstein-Barr virus may affect health in more ways than known. ScienceDaily. Retrieved April 23, 2018 from www.sciencedaily.com/releases/2018/04/180416121606.htm
Tips for boosting the immune system from Harvard Health Publishing
Questions & Answers
What do big lumps under armpits that are full of blood or yellow pus mean?
Armpit lumps are often caused by a minor problem, but they are sometimes caused by a serious one. Infection by the Epstein-Barr virus can cause swollen lymph glands in the armpits during mononucleosis, but there are many other possible causes for the lumps.
Since you say that your lumps are “big” and are “full of blood or yellow pus”, I urge you to visit a doctor as soon as possible. The doctor will be able to diagnose the problem and prescribe treatment.
© 2010 Linda Crampton