Epstein Barr consequences. Epstein Barr virus: symptoms, diagnosis, consequences

Most researchers of the Epstein Barr virus (EBV) classify it as a member of the herpesvirus type 4 family. This type of herpesvirus is considered the most common in the world, since 99% of the adult population and approximately 60% of children over 1 year of age are its carriers. It is worth immediately noting that carriers of the Epstein Barr virus, as a rule, do not suffer from diseases that can be caused by this virus if their immune system functions normally. However, in some cases, the Ebstein-Barr virus can lead to the development of acute damage to various organs and systems of the body.

This virus was discovered back in 1960, but the pathogenicity of the virus and other characteristics have been studied relatively recently. This type of herpes virus has a rather complex structure and is spherical in shape. It was recently found that most children under 16 years of age experience mild forms of illness caused by EBV. As a rule, these diseases occur in the form of a mild cold or intestinal disorders that are not life-threatening. After experiencing the acute phase of the disease, the body acquires stable immunity to the virus. However, in some cases, serious damage to internal organs may occur, so at the first manifestations of the disease, you should urgently seek medical help to conduct a blood test for the presence of the virus.

Currently, the reasons for the defeat of such a significant number of people by this virus are unknown, but researchers of the virus point to the unique structure of this microorganism, which includes more than 85 protein proteins that contain the DNA of the virus. The high pathogenicity of the virus and its ability to quickly penetrate host cells and begin to multiply are explained by the fact that the virus can remain without a host for a long time and be transmitted not only by contact, but also by airborne droplets.

Many researchers of the Epstein Barr virus agree that this virus is dangerous not in its ability to cause diseases characterized by an acute course, but in the fact that, under certain conditions, the pathogenic DNA of the EBV virus can lead to the development of malignant tumors. There are a number of diseases that develop, as a rule, against the background of organ damage by the Ebstein-Barr virus:

• Infectious mononucleosis;
• chronic fatigue syndrome;
• lymphogranulomatosis;
• general immunological deficiency;
• herpes;
• systemic hepatitis;
• malignant neoplasms in the nasopharynx;
• malignant tumors in the intestines and stomach;
• damage to the spinal cord or brain;
• malignant tumors of the salivary glands;
• lymphoma;
• leukoplakia of the oral cavity.

Among other things, the presence of EBV can provoke the development of bacterial and fungal diseases. The course of diseases caused by the EBV virus can be complicated by paratonsillitis, otitis media, splenic rupture, renal failure, pancreatitis, respiratory failure, and myocarditis. Currently, there is no clear classification of the manifestations of the course of diseases caused by this herpesvirus, so doctors use a vague classification, which involves identifying the general characteristic features of the development and course of the existing pathology. As a rule, the following parameters are determined: time of infection, form of the disease, severity of the disease, activity phase, presence of complications, etc.

What symptoms can Epstein Barr virus cause?

The symptoms observed with EBV are extremely diverse and largely depend on which organs and systems of the body were affected. All symptoms of EBV can be formally divided into general and specific. Common symptoms of damage to the body by the Epstein-Barr virus include:

• chills;
• increased body temperature;
• weakness;
• body aches;
• swollen lymph nodes;
• rash on the skin;
• signs of inflammation in the throat;
• redness of the throat;
• a sore throat.

As a rule, general symptoms are observed only in case of an acute reaction of the body to the primary infection. If the disease occurs against a background of reduced immunity, as damage to individual organs and systems develops, symptoms of an inflammatory process may appear in the kidneys, liver, heart and other organs. When the virus affects the nervous system, severe pain, impaired motor ability of individual muscles, contractures, paresis and many other manifestations cannot be ruled out.

The incubation period of the Epstein-Barr virus lasts about 4-5 weeks, therefore, if a group of children has been diagnosed with mononucleosis, most likely, other children who maintain contact with the sick child will also become ill.

After the incubation period, patients immediately experience an increase in body temperature and general symptoms.

It is very important at this time to visit a doctor and get qualified advice regarding treatment and do a blood test, since with improper therapy, not only serious complications can develop, but also a chronic form of the disease.

Diagnosis and treatment of diseases caused by the Epstein Barr virus

In most cases, patients consult a doctor already having a number of characteristic symptoms. This allows you to determine the presence of a viral infection. Diagnosis of the Epstein Barr virus in the body involves a number of studies. First of all, a blood test is done to detect the titer of IgM antibodies. A blood test with an elevated titer of 1:40 is a diagnostic criterion for EBV damage to the body. A similar titer is characteristic of mononucleosis.

Once the basic blood test is done, polymerase chain reaction and enzyme immunoassay may also be performed. After a complete diagnosis of the patient’s condition has been made, a course of treatment can be prescribed. Despite the fact that the human liver produces a special immunoglobulin against the virus, in the presence of an acute phase of the course it is necessary to take medications aimed at treating the symptoms. Pregnancy and the course of the disease with severe complications are the reason for inpatient treatment. It is worth immediately noting that pregnancy can be saved if the expectant mother falls ill with mononucleosis. However, the risk of infection of the fetus and transmission of the virus to the child increases, so in this case it is very important to undergo the correct course of treatment so that the pregnancy continues without complications. In cases where the course of the disease is not complicated, patients are treated on an outpatient basis.

The basis of treatment is various kinds of antiviral and immunomodulating drugs that can quickly eliminate foci of viral infection. An important role in alleviating the patient’s condition is played by medications aimed at eliminating symptoms, that is, antipyretics, painkillers, antiallergic drugs, gargles, and vitamin complexes. As additional treatments, decoctions of chamomile, coltsfoot, mint, oak root, ginseng, calendula, etc. can be used.

During the active phase of the disease, patients are prescribed bed rest and complete rest. The duration of treatment ranges from 2 weeks to several months.

Epstein-Barr virus is a type 4 herpes virus.
It can remain in the human body throughout life, causing autoimmune and lymphoproliferative diseases.
The most common manifestation of infection is mononucleosis.
In adults, the infection is most often transmitted by kissing through saliva, the epithelial cells of which contain a significant amount of virions.

Prevalence of the disease

90% of the population, upon reaching the age of 25, are already carriers of the virus.

Both sexes suffer from Epstein-Barr at equal rates. A specific race does not affect the prevalence of infection.

Routes of infection

Scientists have been studying the virus for more than 40 years, but all the ways Epstein-Barr spreads have not been fully identified to date.

In rare cases, infection through breast milk occurs.

There are known cases of infection through personal hygiene products, touch and shared utensils, sexual contact and through contaminated blood transfusions or bone marrow transplants.

In people who become ill for the first time, the virus is contained in the saliva and oropharyngeal mucus for about 1 – 1.5 years. In 30% of them, the virus content in saliva is detected throughout their life.

Symptoms of Epstein-Barr virus

The incubation period of the disease is about 1-2 months. After this period, the virus begins an active attack on skin tissue and lymph nodes, penetrates the blood and spreads throughout the human body.

The development of symptoms of the virus is long and occurs in several phases. At the initial stage, signs may be absent or appear to a minor extent, like ARVI.

After a chronic infection of viral origin affects the immune system, the following symptoms are observed:

• pain in the abdomen in the upper quadrant;
• general malaise;
• headache;
• sweating;
• nausea;
• sleep disorders;
• increase in body temperature to 38-39 degrees Celsius;
• skin rashes occur in 15% of cases - pale maculopapular rash;
• decreased memory and attention;
• depression.

The infection is characterized by enlarged and reddened lymph nodes, swollen tonsils with plaque, cough, sore throat at rest and when swallowing, and difficulty breathing through the nose.

The course of the infection is characterized by periods of subsidence and increasing symptoms. Many patients mistake the occasional warning signs for chronic flu.

Companions of the Epstein Barr virus are fungal and bacterial infections, for example, thrush, diseases of the gastrointestinal tract, and oncological processes in the body.

If the patient’s immunity is significantly weakened, the cranial and spinal nerves and the central nervous system may be affected.

Possible complications

Complications of the virus include:

• polyradiculoneuritis;
• meningitis;
• encephalitis;
• myocarditis;
• glomeruritis;
• complex forms of hepatitis.

The occurrence of severe complications can lead to death.

On the page: it is written about an operation on how to remove a hump on the nose.

Diseases caused by the presence of the Epstein Barr virus in the body:

• Infectious mononucleosis, observed in 3 out of 4 cases. The patient feels a general malaise, fever appears and lasts up to 2 weeks - a month, the lymph nodes and pharynx, liver and spleen are affected, and rashes are noted on the skin.

  Signs of mononucleosis disappear after a month and a half without treatment. The disease is not characterized by relapses, but there is a risk of complications - autoimmune hemolytic anemia, damage to the cranial nerves and nervous system.

• Chronic fatigue syndrome with the manifestation of causeless anger, depression, joint and muscle pain and deterioration in concentration.
• Lymphogranulomatosis, characterized by enlarged lymph nodes above the collarbone and on the neck without pain. With the progression of a malignant disease of lymphoid tissue, the spread of pathological processes to internal organs and their diffuse damage is observed.
• Burkitt's lymphoma is a malignant tumor that affects the ovaries, lymph nodes, kidneys and adrenal glands. The pathology is characterized by rapid development and leads to death in the absence of therapy.
• Nasopharyngeal carcinoma is a tumor that arises on the lateral wall of the nose and grows into the nasopharynx with metastasis to the lymph nodes. As the disease progresses, the following symptoms are observed: nasal congestion, discharge of mucus and pus from the nose, hearing loss, and frequent tinnitus.

With a weakened immune system, the nervous system, spleen and liver may suffer, which manifests itself in the form of jaundice, severe abdominal pain, and mild mental disorders.

The danger is the risk of splenic rupture, accompanied by severe pain on the left side of the abdomen. In this case, emergency medical attention is required, since internal bleeding that occurs can lead to the death of the patient.

If symptoms of the Epstein-Barr virus appear, you should immediately seek help from a doctor to diagnose, select effective treatment and reduce the risk of deterioration of the condition and the development of complications and pathologies.

Diagnosis of infection

To detect the Epstein Barr virus in the body, specialists conduct an initial examination and identify complaints, then use the following diagnostic methods to confirm the diagnosis:

• Blood chemistry.
• Complete blood count, which reveals neutropenia, leukocytosis or thrombocytopenia.
• The titer of specific bodies is established.
• Molecular diagnostic method with detection of pathogen DNA.
• Serological tests to detect antibodies to Epstein Barr virus antigens.
• Immunological examination, which shows disturbances in the functioning of the immune system.
• Culture method.

