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Epstein-Barr Virus Infection, Symptoms and Treatment

Updated on February 08, 2016
AliciaC profile image

Linda Crampton is a teacher with a first class honors degree in biology. She writes about human biology and the scientific basis of disease.

By the time someone reaches middle age they almost certainly have the Epstein-Barr virus in their body. A healthy diet that includes vegetables may boost the immune system and keep the virus under control.
By the time someone reaches middle age they almost certainly have the Epstein-Barr virus in their body. A healthy diet that includes vegetables may boost the immune system and keep the virus under control. | Source

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, 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, the virus stays in their body.

The Epstein-Barr virus is a member of the herpes family of viruses, which is technically described 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 virus, researchers are discovering that EBV is responsible for more diseases than was once thought.

 Simplified diagram of an Epstein-Barr virion
Simplified diagram of an Epstein-Barr virion | Source

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.

A B lymphocyte, also called a B cell, matures in the bone marrow. The Epstein-Barr virus can be found in B lymphocytes.
A B lymphocyte, also called a B cell, matures in the bone marrow. The Epstein-Barr virus can be found in B lymphocytes. | Source

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. B lymphocytes are a type of white blood cell.

When infected saliva enters someone’s body, the virus first infects the tissues of the mouth. The virus 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 particles. The active virus reproduces and enters the person’s saliva, a process known as shedding. The virus 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.

Two virions (virus particles) of the Epstein-Barr virus; each virion is round and is loosely surrounded by a protective envelope
Two virions (virus particles) of the Epstein-Barr virus; each virion is round and is loosely surrounded by a protective envelope | Source

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 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. 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 virus may cause no symptoms or the symptoms may resemble those of a cold or influenza.

Glandular Fever Causes and Symptoms

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, which is also called infectious mononucleosis, mono, glandular fever or the kissing disease. Mononucleosis may sometimes develop in people of other ages, too. The term “glandular fever” refers to the fact that the lymph glands under the arms, in the groin and sometimes in the neck become swollen and to the fact that the person develops a high temperature.

Someone suffering from mononucleosis may also experience one or more of the following symptoms.

  • a sore throat
  • swollen tonsils
  • headache
  • chills
  • 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.

A stained blood smear from someone with infectious mononucleosis; the blue cells are reactive lymphocytes while the pink cells are red blood cells
A stained blood smear from someone with infectious mononucleosis; the blue cells are reactive lymphocytes while the pink cells are red blood cells | Source

Additional Symptoms

In about fifty percent of mononucleosis cases, the spleen may become enlarged. There may also be hepatitis (liver inflammation) 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.

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.

Treatment 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 should help, as long as their use is recommended by a doctor. Children 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.

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. Contact sports must be avoided.

The Epstein-Barr Virus and Cancer

Cancer and Other 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. It may also cause some cases of fibromyalgia, chronic fatigue syndrome and multiple sclerosis, although this is less certain.

The possible connection between EBV and fibromyalgia is especially interesting to me. My sister has suffered from fibromyalgia, chronic fatigue syndrome 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.

Fruit can be part of a healthy diet and boost the activity of the immune system.
Fruit can be part of a healthy diet and boost the activity of the immune system. | Source

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 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 isn't always the case.

Eating a nutritious diet will strengthen the immune system. We should avoid habits known to weaken the immune system, such as eating too much sugar or fat and drinking too much alcohol. We do need to eat some fat, but this should generally be a healthy kind, such as omega-3 and monounsaturated fat. Smoking suppresses the immune system and should be avoided.

We should also try to maintain a healthy weight, since being very overweight has been shown to lower immunity to disease. Regular exercise boosts the activity of the immune system and often reduces emotional stress. 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. Getting an adequate amount of sleep and avoiding other infections will help to reduce physical stress.

Regular walking in the countryside or in a city can boost the immune system and protect the body from viral infections.
Regular walking in the countryside or in a city can boost the immune system and protect the body from viral infections. | Source

The Future for the Epstein-Barr Virus in Humans

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.

Whole grains are part of a healthy diet. Nutritious food can help the immune system to function properly.
Whole grains are part of a healthy diet. Nutritious food can help the immune system to function properly. | Source

References - The Epstein-Barr Virus and Disease

Mononucleosis information from the CDC (Centers for Disease Control and Prevention)

The Epstein-Barr Virus and Cancer

Multiple Sclerosis and EBV - A Possible Link

Fibromyalgia - Information, Possible Causes and Resources

© 2010 Linda Crampton

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    • brightforyou profile image

      Helen 6 years ago from Florida

      Thank you for this hub. I have the anti-bodies for Epstein-Barr and my two youngest sons have had Mono - my youngest had it very badly when he was 7. He contracted it on the plane when he passed someone who was clearly ill and sneezing. (Being small he was at the target height for the sneeze)! I get a form of 'shingles' whenever I am stressed so it is definitely a very debilitation and multi-faced disease. I didn't know the following.. "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."