Treatment methods

There are currently no specific treatment regimens for Epstein Barr virus.

With strong immunity, the disease can pass without the use of therapy. It is enough to provide the patient with plenty of fluids and rest. Antipyretics and painkillers are used to relieve symptoms.

Treatment is carried out for acute and chronic forms by an infectious disease specialist, and for tumor-like neoplasms - by an oncologist.

The duration of therapy depends on the stage of the disease and can range from 3 weeks to several months.

When immunity is weakened and in order to reduce the risk of complications, the following drugs are used:

To enhance the effect of drugs, medications are prescribed:

• enterosorbents;
• antihistamines;
• hepatoprotectors;
• probiotics.

To analyze the effectiveness of treatment and the patient’s condition, a general blood test is performed once a week and a biochemical blood test is performed once a month.

Depending on the manifestations of the disease, it is possible to hospitalize the patient in the infectious diseases department.

When infectious mononucleosis is associated with the virus, the doctor prescribes antibiotics to the patient (Sumamed, Tetracycline) for 8-10 days, provides rest and rest, mainly to reduce the risk of splenic rupture. Lifting weights is prohibited for 2-3 weeks, sometimes up to 2 months.

To prolong the stage of remission of the Epstein-Barr virus, health spa treatment is recommended.

People who have had the Epstein-Barr virus retain IgG antibodies throughout their lives.

Disease prognosis

In the absence of immunodeficiency in the human body, the prognosis is quite favorable.

In rare cases, patients, mostly women, are bothered by chronic fatigue syndrome that lasts up to 2 years.

Sometimes otitis media or sinusitis appears as complications.

Prevention measures

To date, no vaccine has been developed against herpes type 4, which provokes the development of Epstein-Barr virus infection.

Scientists around the world are working to identify ways to create a vaccine against a common virus that, when complicated, leads to cancer.

There is no way to eliminate the possibility of contracting a virus.

The only way is to take measures to increase the body’s defenses to reduce the risk of getting sick or suffering from diseases without complications:

• Timely treatment of skin pathologies and infectious diseases;
• Hardening the body;
• Elimination of stressful situations;
• Frequent exposure to fresh air;
• Compliance with personal hygiene rules;
• Taking vitamins;
• Getting rid of bad habits.

Epstein-Barr virus is a serious disease that can provoke the development of serious illnesses. It is important to consult a doctor in time when you identify the first alarming symptoms. After diagnosis, the specialist will prescribe competent treatment, which will help eliminate the risk of complications and pathologies and lead to a speedy recovery.

How dangerous the Epstein-Barr virus is for human health is described in the story of the “Live Healthy” program.

The outcome of acute Epstein-Barr virus infection (EBVD) depends on the degree of impairment of the immune system and on hereditary predisposition to diseases associated with EBVD. So, acute VEBI can end in the following ways:

• Complete recovery, as a result of which the person simply becomes a carrier of the virus;

Latent VEBI, in which a person does not get sick, but the virus multiplies in the body and becomes a source of infection for other people;

Development of cancer;

Development of systemic autoimmune diseases.

Chronic VEBI can occur as a type of chronic infectious mononucleosis, which affects the heart, kidneys and central nervous system. In addition, chronic VEBI can occur in an atypical form, which is characterized by a long-term and persistent increase in body temperature not exceeding 37.5 o C and immunodeficiency, which provokes persistent and long-term bacterial, fungal and mixed infections of the respiratory tract, digestive tract, skin, etc. .d.

In addition to the listed consequences, the Epstein-Barr virus can lead to complications in various organs and systems. Currently, the following consequences of the Epstein-Barr virus, classified as complications, have been identified:

Dr. Komarovsky about Epstein Barr virus in children

The most common diseases among children are viral. The reason is that the child’s immunity is not yet strong enough, immature, and it is not always easy for him to withstand numerous threats from the outside. But if a lot has been said and written about influenza and chickenpox, and even with measles everything is more or less clear to mothers, then there are viruses in this world, the very names of which fill parents with sacred horror.

One of these little-studied and very common is the Epstein-Barr virus. The famous pediatrician and TV presenter Evgeniy Komarovsky is often asked about him.

What it is

EBV - Epstein Barr virus. One of the most common viruses on the planet. It was first found in tumor samples and described in 1964 by English professor Michael Epstein and his assistant Yvonne Barr. This is the fourth type of herpes virus.

According to medical statistics, traces of past infection are found in the blood tests of half of children aged 5-6 years and in 97% of adults, and they themselves often do not even know about it, because in most people EBV proceeds unnoticed, without symptoms.

A child can become infected in different ways. Most often, EBV is released through biological fluids, usually through saliva. For this reason, infectious mononucleosis, caused by a virus, is called the “kissing disease.”

Infection can occur during transfusion of blood and its components, through things and toys shared with the patient, and the virus is transmitted from an infected mother through the placenta to the fetus during pregnancy. EBV is easily spread through the air and from donor to recipient during bone marrow transplantation.

At risk are children under one year of age who actively explore the world around them through their mouths, trying to taste absolutely every object and thing they can get their hands on. Another “problem” age is children from 3 to 6 years old who regularly attend kindergarten and have numerous contacts.

The incubation period is from 1 to 2 months, after which children develop vivid symptoms characteristic of many viral infections.

However, the virus itself with a complex name is not so scary as the fact that its consequences are completely unpredictable. It may go completely unnoticed in one child, while in another it can cause the development of serious conditions and even cancer.

Komarovsky about VEB

Evgeny Komarovsky urges parents not to create unnecessary hysteria around the Epstein-Barr virus. He believes that most children have already encountered this agent in early childhood, and their immunity has “remembered” it and is able to identify and resist it.

Now let's listen to Dr. Komarovsky about infectious monoculosis.

The symptoms that allow one to suspect EBV in a child are quite vague:

• Irritability, tearfulness, increased moodiness and frequent causeless fatigue.
• Mild or more noticeable enlargement of lymph nodes. Most often - submandibular and behind-the-ear. If the infection is severe, it spreads throughout the body.
• Lack of appetite, digestive problems.
• Rash.
• High temperature (up to 40.0).
• Sore throat (as with sore throat and pharyngitis).
• Heavy sweating.
• Slight increase in the size of the liver and spleen. In a child, this may manifest itself as aching pain in the abdomen.
• Yellowness of the skin. This symptom is extremely rare.

Komarovsky emphasizes that it is impossible to make a diagnosis based on complaints and the presence of certain symptoms alone, since the child’s condition will resemble a sore throat, enterovirus, and lymphogranulomatosis.

To confirm or refute the Epstein-Barr virus, laboratory diagnostics of the patient’s blood samples is required, including biochemical analysis, serological testing, PCR, and it is also advisable to do an immunogram and conduct an ultrasound examination of the abdominal organs - the liver and spleen.

Komarovsky often compares EBV to chickenpox. Both diseases are more easily tolerated at an early age; the younger the person, the simpler the disease and the fewer consequences. The older the primary infection occurs, the greater the chances of severe complications.

Treatment according to Komarovsky

Evgeniy Olegovich warns that treatment with penicillin antibiotics for one of the diseases associated with EBV, infectious mononucleosis, can cause serious complications. Typically, such a prescription is erroneous when the doctor mistakes mononucleosis for an ordinary bacterial sore throat. In this case, exanthema may develop.

Ordinary children who do not suffer from HIV and other severe disorders of the immune system, according to Evgeniy Komarovsky, do not need any antiviral treatment for mononucleosis caused by EBV, and even more so they do not urgently need to be given immunostimulants. The famous pediatrician is confident that the child’s body is able to cope with this threat on its own.

If the course of the disease is severe, which, according to Komarovsky, is very rare, treatment in a hospital may be required. There, most likely, antiherpetic drugs will be used (quite justifiably).

In all other cases, symptomatic treatment is sufficient. This includes antipyretic drugs (if the temperature is above 38.5-39.0), drugs that reduce sore throats (lozenges, antiseptics, gargles), ointments, gels and external sprays with antiseptics for severe skin rashes.

What is the Epstein-Barr virus, what are its symptoms in children and how is it treated, why is the disease dangerous?

Epstein-Barr virus is an infectious disease of herpes origin, named after the two scientists - researchers who discovered it in 1964, namely Canadian professor and virologist Michael Epstein and Iwona Barr, who was his graduate student. Due to its nature, EBV is also called herpes type 4. Recently, its prevalence (especially in children) has increased significantly and amounts to up to 90% of the total population of the planet.

Epstein-Barr virus in children - what is it and why is it dangerous?

The Epstein-Barr virus can be present in the body for several years and not manifest itself in any way. 25% of people who are carriers may have it throughout their lives. A weakened immune system can trigger its activation. After infection, a person subsequently develops permanent immunity to the disease. However, the virus continues to exist in the body, like its herpes counterparts.

According to statistics, children aged one year and older are most susceptible to it, since it is during this period that children begin to actively interact with other children. Until the age of three, the course of the disease often occurs without severe symptoms and has much in common with the common cold in a mild form. Characteristic signs of the disease begin to appear in schoolchildren and adolescents.

The number of infected people after 35 years of age is minimal, and in cases where infection occurs, the pathology is not accompanied by its characteristic symptoms. This is due to the fact that adults already have immunity to herpes viruses.

As a result of the penetration of the virus into the body, acute infectious mononucleosis usually develops. However, this is not the only pathology that this type of pathogen can provoke. The Epstein-Barr virus is dangerous due to its development:

• respiratory infectious diseases of the respiratory tract;
• nasopharyngeal carcinoma, which is a malignant disease of the nasopharynx;
• Burkitt's lymphoma;
• multiple sclerosis;
• herpes;
• systemic hepatitis;
• lymphomas;
• tumors of the salivary glands and gastrointestinal tract;
• immune deficiency;
• Hodgkin's disease or lymphogranulomatosis;
• polyadentopathy;
• hairy leukoplakia of the oral cavity;
• chronic fatigue syndrome.

The table below shows the conditional classification of VEB according to certain criteria:

• congenital;
• acquired.

• typical, manifests itself as infectious mononucleosis;
• atypical, divided into erased, asymptomatic or affecting internal organs.

• easy;
• average;
• heavy.

• spicy;
• protracted;
• chronic.

• active;
• inactive.

Routes of transmission of the virus and sources of infection

The main route by which viral pathogens are transmitted is contact with an infected person or someone who is healthy but is a carrier of the virus. A person who has had EBV, but is already absolutely healthy from a clinical point of view, still sheds the infectious agent in the period from 2 months to one and a half years after complete recovery and disappearance of symptoms.

The largest accumulation of particles is in human saliva, which people exchange when kissing each other. It is for this reason that the Epstein-Barr virus is called the “kissing disease.” In addition to close contact with a sick person or carrier, there are other ways to become infected:

• in the process of blood transfusion - parenteral method;
• during transplantation;
• contact-household route, when people use the same dishes or household and personal hygiene items - this option is unlikely, because this type of herpes virus is unstable and does not live in the environment for a long time;
• airborne route, which is the most common;
• during sexual intercourse, if the causative agent of the disease is present on the mucous membrane of the genital organs.

As for children, they can be infected not only by communicating with a child infected with the virus, by handling his toys, but also in utero through the placenta. The virus can be transmitted to the baby during childbirth, when it passes through the birth canal.

Thus, the main source of spread of the Epstein-Barr virus is an infected person. Particularly dangerous are those people whose disease is asymptomatic or latent. The threat of becoming infected with EBV from a patient becomes real a couple of days before the end of the incubation period.

Symptoms of the disease in a child

Due to the fact that most often the Epstein-Barr virus provokes the development of acute infectious mononucleosis, it is also characterized by corresponding manifestations, which include four main signs of this disease:

• fatigue;
• increased body temperature;
• the appearance of a sore throat;
• enlarged lymph nodes.

The incubation period of EBV can last from 2 days to 2 months. The active period of the disease is 1-2 weeks, after which gradual recovery begins. The course of the pathological process occurs in stages. At the initial stage, the infected person develops a feeling of malaise, which can last about a week, and a sore throat. At this stage, temperature indicators remain normal.

Symptoms of Epstein-Barr virus in children

At the next stage, there is a sharp increase in body temperature up to several degrees. This symptom is accompanied by intoxication of the body and polyadenopathy - a change in the size of the lymph nodes, which reach 0.5 - 2 cm. Usually the anterior and posterior cervical lymph nodes are enlarged, but enlargement of the lymph nodes located on the back of the head, under the jaw, above and below the collarbones is also possible, under the arms, elbows, groin and thighs. When palpated, they become dough-like, and minor painful sensations appear.

In addition, the pathological process extends to the tonsils, which resembles the symptoms of a sore throat. The tonsils swell, the back wall of the pharynx becomes covered with purulent plaque, nasal breathing is disrupted and a nasal voice appears.

In the later stages of development, the Epstein-Barr virus affects internal organs such as the liver and spleen. Liver damage is accompanied by hepatomegaly, its enlargement and heaviness in the right hypochondrium. Sometimes the urine becomes dark in color and mild jaundice occurs. The spleen with EBV also increases in size.

Another symptom of Epstein-Barr virus that is often seen in children is a rash. Usually the rash lasts up to 10 days. The degree of their severity is determined by the use of antibiotics. They may look like:

Diagnostic methods

The symptoms of the Epstein-Barr virus have much in common with various diseases, including:

• cytomegalovirus;
• herpes No. 6;
• HIV infection and AIDS;
• anginal form of listeriosis;
• measles;
• viral hepatitis;
• localized diphtheria of the throat;
• angina;
• adenoviral infection;
• blood diseases.

For this reason, it is important to carry out differential diagnosis in order to distinguish pathological processes from each other and prescribe the correct treatment. In order to accurately determine the causative agent of the virus, it is necessary to take blood, urine and saliva tests and conduct laboratory tests.

Blood tests

Examining blood for the presence of EBV in it is called an “enzyme-linked immunosorbent assay” (ELISA), during which the qualitative and quantitative indicators of antibodies to the infection are deciphered, which makes it possible to find out whether the infection is primary and how long ago it occurred.

Two types of antibodies can be found in the blood:

1. Immunoglobulins or primary antibodies of type M. Their formation occurs when the virus first enters the body or due to the activation of an infection that is in a “dormant” state.
2. Immunoglobulins or secondary antibodies of type G. They are characteristic of the chronic form of the pathology.

A general blood test also determines the presence of mononuclear cells in the blood. This is an atypical form, which occurs in 20-40% of lymphocytes. Their presence indicates infectious mononucleosis. Mononuclear cells may continue to be present in the blood for several years after recovery.

PCR method

DNA of the Epstein-Barr virus is detected by examining biological fluids of the body: saliva, mucus from the nasopharynx and oral cavity, cerebrospinal fluid, prostate secretions or discharge from the genitals using the PCR (polymerase chain reaction) method.

PCR is characterized by high sensitivity exclusively during the reproduction period of the viral pathogen. However, the method is effective in detecting herpes infections types 1, 2 and 3. Sensitivity for herpes number 4 is lower and is only 70%. As a result, the PCR method of examining salivary secretions is used as a test that will confirm the presence of the virus in the body.

Features of treatment of the disease in children

Epstein-Barr virus is a young and not yet fully understood disease, and treatment methods continue to improve. In the case of children, any medications are prescribed only after they have been carefully studied and all side effects have been identified.

Currently, antiviral drugs that would effectively combat this type of pathology and are suitable for any age category of people remain at the development stage. Children may be prescribed a course of such medications in exceptional situations when the baby’s life is at risk.

The first thing parents of a child infected with EBV need to do is to provide their body with healthy conditions so that the baby can cope with the infection on his own, because he has the resources and protective mechanisms for this. You should:

• cleanse the body of toxins using sorbents;
• diversify the diet so that the baby receives adequate nutrition;
• provide additional support to the immune system by drinking vitamins that act as antioxidants, immunomodulators, cytokines and biostimulants;
• eliminate stress and increase the amount of positive emotions.

The second thing therapy comes down to is symptomatic treatment. In the acute form of the disease, you should alleviate the condition of the baby by reducing the severity of his symptoms - give antipyretic drugs when the body temperature rises or put drops in the nose if there are breathing problems. If you have signs of a sore throat, you need to gargle and treat your throat, and if you have hepatitis, you need to take medications that will support the liver.

Recovery prognosis and possible complications

In general, with proper and timely care, the acute form of Epstein-Barr virus has a favorable prognosis. The person recovers and develops lifelong immunity to this type of herpes (or becomes an asymptomatic carrier). Otherwise, everything is determined by the severity of the disease, its duration, the presence of complications and the development of tumor formations.

The main danger of this virus is that it spreads through the circulatory system of the human body, as a result of which after a certain period of time it is able to affect the bone marrow and any other internal organ.

The Epstein-Barr virus can cause the development of such serious and dangerous pathologies as:

• oncological diseases of various organs;
• pneumonia;
• immunodeficiency;
• damage to the nervous system that cannot be cured;
• heart failure;
• otitis;
• paratonsillitis;
• respiratory failure, which leads to swelling of the tonsils and soft tissues of the oropharynx;
• hepatitis;
• splenic rupture;
• hemolytic anemia;
• thrombocytopenic purpura;
• liver failure;
• pancreatitis;
• myocarditis.

Another possible consequence of infection with herpes type 4 is hemophagocytic syndrome. It is caused by an infection of T lymphocytes, which results in the destruction of blood cells, namely red blood cells, platelets and white blood cells. The known symptoms include anemia, hemorrhagic rash and problems with blood clotting, which, in turn, can be fatal.

The Epstein-Barr virus also negatively affects the functioning of the entire immune system. As a result of the body’s inability to recognize its own tissues, various autoimmune pathologies begin to develop, including:

• chronic glomerulonephritis;
• rheumatoid arthritis;
• autoimmune hepatitis;
• systemic lupus erythematosus;
• Sjögren's syndrome.

Among the oncological diseases that can be triggered by EBV are:

1. Burkitt's lymphoma. Tumors affect the lymph nodes, upper or lower jaw, ovaries, adrenal glands and kidneys.
2. Nasopharyngeal carcinoma. The location of the tumor is the upper part of the nasopharynx.
3. Lymphogranulomatosis. The main signs are enlargement of lymph nodes of different groups, including retrosternal and intra-abdominal, fever and weight loss.
4. Lymphoproliferative disease. This is a malignant proliferation of lymphoid tissue cells.

Prevention of EBV in a child

There are currently no specific preventive measures aimed at preventing Epstein-Barr virus pathogens from entering the body and their reproduction. First of all, this concerns vaccination. It is not being carried out because the vaccine has not yet been developed. Its absence is due to the fact that the proteins of the virus change greatly in their composition - this is influenced by the stage of development of the pathology, as well as the type of cells where pathogenic bacteria multiply.

Despite the fact that in the vast majority of cases of infection with this type of virus, the result of proper treatment is recovery, the pathology is dangerous due to its complications. In view of this, it is still necessary to think about any possible preventive measures. The main method of prevention comes down to the general strengthening of immunity, because it is as a result of its decrease that activation of the disease can occur.

The normal functioning of the immune system in an adult or child can be maintained in the simplest and most reliable way by following a healthy lifestyle, which includes:

1. Complete nutrition. The diet should be varied, providing a person with vitamins and beneficial minerals.
2. Hardening. Reasonable hardening procedures are an effective way to strengthen health and immunity.
3. Physical activity. Movement is life, and for the body to function fully, it must be regularly kept in good shape by playing sports or taking regular walks in the fresh air. It is important not to sit at home all the time at the computer or in front of the TV.
4. Taking immunomodulators of plant origin. Examples of such drugs are Immunal and Immunorm. According to the instructions, they are taken 20 drops three times a day. They stimulate immune reactions and activate the regeneration of mucous membranes of various organs and cavities in the human body. You can turn to folk remedies, namely herbal remedies.

Prevention of the Epstein-Barr virus in childhood consists not only of strengthening the immune system, but also of minimizing the possibility of becoming infected through contact and household contact when communicating with other children. To do this, it is necessary from an early age to teach the child to observe basic rules of personal hygiene, including washing hands after walks and before eating and other sanitary procedures.