      Thanks for all this very useful information! Great hub.

    • AliciaC profile image
      Author

      Linda Crampton 6 years ago from British Columbia, Canada

      Thank you for your comment. It will be interesting to learn how many other diseases and health problems the Epstein-Barr virus creates as scientists continue their research. Hopefully they’ll also discover better ways to treat the infection.

    • RTalloni profile image

      RTalloni 6 years ago from the short journey

      Good practical advice with helpful info. Thanks.

    • AliciaC profile image
      Author

      Linda Crampton 6 years ago from British Columbia, Canada

      Thank you for your comment, RTalloni. I'm glad that you found the hub useful.

    • profile image

      workingsmarter1 4 years ago

      I was diagnosed with EBV in 1995, I still suffer to this day when I do too much activity, heavy lifting etc. . I am suffering to day after working back to back workshifts with hardly any rest and had to move my belongings to a new space myself. I was very tired and drank A lot of water but it caught up to me the last 2 days. I ache, my armpit lymph nodes are sore and I can barely move w/o pain again.! I hate this feeling. I have to Always try to remind myself to slow down but there is no one to help me do the things i need to do. Im alone and no insurance for doctor care either. Medicaid wont take me because (lol) make too much money. I just go day to day but no one in my family understands how I feel and EBV at All! They all just say, you're sick again?! Any comments/suggestion etc. would help Thanks

    • AliciaC profile image
      Author

      Linda Crampton 4 years ago from British Columbia, Canada

      I am so sorry that you are suffering from a chronic Epstein-Barr infection, workingsmarter1. I wish I could offer more advice than I've given in this hub, but I'm not a doctor. All I can suggest is to follow a healthy diet to strengthen your immune system, drink lots of water and get enough rest whenever this is practical. If at any time you can get treatment at a free medical clinic, be sure to take advantage of this opportunity to get a doctor's advice.

    • profile image

      workingsmarter1 4 years ago

      Thank you So much Alicia~ These are things I Know but I sometimes get SO into just doing & going that I over do it & then suffer! I may be able to get some help with medical bur If i have to pay for my care/insurance i will. I cant keep going like this and just let it go. . . i have chronic back problems too (degenerative disk disease). I eat A lot of fruit & drink water too but sometimes i think my downfall (Of course) is sugar or even 1 drink of alcoholic beverage i noticed before my period! I have been running on empty & dealing with caring for my cat/dog i had with my ex boyfriend while he's in rehab. I Need to cut the cord on Him completely I told his mom. He's Draining me with my work & having to care for his & my own stuff! Stayed home from work today because I'm still feeling miserable! Drinking Echinacea Tea & having Chicken soup! Resting resting resting! thanks Again for your input!

    • profile image

      ineedinfo 3 years ago

      my doctor is having me get blood work for this tomorrow, one thing i did not read was, what is this caused by? is it genetic? I am very worried everything i read on this page and all these comments fit me exactley. I see him friday for the results. please pray for me.

    • AliciaC profile image
      Author

      Linda Crampton 3 years ago from British Columbia, Canada

      Ineedinfo, as my article says, this infection is caused by a virus. It's sometimes an annoying infection and can produce unpleasant symptoms, which may be temporary or longer lasting, but in most people it's not dangerous. I suggest that you write down a list of questions that you would like to ask your doctor so that he or she can give you all the information that you need and set your mind at ease.

    • profile image

      Albert 2 years ago

      Hi! Hiv and ebv got relation or not?

    • AliciaC profile image
      Author

      Linda Crampton 2 years ago from British Columbia, Canada

      Hi, Albert. The Epstein-Barr virus and HIV are different viruses. They both affect the immune system, but they do this in different ways.

    • profile image

      Albert 2 years ago

      Hi! Now i am ebv positive, i worried causes by hiv virus. Anybody can explain?

    • AliciaC profile image
      Author

      Linda Crampton 2 years ago from British Columbia, Canada

      Albert, Epstein-Barr infections and HIV infections have different and unrelated causes. Many, many people have EBV in their body without having the HIV virus. In order to become infected by the HIV virus, a person needs to have been engaged in a specific risk activity for the transmission of the virus. You should talk to your doctor about your concerns.

    • profile image

      Albert 2 years ago

      Hi! AliciaC.

      Now i am Ebv positive. 7Nov reading 0.82, 17Nov 0.99, 28Nov 0.96, 31Dec 1.46.

      Since oct i always suffer with sore throat, recovered then come again sore throat, on and off. When i drink water the felling like got ulcer very pain. Start with white spot on sore throat, then sore throat will continue for rew weeks even i am taken Amoxicillin also can't recover. It is this is EBV symptom? Is is normal? Kindly advise. Thanks

    • AliciaC profile image
      Author

      Linda Crampton 2 years ago from British Columbia, Canada

      I cannot advise you, Albert. I'm a science writer, not a doctor! Visit your physician and ask him or her your questions.

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