Signs and symptoms of the Epstein-Barr virus in children: general information about the disease and a selection of treatment methods

Due to weakened immunity, children suffer from various diseases much more often than adults. One of the causative agents of illnesses is the Epstein-Barr virus; in most cases it provokes mononucleosis. The infection does not pose a particular danger to the baby’s life; specific treatment is required only in advanced cases complicated by HIV infection.

The virus was discovered relatively recently and is poorly studied, but doctors know several features of the diseases that are caused by the pathogen. Young parents need to know the characteristic symptoms of the pathology and what needs to be done in such a situation.

general information

Epstein-Barr virus was discovered in 1964. As a result of research, the virus was classified as a herperovirus; it is widespread among the world's population. According to statistics, about 50% of eighteen-year-old residents are carriers of the virus. A similar situation exists with children over five years old. Babies under one year old get sick very rarely; along with breast milk, the baby receives the mother's antibodies (passive immunity), which protect the child's body from infection.

The main risk group is children older than one year. They actively communicate with other children and gradually switch from breastfeeding to full nutrition. It is worth noting that in children under three years of age, infection with the virus is practically asymptomatic and resembles a common cold.

As a result of infection, the pathogen ensures the formation of stable immunity in the child; the virus itself is not destroyed, it continues to exist without causing any discomfort to its owner. However, this situation is typical for all types of herpes virus.

The Epstein-Barr virus is quite resistant to the environment, but it quickly dies when exposed to high temperatures, disinfectants, or drying out. When the pathogen enters a child’s body, it thrives in the patient’s blood, brain cells, and in case of cancer, in the lymph. The virus has a special tendency to infect its favorite cells (lymphatic system, immune system, upper respiratory tract, digestive system).

The pathogen can provoke an allergic reaction; 25% of sick children experience the appearance of Quincke's edema and rashes on the baby's body. Particular attention should be paid to the special property of the virus – lifelong presence in the body. Infection of the immune system gives cells an unlimited ability for active life and constant synthesis.

What to do if your child is sunburned? Read useful information.

Find out the rules for taking Suprastin tablets and dosage for children from this article.

Routes of transmission and infection

The source of the virus is an infected person. The patient becomes dangerous to others in the last days of the incubation period. Although the pathogen is released in small quantities at the beginning of the disease, the period of its course is even six months after recovery. About 20% of all patients become carriers of the virus, which is dangerous to others.

Routes of transmission of the Epstein-Barr virus:

• airborne. Mucus and saliva released from the nasopharynx pose a danger to others (through coughing, kissing, talking);
• contact-household. Infected saliva can remain on toys, towels, clothing, and household items. An unstable virus will not survive in the environment for long; this route of transmission of the pathogen is unlikely;
• during blood transfusion, its preparations;
• recent studies have proven that transmission from mother to fetus is possible, in which case the child is diagnosed with congenital Epstein-Barr viral infection.

Despite the variety of routes of transmission of the pathogen, there is a large group of people among the population who are immune to the virus (about 50% of children, 85% of adults). Most people become infected without developing a clinical picture, but antibodies are produced and the immune system becomes resistant to the pathogen. That is why the disease is considered low contagious, because many have already developed immunity to the Epstein-Barr virus.

How dangerous is the disease?

First of all, the virus is dangerous because it has a number of different manifestations. Because of this, parents, even experienced doctors, do not always immediately understand what they are dealing with and confuse it with other diseases. Only by carrying out the necessary studies (blood test, PCR diagnostics, DNA, biochemistry, serological manipulations) will it be revealed that the baby is infected with herpes virus 4.

The disease is dangerous because the virus spreads through the blood, multiplies in the bone marrow, and over time can affect any organ in the child’s body. Pediatricians identify several of the most dangerous consequences of infection with the Epstein-Barr virus infection:

• oncological diseases of various organs;
• pneumonia;
• immunodeficiency;
• serious damage to the nervous system that cannot be treated;
• heart failure;
• gradual enlargement of the spleen, its further rupture.

Characteristic signs and symptoms

Children with strong immunity experience infection in the form of a mild cold or are completely asymptomatic. The clinical picture of a child with a weak immune system is significantly different from a child with strong body defenses. The incubation period is about two months, after this period the following clinical picture is observed:

• swelling of the lymph nodes (in the neck), discomfort is felt upon palpation;
• elevated body temperature, it lasts for quite a long period of time. Antipyretics have little or no effect;
• the child is constantly bothered by headaches, chronic fatigue and weakness;
• wave-like pain in the throat is noted, attacks are felt;
• the baby’s body becomes covered with red rashes of unknown etiology;
• the liver and spleen are significantly enlarged;
• there are digestive problems (diarrhea, constipation, abdominal pain);
• the baby loses appetite, weight decreases uncontrollably;
• there are herpetic rashes on the oral cavity;
• against the background of chills, muscle pain and discomfort appear throughout the body;
• sleep is disturbed, the child has increased anxiety.

Over time, and without proper treatment, each symptom provokes the emergence of various ailments (pneumonia, tonsillitis, infectious mononucleosis, lymphoma, multiple sclerosis, hepatitis and others). Doctors often mistake the disease for other pathologies, the course becomes more complicated, and the child gets worse. If the problem is not identified in time, a sharply negative outcome is possible.

Diagnostics

To differentiate mononucleosis from other pathologies, a number of clinical studies are carried out:

• serological diagnosis, in which the antibody titer is determined, especially with the characteristic picture of infectious mononucleosis;
• identification of certain titers of antibodies to the pathogen. This method is relevant for children who do not yet have heterophilic antibodies;
• cultural method;
• general blood analysis;
• polymerase chain reaction.

The above methods help to find viral particles or its DNA in individual tissues, blood. Only a qualified specialist can prescribe the required range of studies; it is strictly forbidden to deal with the problem independently; making a diagnosis is strictly prohibited.

A selection of treatment methods

To date, there is no specific treatment for Epstein-Barr virus. Strong immunity copes with the pathogen, the disease is asymptomatic, without consequences. A complicated acute form of the disease requires complex therapy and hospitalization of a small patient. The following medications are used to treat pathology:

• Zovirax, Acyclovir. Children under two years old are prescribed 200 mg, children from two to six years old - 400 mg, over six years old - 800 mg four times a day. The duration of treatment is no more than 10 days, the individual course is determined by the doctor;
• Viferon is used in the form of rectal suppositories (for children under 7 years old), tablets (for children over seven years old);
• use interferon inducers (Cycloferon, Arbidol);
• Human immunoglobulin is actively used. Drugs in this group increase the body’s resistance to the virus, promote the elimination of toxins, and have an antibacterial effect;
• In addition, the baby is prescribed multivitamins.

Treatment tactics depend on the complexity of the situation and the child’s condition. During the period of rising temperature, the following actions are recommended:

• drink plenty of fluids (mineral waters, natural juices, fruit drinks, fresh fruit compotes);
• bed rest;
• nasal drops with a vasoconstrictor effect (Naphthyzin, Sanorin, Sofradex);
• gargling, mouthwash with antiseptic agents: decoction of chamomile, calendula, Furacilin, Iodinol;
• taking antipyretic drugs (Paracetamol, Nurofen, Panadol);
• If necessary, the baby is given antihistamines.

Hospitalization of a small patient is necessary only in isolated cases with severe fever or high temperature. If necessary, medications are prescribed to support normal liver function.

Find out about the normal weight gain of a newborn in the first months of life.

What does a child need for kindergarten? List of documents and accessories on this page.

Preventive measures

You can avoid infection or protect your baby from the acute course of the disease by strengthening the immune system from an early age:

• accustom your baby to being in the water and performing water procedures;
• balance your diet (exclude spicy, salty foods, limit your consumption of sweets);
• avoid stress;
• From childhood, accustom your child to regular physical activity.

Epstein-Barr virus in children: symptoms and consequences

The most common virus among people is the Epstein-Barr virus, or EBV for short. This herpes virus infection can affect young children, starting from one year old, schoolchildren, adolescents and adults. If a baby encounters it after a year, the symptoms of the disease are mild, very similar to a mild flu. If the infection occurs after 2-3 years of age against the background of reduced immunity, the child develops a rich clinical picture. Epstein-Barr virus in adolescent children occurs in the form of infectious mononucleosis. More than 90% of people on the planet are infected with this group of herpesvirus and are carriers of the disease. The danger of infection with this virus in children is manifested by disorders of the brain, lymphatic system, liver and spleen. Let's consider the main causes, symptoms and consequences of the development of the Epstein-Barr virus.

Introduction to Epstein-Barr Virus

The virus was first identified by Michael Anthony Epstein in 1964 through collaboration with graduate student Yvonne M. Barr. The discovery of the virus occurred after examining samples of Burkitt's lymphoma tumors. Samples were provided by surgeon Denis Parson. He studied the development of lymphoma in children under 7 years of age living in Africa.

Epstein-Barr virus in children is transmitted through airborne droplets, saliva, personal hygiene products, dishes, blood transfusion or transplantation. After infection and recovery, a person usually develops lasting immunity to this group of viruses.

Although neither a child nor an adult will be able to completely get rid of the presence of the virus in the body. The Epstein-Barr virus in children and adults will remain dormant after successful treatment.

Symptoms of virus development

The first organs to be infected by the virus are the salivary glands, lymph nodes, and tonsils. In the first years of a child’s life after infection with the virus, the clinical picture does not manifest itself in any way, or mild symptoms are noticeable, which often resemble a cold. Therefore, pediatricians treat a cold rather than a virus. If the infection enters the child’s body after 2 years, an increase in lymph nodes, salivary glands, and adenoids may be observed. In addition, the temperature rises to several degrees, the child feels weak, does not want to sleep or eat, frequent abdominal pain appears, the nasopharynx swells, and nasal discharge may appear.

Possible consequences and diagnosis of Epstein-Barr virus

If the infection in the child’s body is acute and rapid, there will most likely be disturbances in the functioning of the kidneys, liver, spleen, and immune system. Oncological processes can also develop in the lymph nodes or other organs: cancer of the stomach, nasopharynx, colon or small intestine, and oral mucosa. In addition, the development of EBV in children can cause not only enlarged lymph nodes, the development of lymphadenopathy or lymphadenitis, but also persistent tonsillitis.

If the Epstein-Barr virus in children occurs in the form of infectious mononucleosis, characteristic symptoms may be: vomiting, pain in the abdomen, rare stools, pneumonia, enlarged lymph nodes, weakness and headache.

A child who has had mononucleosis may experience enlarged lymph nodes and problems with the liver, kidneys and spleen for a year and a half, and tonsillitis and pharyngitis may occur.

It is especially dangerous to send a child for vaccination if he is infected with a virus - the unpredictability of the reaction puts the baby’s life at risk.

Attention! If a child has any of the above symptoms and manifestations, we kindly ask that the child be tested for the presence of the Epstein-Barr virus!

How to diagnose a virus

To identify a child’s infection with the virus, it is necessary to donate blood and saliva for laboratory testing: general blood test, biochemical blood test, immunogram, serological methods.

Treatment of Epstein-Barr virus

There are currently no effective methods for curing sick children infected with the Epstein-Barr virus. Doctors can only eliminate clinical manifestations and transfer the active infection to a latent phase, which is not harmful to the child’s health.

Infectious mononucleosis and organs affected by the virus in the child’s body are treated in a hospital. In addition, if there is still a chance that the virus may further affect the brain and vital organs, doctors prescribe antibiotics, antihistamines, and medications to relieve acute symptoms: relieve swelling in the nose, normal lymph flow.

If there are slight enlargements of the lymph nodes and slight swelling in the nasopharynx, treatment can be carried out by a pediatrician. In all other cases, observation and treatment is carried out by an infectious disease specialist.

Symptoms of Epstein-Barr virus in a child and are there effective treatments

Epstein-Barr virus

If we add to all this its amazing potential for imitating the symptoms of other diseases and the general secrecy of its presence in the body, we can say that this pathogen is indeed one of the most dangerous in the world.

• It is extremely common. Wider than its “brother” cytomegalovirus. Among the adult population of the planet, up to 98% of adults and at least 50% of children under five years of age are its carriers.
• He defends well. The virus has structures related to receptors on lymphocytes, so it is not recognized by the immune system. Instead, it is able to penetrate even these immune cells and multiply within them, which allows it to very successfully suppress the immune defense of the invaded organism.

Epstein-Barr virus in children: how to recognize

The question of how such a secretive pathogen manifests itself is a separate big topic, since even its most striking signs rarely seem alarming to us. It is curious that the set of symptoms of the Epstein-Barr virus in a child depends most on his age. So, the younger he is, the easier the acute stage will be, and vice versa: in children over three years old, EBV is much more pronounced than in one-year-olds or newborns.

Signs of infection with herpes type 4

In the vast majority of cases, EBV (Epstein-Barr virus) in children does not manifest itself at all or appears as a mild illness, say, due to a cold. In this case, they may experience:

• moderate temperature (within 37-37.5 °C);
• a sore throat;
• hoarseness of voice;
• cough;
• sometimes - swelling of the cervical lymph nodes.

Complications of infection

The consequences of infection with it can be very different, but the most common among them are the following.

Mononucleosis serves as the main acute form of infection (that is, in addition to conditions very similar to the common cold). It manifests itself in two groups of symptoms, one of which is familiar to everyone, but the second is not entirely typical. The first group of signs of mononucleosis is characterized by:

• loss of strength;
• bronchitis;
• headache;
• aches in joints and muscles;
• temperature about 37 C;
• sore throat;
• the appearance of a herpetic sore somewhere in the lip area.

It is not surprising that the first part of the signs of mononucleosis does not cause any suspicion either in children or their parents, because it cannot be distinguished from a cold. But this is exactly until he begins to show persistence in treatment (including antibiotics and folk remedies), which is atypical for acute respiratory infections, and the second group of symptoms appears. It includes the following.

• Inflammation of the lymph nodes. It is limited at first, but can appear anywhere on the body. Without specialized treatment, such a lesion will not go away on its own. It spreads further over the next few months, turning one “ball” under the skin into a sequence of several “balls” connected by thin threads.
• Increased size of the spleen and liver. As a rule, this happens simultaneously, but scenarios are also possible when only one of these organs “swells.”

Malignant tumors

One of the most dangerous diseases that mononucleosis (with damage to the lymph nodes) or the Epstein-Barr virus infection itself can develop into is Burkitt lymphoma. Another serious complication is lymphogranulomatosis.

Brackett's lymphoma

Burkitt's lymphoma is a type of non-Hodgkin's (not containing specific cells) lymphoma - that is, a malignant tumor of the lymphatic system. Lymphomas in general are characterized by rapid spread and resistance to any treatment, since cancer cells are carried by lymph throughout the body (this is not a local tumor that can be removed). In the case of Burkitt's lymphoma, B-lymphocytes undergo degeneration - one of the types of immune lymph bodies that are successfully attacked by the Epstein-Barr virus.

Lymphogranulomatosis

Unlike Burkitt's lymphoma, lymphogranulomatosis is a Hodgkin's lymphoma. The difference between these two types of lymphomas is much greater for doctors than for us, and it lies in whether the affected lymph nodes contain giant cells that are unlike anything else. But what is much more important for us is that this is also cancer of the lymphatic system, and it is impossible to remove it as a local tumor - due to its uncertain localization.

However, the course of lymphogranulomatosis is not characterized by such malignancy. And modern oncology has already managed to achieve a five-year remission in the vast majority of cases. In addition to two types of lymphomas, a relationship has been established between the Epstein-Barr virus and nasopharyngeal cancer.

Routes of infection

EBV is poorly adapted to survive in the environment - it lives much more comfortably in immune, nerve and other cells. Therefore, children, like adults, become infected with it in the following way.

• Upon contact. This refers to direct physical contact with the wearer. For example, in everyday life, when using common household items. In adults, transmission often occurs through sexual intercourse.
• Through blood. For example, through a common circulatory system with the mother’s body during intrauterine development, especially if the mother became infected while already pregnant. But infection can also occur through blood transfusion.
• By airborne droplets. Especially when kissing (including on the cheek) during the period of herpes type 4 rashes on the lips. When coughing near a child during an acute period of illness.

Diagnosis and treatment of EBV

To diagnose this disease, a blood test for herpes virus type 4 is used. More precisely, when testing blood for the Epstein-Barr virus in children, the laboratory technician looks for antibodies to the so-called “capsid” antigen of the virus in the taken smear.

How exactly is the pathogen detected?

In general, the capture of more and more new cells by the pathogen leads to the appearance of three types of antigens in them:

And only then immune proteins to these antigens are formed in the blood. And the capsid antigen is especially valuable because both it and antibodies to it appear first - sometimes even before the onset of the first symptoms of the disease. We are talking about IgM class antibodies. A positive result indicates that no more than a month has passed since the child was infected.

Treatment

Unfortunately, all treatment for the Epstein-Barr virus in children comes down to taking antiviral drugs - especially those that have proven effective not only against the herpes virus type 4, but also its “brothers”.

• "Acyclovir". It gives good results in the treatment of herpes zoster.
• "Ganciclovir." Mainly due to its ability to suppress the activity of cytomegalovirus - a very close “relative” of the Epstein-Barr virus.
• Recombinant α-interferon. Interferons are universal cell defense proteins, so their number increases in response to any infection. The only difficulty is that effective interferon preparations are produced only in the form of ampoules for intravenous injection.
• Immunoglobulin. Immunoglobulins, unlike interferons, serve as part of the immune system not of cells, but of blood. Therefore, preparations of these two proteins are often used simultaneously.

Is prevention possible?

Vaccines against the Epstein-Barr virus have not yet been developed, since the composition of its proteins is very variable and depends not only on the stage of its development, but also on the type of cells in which it multiplies. Therefore, in the complete absence of effective treatment and prevention from official medicine, we are completely free to choose tactics to protect ourselves from the virus.

The only thing we must understand is that treatment of the Epstein-Barr virus in children at home and using traditional methods is 100% likely to be as “effective” as in the hospital. The world only recently learned about the existence of this pathogen. And even the “people” could not create a method of treating something that no one suspects. The same applies to his treatment with homeopathy. Therefore, at the moment, the only means of treatment and prevention of its complications is, perhaps, systematic work to strengthen the child’s immunity. But if we are sure that it can be strengthened with the help of medicinal herbs or the “memory” of water, they can also be included in the therapeutic program.

Epstein-Barr virus (EBV): symptoms, treatment, what diseases it causes

Considering the high infection rate of the adult population with the Epstein-Barr virus (up to 90% of people), there is an unfairly frivolous attitude towards this pathogen. Recently, a number of studies have been carried out, as a result of which it was revealed that this virus is involved in the occurrence of not only infectious mononucleosis, but also belongs to the group of oncogenic viruses. It can cause some nasopharyngeal tumors, as well as high-grade lymphoma.

Epstein-Barr virus (EBV) is a member of the herpes virus. In 1964, Canadian scientists discovered this pathogen, after whom it was named. According to its structure, this virus contains a DNA molecule that has a spherical shape. This virus was initially discovered in lymphoma cells. Upon further study of this microorganism, it turned out that it can cause many diseases, the clinical picture of which has different “masks”.

Diseases that can be caused by the Epstein-Barr virus:

• Infectious mononucleosis.
• Damage to the respiratory tract (respiratory infection).
• Nasopharyngeal carcinoma (malignant disease of the nasopharynx).
• Burkitt's lymphoma.
• Chronic fatigue syndrome.

How does a viral infection spread?

EBV is transmitted in the following ways:

1. Airborne (is the most common).
2. Contact (the virus is transmitted through saliva, infection is possible through kissing, passing toys from children, using the same dishes, towels).
3. Reproductive tract (the pathogen is found on the mucous membrane of the genital organs).
4. Infection of a child during childbirth when passing through the birth canal.
5. Transmission of the virus through blood (through transfusion of blood components).
6. Penetration of the virus through the placenta in utero.

EBV or human herpes virus type 4

Important! Human susceptibility to EBV is extremely high. By the age of 40, almost all people become infected with this pathogen. But this does not mean that a person will develop a certain disease. The likelihood of a particular pathology caused by this virus largely depends on our immune system. But the degree of viral load is also very important when the infection spreads. This means that the transmission of viral particles from a person suffering from an acute stage of the disease is hundreds of times greater than from a virus carrier who does not have any symptoms.

It is also interesting that a person who has had an acute EBV infection continues to shed the pathogen for 2-18 months even after complete clinical recovery and the absence of any symptoms of the disease.

Infectious mononucleosis

Infectious mononucleosis is an infectious disease characterized by the spread and multiplication of the virus in human lymphoid tissue.

This disease most often affects children during adolescence, but can also occur in adults. This pathology is very characterized by seasonality with a pronounced autumn and spring peak.

• A typical incubation period lasts 15 days. During this time, no symptoms of the disease are observed. Rare cases have been recorded where the incubation period lasted about 2 months.
• Fever worries 93% of patients. In the vast majority of patients, the temperature reaches 39-40ºС. Fever is more severe in children than in adults.
• Most often, the first symptom is sore throat, since the tonsils of the oropharynx are the first “gate of entry” when the virus enters the body. The tonsils increase sharply in size, become red and swollen. Often a yellowish coating in the form of “islands and stripes” appears on their surface. This symptom occurs in almost all patients with mononucleosis (99.5%).
• Sore throat (pharyngitis). The mucous membrane of the oropharynx becomes swollen. The patient complains of sore throat when swallowing.
• Difficulty in nasal breathing is more common in children, since enlarged tonsils in the nasopharynx make it difficult to inhale. As a result, children often begin to breathe through their mouths.
• Damage to almost all lymph nodes (behind the ear, mandibular, pharyngeal, supraclavicular, subclavian, axillary, inguinal). When palpating the nodes, an increase in their size is noted, as well as the appearance of sharp pain.
• Enlargement of the liver and spleen occurs in 98% of patients by the end of the first week of the disease. On palpation, the edge of the liver becomes dense and painful. Sometimes the patient can see yellowness of the skin and sclera of the eyes. The enlargement of the spleen occurs somewhat faster than the liver. So, by the 4th day of the disease, the enlarged spleen can be reliably palpated.
• Increased heart rate.
• Less commonly, symptoms appear: swelling of the face, runny nose, diarrhea.

It is extremely rare (in 0.1% of cases) that patients experience rupture of the spleen as a result of a significant enlargement of this organ. The spleen capsule cannot withstand tension and ruptures. The clinical picture of intra-abdominal bleeding develops (sharp drop in pressure, tachycardia, fainting, sharp abdominal pain, positive peritoneal phenomena, tension of the abdominal wall muscles on the left side in the hypochondrium). In such a situation, emergency surgery is necessary to stop the bleeding.

In addition to the typical form of the disease with a clear clinical picture, infectious mononucleosis can occur atypically:

1. Erased form. It is characterized by the presence of symptoms, but mild ones. The patient has virtually no complaints. Also, the erased form can manifest itself as an acute respiratory disease.
2. The asymptomatic form occurs completely without any signs of disease. In this case, the person is only a carrier of the virus.
3. The visceral form is characterized by severe damage to internal organs (kidneys, adrenal glands, liver, heart, etc.)

Diagnosis of mononucleosis

This disease is characterized by:

1. The appearance of inflammatory changes in the blood (moderate increase in leukocytes, increase in erythrocyte sedimentation rate (ESR), decrease in segmented and increase in band neutrophils).
2. The most characteristic is the appearance in the blood of cells specific for this disease - wide-plasma mononuclear cells. They are present in 100% of patients and differ from other cells in their large size, as well as a wide light “belt” around the dark cell nucleus.
3. Decreased platelet count. This process is associated with the production of antiplatelet antibodies in the body, as well as additional destruction of platelets in the enlarged spleen.

What diseases need differential diagnosis?

The clinical symptoms of some diseases (especially diphtheria and lacunar tonsillitis) are very similar to infectious mononucleosis. In order to distinguish them and make a correct diagnosis, you need to know some of the features of these diseases.

Treatment of infectious mononucleosis

In mild forms of the disease, treatment is exclusively symptomatic, that is, it is aimed only at eliminating and alleviating the main symptoms of the disease. However, in severe cases the treatment regimen is different. Given the viral nature of the infection, the main treatment is aimed at reducing the activity of the virus.

• Antiviral drugs. Today, there are a large number of drugs with antiviral activity on the pharmacological market. However, few of them are active against the Epstein-Barr virus. For example, despite the fact that EBV belongs to the family of herpes viruses, the drug Acyclovir (Zovirax) has practically no effect on it. The drug “Isoprinosine” (“Inosine pranobex”), which stimulates a person’s own immunity, has shown good effectiveness against EBV-associated infections. It is important that this medicine can be used in children over 3 years of age. In addition, the drug is well tolerated and causes virtually no adverse reactions. The combined use of Isoprinosine with recombinant alpha-interferons has shown decent results. These drugs include: “Roferon-A”, “Intron-A”, “Viferon”
• Local treatment in the form of gargling with antiseptic solutions (for severe sore throat, a 2% solution of Lidocaine, which has a local anesthetic effect, can be added to the solution).
• Hepatoprotectors (“Essentiale”) for the appearance of icteric syndrome.
• Given the prolonged fever, the prescription of antipyretic drugs is justified. For children, Nurofen drops, as well as Tsefekon rectal suppositories, are effective. For adult patients with prolonged high, debilitating fever, the use of the drug “Perfalgan”, which is administered intravenously, is effective.
• In immunodeficiency states, the use of the drug “Polyoxidonium”, as well as B vitamins, is justified.
• In rare cases, infectious mononucleosis occurs with an exacerbation of a fungal infection (especially in people with immunodeficiency). In such cases, it is necessary to add antifungal drugs to the treatment regimen (Fluconazole, Nystatin). If the fungal infection is resistant to these drugs, you can use the drug Cancidas.
• Prescribing antibiotics for mononucleosis is not always justified. Many doctors are inclined to believe that the prescription of this group of drugs is allowed only in cases where a bacterial infection occurs, or if the disease was initially caused by a mixed infection (several pathogens at the same time). The most commonly used antibiotics in this situation: Cephalosporins (Cefotaxime), Macrolides (Macropen).

Important! The administration of penicillin antibiotics is contraindicated for infectious mononucleosis due to the risk of developing an allergic reaction.

The key to success in the treatment of infections caused by the Epstein-Barr virus is the complex prescription of drugs that enhance the effect of each other.

Disease outcome and prognosis

In most cases, infectious mononucleosis occurs without complications. After 4 weeks, as a rule, the symptoms of the disease disappear. But it is impossible to talk about a complete recovery, since the Epstein-Barr virus continues to reside in the body in the lymphoid tissue. However, its reproduction (virus replication) stops. It is for this reason that antibodies remain in the body of those who have recovered from mononucleosis for the rest of their lives.

Rehabilitation after infectious mononucleosis

1 month after the symptoms of the disease disappear, you must take a general blood test. After 6 months, you need to check the viral load in the body. To do this, an ELISA test is performed to determine antibody titers. If the virus remains active in the body, it is necessary to take maintenance antiviral therapy in small doses. Patients with chronic EBV infection in remission need to take vitamin and mineral complexes to maintain immunity.

Video: Epstein-Barr virus in children, mononucleosis - Dr. Komarovsky

Chronic fatigue syndrome

This disease began to be discussed more than 30 years ago, when the Epstein-Barr virus was discovered in most people suffering from similar symptoms.

Symptoms of the disease

1. Feeling of “soreness” in the throat.
2. Slight enlargement of lymph nodes, especially cervical and occipital.
3. Constant temperature, often low.
4. Severe muscle weakness.
5. A significant decrease in overall performance by more than 50% of the original level.
6. Constant feeling of fatigue, weakness.
7. Violation of the daily routine, insomnia.
8. Memory disorder.
9. Pain and dryness in the eyes.
10. Irritability.

Features of treatment

In addition to prescribing antiviral therapy, it is important to take an individual approach in the treatment of chronic fatigue syndrome. Unfortunately, there is no strictly developed treatment regimen for this condition.

However, the following methods are effective:

• General restorative therapy (immunomodulatory drugs, physiotherapeutic treatments, vitamin therapy).
• In cases of depression associated with this disease, consultation with a psychiatrist is necessary.

Disease prognosis

In most cases, patients notice an improvement in their condition after treatment after 1-2 years. But, unfortunately, complete restoration of performance practically does not occur.

Oncological diseases caused by EBV infection

Nasopharyngeal carcinoma

Nasopharyngeal carcinoma is a malignant disease of the nasopharynx.

It has been proven that the main triggering factor for the development of nasopharyngeal carcinoma is the long-term presence of EBV infection in the body.

1. Difficulty in nasal breathing.
2. Unilateral hearing loss is possible (when a malignant oncological process moves to the Eustachian tube).
3. Patients often experience nosebleeds.
4. Unpleasant odor from the mouth and when breathing.
5. Pain in the nasopharynx.
6. Non-healing ulcers in the throat.
7. Pain when swallowing.

Treatment methods

Nasopharyngeal carcinoma is an example of a long-term advanced chronic viral infection that causes an oncological process.

Among the treatment methods, the fight against malignancy comes to the fore:

1. Surgery. The use of Cyber ​​Knife in the early stages of the disease showed good results.
2. Radiation and chemotherapy are complementary to the surgical method. The use of this type of treatment before and after surgery improves the prognosis for the patient.
3. Antiviral treatment is prescribed after surgery for a long period in order to minimize the activity of oncogenic viruses.

Burkitt's lymphoma

Burkitt's lymphoma is a malignant disease that affects lymphoid tissue. In advanced stages, the oncological process may spread to other organs and tissues.

In 95% of cases, the Epstein-Barr virus is involved in the occurrence of this disease.

1. Most often, the disease begins with damage to the lymph nodes of the nasopharynx and oropharynx, mandibular, postauricular, supraclavicular lymph nodes. It is for this reason that the first symptoms are impaired nasal breathing and pain when swallowing.
2. The disease progresses quite quickly, involving new groups of lymph nodes in the pathological process.
3. In advanced stages of the cancer process, the organs of the chest and abdominal cavity are affected.

Treatment

Given the high malignancy of the disease, surgical methods, as well as radiation and chemotherapy, are used simultaneously. This disease has a high risk of recurrence. When symptoms of the disease reappear in the patient’s blood, a high titer of antibodies to the Epstein-Barr virus can be detected. It is for this reason that antiviral therapy is necessary.

The prognosis for the patient is unfavorable, given the high malignancy of Burkitt's lymphoma. In the early stage of the disease, with timely initiation of complex treatment, the prognosis improves.

Diagnosis of diseases, antibodies to Epstein-Barr virus

Given the variety of diseases caused by this virus, making a diagnosis is often very difficult.

If symptoms suspicious for EBV infection appear, it is necessary to use additional laboratory methods that identify this pathogen.

The Epstein-Barr virus is recognized by our body due to the presence in its structure of the following foreign components (antigens):

The body's immune system responds to the presence of a virus in the body by producing specific proteins against this microorganism. These proteins are called antibodies, or immunoglobulins (Ig). When the virus initially enters the body, class M immunoglobulins are formed within 3 months, and when the infection becomes chronic and the pathogen remains in the body’s tissues for a long time, class G immunoglobulins are synthesized.

In order to confirm the involvement of this virus in the disease, it is necessary to detect specific antibodies (immunoglobulins) in the blood using the ELISA method (enzyme-linked immunosorbent assay):

• Antibodies to early antigen indicate an early stage of the disease and primary lesion (class M immunoglobulins - IgM)
• Antibodies to capsid and nuclear antigen are an indicator of long-standing infection and the chronic nature of the disease (class G immunoglobulins - IgG).

What to do if antibodies to EBV are detected during pregnancy?

Despite the fact that EBV can cross the placenta to the baby, the presence of positive antibodies is not always dangerous.

When should you not worry?

1. If a low titer of class G immunoglobulins is detected, then this probably indicates the presence of the virus in the body in an inactive stage.
2. Absence of any clinical manifestations of viral infection.

When is antiviral therapy needed during pregnancy?

• If a high titer of class G immunoglobulins is detected, even in the absence of symptoms of the disease, this indicates the presence of a chronic EBV infection, which can be dangerous for the development of the child.
• Detection of class M antibodies (IgM) means an exacerbation of EBV infection.

The presence of IgM antibodies is dangerous for the baby and also creates a risk for the course of the pregnancy. It has been proven that the presence of EBV infection in the body of a pregnant woman leads to gestosis, the threat of miscarriage, pathology of the placenta, premature birth, impaired blood flow, and fetal hypoxia.

It is necessary to approach the prescription of antiviral treatment during pregnancy individually. Consultation with an infectious disease specialist and immunologist is also required. The prescription of any drug must be justified and have an evidence base.

Such a widespread distribution of the Epstein-Barr virus, as well as the significant variety of “masks” that this infection takes on, contribute to increased attention to this microorganism. Unfortunately, at the moment, there is no single and clear treatment regimen for this infection. Moreover, complete disposal of this virus is impossible, since it continues to be in the body in an inactive stage. However, despite all these difficulties, today there are drugs that successfully help fight the symptoms of this disease.

It is important to remember that antiviral treatment should not be neglected, since advanced EBV infection can cause malignant oncological processes that are very difficult to treat.

Infection of children with viral infections is facilitated by the fact that their immune system is weakened, and at the same time they are more likely than adults to have close contact with virus carriers. It is almost impossible to recognize diseases that arise as a result of the development of viruses of various types without special tests. Even the same virus can manifest itself as symptoms of several diseases with different consequences and manifestations. For example, the development of the Epstein-Barr virus in a child’s body sometimes proceeds unnoticed. But it can also be a source of very dangerous diseases.

Content:

Characteristics of the virus

The discoverers of this infectious pathogen are the English microbiologist Michael Epstein and his assistant Yvonne Barr. This type of microorganism is one of the representatives of the herpetic group of viruses. Human infection usually occurs during childhood. Most often, children aged 1-6 years are infected as a result of the physiological imperfection of their immunity. A contributing factor is that at this age most children are still little familiar with the rules of hygiene. Their close contact with each other during play inevitably leads to the spread of the Epstein-Barr virus (EBV) from one baby to another.

Fortunately, in most cases, infection does not lead to serious consequences, and if the baby does get sick, he develops a strong immunity. In this case, the pathogen remains in the blood for life. Such microorganisms are found in approximately half of children undergoing virological examination and in most adults.

In infants fed breast milk, EBV infection occurs extremely rarely, since their body is protected from the effects of viruses by the mother's immunity. At risk are small children born prematurely, with poor development or congenital pathologies, and with HIV.

At normal temperature and humidity, this type of virus is quite stable, but in dry conditions, under the influence of high temperatures, sunlight, and disinfectants, it quickly dies.

What is the danger of contracting Epstein-Barr infection?

Until 5-6 years of age, infection most often does not pose a serious threat to health. Symptoms are typical for ARVI, sore throat. However, children may become allergic to EBV. In this case, the body’s reaction can be unpredictable, up to Quincke’s edema.

The danger is that once the virus enters the body, it remains there forever. Under certain conditions (decreased immunity, the occurrence of injuries and various stresses), it is activated, which becomes the cause of the development of serious diseases.

The consequences may appear many years after the infection occurs. The development of the Epstein-Barr virus is associated with the occurrence of the following diseases in children:

• mononucleosis – destruction of lymphocytes by viruses, the consequences of which are meningitis and encephalitis;
• pneumonia, increasing airway obstruction (obstruction);
• immunodeficiency state (IDS);
• Multiple sclerosis is a disease caused by the destruction of nerve fibers in the brain and spinal cord;
• heart failure;
• rupture of the spleen due to its strong enlargement (this causes acute abdominal pain), which requires immediate hospitalization;
• lymphogranulomatosis - damage to the lymph nodes (cervical, axillary, inguinal and others);
• malignant lesion of the lymph nodes (Burkitt's lymphoma);
• nasopharyngeal cancer.

Most often, an infected baby, after promptly started treatment, fully recovers, but is a virus carrier. As the disease becomes chronic, symptoms periodically worsen.

If timely examination is not carried out, doctors may not recognize the true nature of the symptoms. The patient's condition worsens. A severe option is the development of deadly diseases.

Causes and risk factors

The main cause of infection is the entry of the Epstein-Barr virus directly from a sick person into the body of a small child, who is especially contagious at the end of the incubation period, which lasts up to 1-2 months. During this period, these microorganisms multiply rapidly in the lymph nodes and mucous membranes of the nose and throat, from where they then enter the blood and spread to other organs.

The following routes of transmission of infection exist:

1. Contact. Many viruses are found in saliva. A child can become infected if a sick person kisses him.
2. Airborne. Infection occurs when particles of the patient's sputum are scattered around when coughing and sneezing.
3. Contact and household. Infected saliva ends up on the child's toys or objects he touches.
4. Transfusion. Transmission of the virus occurs through blood during a transfusion procedure.
5. Transplantation. The virus is introduced into the body during a bone marrow transplant.

The patient's symptoms may be hidden, so he, as a rule, is unaware of his illness, continuing to be in contact with the small child.

Video: How EBV infection occurs, what are its manifestations and consequences

Classification of Epstein-Barr infections

When prescribing a course of treatment, various factors are taken into account, indicating the degree of activity of the pathogen and the severity of the manifestations. There are several forms of Epstein-Barr virus disease.

Congenital and acquired. Congenital infection occurs during the period of intrauterine development of the fetus when viruses are activated in a pregnant woman. A child can also become infected during passage through the birth canal, since viruses also accumulate in the mucous membranes of the genital organs.

Typical and atypical. In the typical form, symptoms of mononucleosis usually appear. With an atypical course, the symptoms are smoothed out or similar to manifestations of respiratory tract diseases.

Mild, moderate and severe forms. Accordingly, in a mild form, the infection manifests itself as a short-term deterioration in well-being and ends with complete recovery. A severe form leads to brain damage, progressing to meningitis, pneumonia, and cancer.

Active and inactive form, that is, the appearance of symptoms of rapid reproduction of viruses or a temporary lull in the development of infection.

Symptoms of EBV infection

At the end of the incubation period, when infected with the EB virus, symptoms appear that are characteristic of the development of other viral diseases. It is especially difficult to understand what a child is sick with if he is less than 2 years old and is unable to explain what exactly is bothering him. The first symptoms, as with ARVI, are fever, cough, runny nose, drowsiness, and headache.

In primary schoolchildren and adolescents, the Epstein-Barr virus is usually the causative agent of mononucleosis (glandular fever). In this case, the virus affects not only the nasopharynx and lymph nodes, but also the liver and spleen. The first sign of such a disease is swelling of the cervical and other lymph nodes, as well as an enlargement of the liver and spleen.

Typical symptoms of such an infection are:

1. Increased body temperature. By 2-4 days it can rise to 39°-40°. In children, it remains high for up to 7 days, then drops to 37.3°-37.5° and remains at this level for 1 month.
2. Intoxication of the body, symptoms of which are nausea, vomiting, dizziness, diarrhea, bloating, aching bones and muscles.
3. Enlargement of lymph nodes (mainly cervical) due to their inflammation. They become painful.
4. Pain in the liver area.
5. Inflammation of the adenoids. It is difficult for the patient to breathe through his nose due to its congestion; he has a nasal sound and snores in his sleep.
6. The appearance of a rash all over the body (this sign is a manifestation of an allergy to toxins). This symptom occurs in approximately 1 in 10 children.

Warning: When visiting a doctor, parents of preschool children should insist on examining their child for the presence of EBV if he often suffers from colds and sore throats, eats poorly, and often complains of fatigue. Treatment with specific antiviral drugs may be required.

With the atypical form of Epstein-Barr virus infection, only isolated symptoms appear, and the disease is not as acute as the typical one. Mild discomfort can last much longer than with the usual acute form.

Video: Symptoms of infectious mononucleosis. Can the disease be treated with antibiotics?

Diagnostics

Laboratory blood testing methods are used to detect viruses, determine the degree of damage to lymphocytes, and other characteristic changes.

General analysis allows you to determine the level of hemoglobin and the presence of an atypical structure of lymphocyte cells. These indicators are used to judge the activity of the virus.

Biochemical analysis. Based on its results, the condition of the liver is judged. The content of enzymes, bilirubin and other substances produced in this organ in the blood is determined.

ELISA (enzyme-linked immunosorbent assay). It allows you to detect the presence of specific antibodies in the blood - immune cells that are produced in the body to destroy the EB virus.

Immunogram. The number of cells of various blood elements in a sample taken from a vein (platelets, leukocytes, immunoglobulins) is counted. Their ratio determines the state of immunity.

PCR (polymerase chain reaction). The DNA of microorganisms found in a blood sample is examined. This allows the presence of Epstein-Barr viruses to be confirmed, even if they are present in small quantities and are in an inactive form. That is, the diagnosis can be confirmed at the earliest stages of the disease.

Ultrasound of the liver and spleen. The degree of their increase and the presence of changes in tissue structure are determined.

Video: How EBV is diagnosed. What diseases is it differentiated from?

Epstein-Barr treatment method

If the disease occurs in a complicated form, shortness of breath appears or signs of heart failure or acute abdominal pain occur, the child is hospitalized. An urgent examination is carried out. If the presence of a viral infection is confirmed, specific antiviral and auxiliary treatment is prescribed.

For mild forms of the disease, treatment is carried out at home. Antibiotics are not prescribed, since they are powerless in the fight against viruses. Moreover, their prescription for mononucleosis can only worsen the patient’s condition, since antibiotics have a lot of side effects that are not harmless for children.

Specific therapy for Epstein-Barr infection

Drugs to strengthen the immune system and antiviral drugs are prescribed only in severe cases of the disease, when signs of severe intoxication and immunodeficiency occur. Children of any age can take Acyclovir, Isoprinosine. From the age of 2, Arbidol and Valtrex are prescribed. After 12 years you can use Famvir.

Antiviral and immunomodulatory agents include interferon derivatives: Viferon, Kipferon (prescribed at any age), Reaferon (from 2 years). Interferon inducer drugs (stimulating its own production in the body) are used. Among them are Neovir (prescribed from infancy), Anaferon (for children over 1 year old), Kagocel (from the age of 3 years), Cycloferon (after 4 years), Amiksin (after 7 years).

Based on the results of the immunogram, the patient may be prescribed immunomodulatory drugs of other groups, such as Polyoxidonium, Derinat, Lykopid.

Note: Any medications, especially those with specific effects, should only be prescribed to children by a doctor. It is necessary to strictly adhere to the instructions without violating the dosage and treatment regimen.

Additional (symptomatic) therapy

It is carried out to alleviate the general condition of sick children.

Paracetamol or ibuprofen are usually given as antipyretics in forms suitable for children: syrups, capsules, suppositories. To facilitate nasal breathing, vasoconstrictors Sanorin or Nazivin (in the form of drops or spray) are prescribed. Gargling with antiseptic solutions of furatsilin or soda helps with sore throat. A decoction of chamomile or sage is used for the same purpose.

Anti-allergenic drugs are prescribed (Zyrtec, Claritin, Erius), as well as drugs that improve liver function (hepatoprotectors Essentiale, Karsil and others). Vitamins C, group B and others are prescribed as general tonics.

Prevention

There is no specific vaccine for the Epstein-Barr virus. You can protect your baby from infection only by instilling hygiene skills in him from birth, as well as strengthening his immunity. The development of the immune system is promoted by hardening, long walks in the fresh air, good nutrition, and a normal daily routine.

If symptoms of a viral infection occur, you should immediately contact your pediatrician. In the acute form of Epstein-Barr infection, timely treatment leads to rapid recovery. If the symptoms are smoothed out, this does not mean that you should not pay attention to them. The disease can become chronic and cause serious complications.

According to research, half of schoolchildren and 90% of forty-year-olds have encountered the Epstein-Barr virus (EBV), are immune to it and do not even know it. This article will focus on those for whom getting to know the virus was not so painless.

Infectious mononucleosis

At the onset of the disease, mononucleosis is practically indistinguishable from ordinary ARVI. Patients are bothered by a runny nose, moderate sore throat, and body temperature rises to subfebrile levels.

The acute form of EBV is called. The virus enters the human body through the nasopharynx. More often through the mouth - it’s not for nothing that infectious mononucleosis received the beautiful name “kissing disease”. The virus multiplies in cells of lymphoid tissue (in particular, in B lymphocytes).

A week after infection, a clinical picture resembling an acute respiratory infection develops:

• temperature increase, sometimes up to 40 °C,
• hyperemic tonsils, often with plaque,
• as well as a chain of lymph nodes in the neck along the sternocleidomastoid muscle, as well as in the back of the head, under the lower jaw, in the armpits and in the groin area,
• may be detected during examination of “packets” of lymph nodes in the mediastinum and abdominal cavity, the patient may complain of cough, pain in the sternum or in the abdomen,
• the liver and spleen increase in size,
• Atypical mononuclear cells appear in a blood test - young blood cells similar to both monocytes and lymphocytes.

The patient spends about a week in bed, during which time he drinks a lot, gargles and takes antipyretics. There is no specific treatment for mononucleosis, the effectiveness of existing antiviral drugs has not been proven, and antibiotics are needed only in the case of a bacterial or fungal infection.

Typically, the fever disappears within a week, the lymph nodes shrink within a month, and blood changes can persist for six months.

After suffering from mononucleosis, specific antibodies remain in the body for life - immunoglobulins of class G (IgG-EBVCA, IgG-EBNA-1), which provide immunity to the virus.

Chronic EBV infection

If the immune response is not effective enough, a chronic Epstein-Barr viral infection may develop: erased, active, generalized or atypical.

1. Severe: the temperature often rises or stays for a long time within 37–38 ° C, increased fatigue, drowsiness, muscle and joint pain, and swollen lymph nodes may appear.
2. Atypical: infections often recur - intestinal, urinary tract, repeated acute respiratory infections. They are protracted and difficult to treat.
3. Active: symptoms of mononucleosis (fever, sore throat, lymphadenopathy, hepato- and splenomegaly) recur, often complicated by bacterial and fungal infections. The virus can cause damage to the mucous membrane of the stomach and intestines; patients complain of nausea, diarrhea, and abdominal pain.
4. Generalized: damage to the nervous system (encephalitis, radiculoneuritis), heart (), lungs (pneumonitis), liver (hepatitis).

In case of chronic infection, both the virus itself can be detected in saliva by PCR, and antibodies to nuclear antigens (IgG-EBNA-1), which are formed only 3-4 months after infection. However, this is not enough to make a diagnosis, because the same picture can be observed in a completely healthy carrier of the virus. Immunologists examine the entire spectrum of antiviral antibodies at least twice.

An increase in the amount of IgG to VCA and EA will suggest relapse of the disease.

How dangerous is Epstein-Barr virus?

Genital ulcers associated with EBV

The disease is quite rare and occurs more often in young women. Quite deep and painful erosions appear on the mucous membrane of the external genitalia. In most cases, in addition to ulcers, general symptoms typical of mononucleosis also develop. Acyclovir, which has proven itself in the treatment of herpes type II, was not very effective for genital ulcers associated with the Epstein-Barr virus. Fortunately, the rash goes away on its own and rarely recurs.

Hemophagocytic syndrome (X-Linked Lymphoproliferative Disease)

Epstein-Barr virus can infect T lymphocytes. As a result, a process is launched that leads to the destruction of blood cells - red blood cells, platelets, and leukocytes. This means that in addition to the symptoms characteristic of mononucleosis (fever, lymphadenopathy, hepatosplenomegaly), the patient develops anemia, hemorrhagic rashes, and blood clotting is impaired. These phenomena may disappear spontaneously, but can also lead to death and therefore require active treatment.

Cancers associated with EBV

Currently, the role of the virus in the development of such cancers is not disputed:

• Burkitt's lymphoma,
• nasopharyngeal carcinoma,
• lymphogranulomatosis,
• lymphoproliferative disease.

1. Burkitt's lymphoma occurs in preschool children and only in Africa. The tumor affects the lymph nodes, upper or lower jaw, ovaries, adrenal glands and kidneys. Unfortunately, there are no drugs that guarantee success in its treatment yet.
2. Nasopharyngeal carcinoma is a tumor located in the upper part of the nasopharynx. It manifests itself as nasal congestion, nosebleeds, hearing loss, sore throat and persistent headache. Most often found in African countries.
3. Lymphogranulomatosis (otherwise known as Hodgkin's disease), on the contrary, more often affects Europeans of any age. It is manifested by enlarged lymph nodes, usually of several groups, including retrosternal and intra-abdominal, fever, and weight loss. The diagnosis is confirmed by a lymph node biopsy: giant Hodgkin (Reed-Berezovsky-Sternberg) cells are detected. Radiation therapy can achieve stable remission in 70% of patients.
4. Lymphoproliferative disease (plasma hyperplasia, T-cell lymphoma, B-cell lymphoma, immunoblastic lymphoma) is a group of diseases in which malignant proliferation of lymphoid tissue cells occurs. The disease is manifested by enlarged lymph nodes, and the diagnosis is made after a biopsy. The effectiveness of chemotherapy varies depending on the type of tumor.

Autoimmune diseases

The impact of the virus on the immune system causes failures in the recognition of its own tissues, which leads to the development of autoimmune diseases. EBV infection is listed among the etiological factors in the development of SLE, chronic glomerulonephritis, autoimmune hepatitis and Sjogren's syndrome.

Chronic fatigue syndrome

Chronic fatigue syndrome may be a manifestation of chronic EBV infection.

Often associated with viruses of the herpes group (which includes the Epstein-Barr virus). Typical symptoms of chronic EBV infection: enlarged lymph nodes, especially cervical and axillary, pharyngitis and low-grade fever, combined with severe asthenic syndrome. The patient complains of fatigue, decreased memory and intelligence, inability to concentrate, headache and muscle pain, and sleep disturbances.

There is no generally accepted treatment regimen for EBV infection. In the arsenal of doctors today there are nucleosides (Acyclovir, Ganciclovir, Famciclovir), immunoglobulins (Alfaglobin, Polygam), recombinant interferons (Reaferon, Cycloferon). However, a competent specialist should decide how to take them and whether it is worth doing at all after a thorough study, including laboratory research.

Which doctor should I contact?

If a patient has symptoms of an Epstein-Barr virus infection, they should be evaluated and treated by an infectious disease specialist. However, often such patients first turn to a general practitioner/pediatrician. If complications or diseases associated with the virus develop, consultations with specialized specialists are prescribed: a hematologist (for bleeding), a neurologist (for the development of encephalitis, meningitis), a cardiologist (for myocarditis), a pulmonologist (for pneumonitis), a rheumatologist (for damage to blood vessels and joints). In some cases, consultation with an ENT doctor is required to rule out bacterial tonsillitis.