Epstein-Barr virus: symptoms in adults and treatment

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The fourth type of herpes virus was discovered in the sixties of the last century by scientist M.E. Epstein and his assistant I. Barr during microscopic studies of cells of a malignant tumor, which later became known as Burkitt's lymphoma.

It has the ability to persist throughout life in the human body and cause various autoimmune diseases.

What kind of disease is this?

This virus is from the herpetic family, namely herpes type 4. The Epstein-Barr virus attacks the immune system, the central nervous system, as well as all human systems and organs.

Penetrating through the mucous membranes of the mouth and nose, it enters the bloodstream and spreads throughout the body. That is why EBV has many faces and can have various manifestations, ranging from mild illness to extremely serious health problems.

There are cases when a carrier of the Epstein-Barr virus never suffers from its manifestations. Many famous doctors consider it the culprit of all existing diseases among humanity.

In the medical literature, for better visual perception, the Epstein-Barr virus is designated by the abbreviation VEB or WEB.

The history of the discovery of the virus and its features

The Epstein-Barr virus was discovered and described in 1964 by two English virologists - Michael Epstein and Yvonne Barr. Epstein was then a professor at a British institute, and Barr worked as his assistant.

Back in 1960, Epstein became interested in the report of the English surgeon Denis Burkitt, who worked in equatorial Africa, about a specific local cancer disease, later called Burkitt's lymphoma. This tumor appeared mainly in children under 7 years of age in Kenya, Uganda, Malawi and Nigeria, countries with hot and relatively humid climates.

After Epstein received a grant from the US National Cancer Institute to study the disease, Burkitt sent him tumor samples. Using an electron microscope, a virus was discovered in the images, previously unknown to science, and named “Epstein-Barr virus” after the names of its discoverers.

The virus turned out to belong to the herpesvirus family, the average size of the virion is about 150 nanometers. Unlike many other herpes viruses, the genome of the Epstein-Barr virus encodes approximately 85 proteins—for the herpes simplex virus, for example, this number barely exceeds 20.

Each virion is a spherical capsid containing genetic information. On the surface of the capsid there is a large number of glycoproteins that serve to attach the virus to the surface of the cell and introduce DNA inside it. This mechanism of infection is quite simple and effective, which makes the infection highly contagious: after the virus reaches the surface of a person’s mucous membranes, it is likely to penetrate the cell and begin to multiply there.

Prevalence of the disease

WEB is one of the most common viruses in the world among the population. According to WHO (World Health Organization) statistics, 9 out of 10 people are carriers of this herpetic infection.

Despite this, its research began only recently, so it cannot be said that it has been sufficiently studied. Children are often infected with EBV in utero or in the first few months after birth.

Recent studies show that it is the Epstein-Barr virus that is the provoking factor for other pathologies that cannot be completely cured.

Namely:

• Rheumatoid polyarthritis;
• Autoimmune thyroidin;
• Diabetes mellitus.

However, the infection does not lead to diseases on its own, but through interaction with other viral lesions.

If a person is susceptible to chronic fatigue syndrome and it seems to him that he is not getting enough sleep, there is a lack of vitamins in the body or a reaction to weather conditions, then it is possible that the Epstein-Barr virus provokes all of the above symptoms.

Often it is herpes that causes a decline in vitality.

Consequences and complications

The risk of complications is relatively small and increases in the absence or inadequate treatment of EBV infection. There are early and late complications. Early diseases that dissipate within 1-3 weeks include: splenic rupture, interstitial pneumonia , encephalitis , meningoencephalitis , myocarditis , polyneuritis . Late complications include: hemolytic/aplastic anemia , hepatitis , thrombocytopenic purpura malabsorption syndrome , malignant neoplasms, inflammation of the paranasal sinuses, proliferative syndrome, chronic fatigue syndrome .

Routes of infection

Sources of EBV infection are:

• Those in whom it has been present in active form since the last days of the incubation period;
• People who became infected with the virus more than six months ago;
• Any carrier of the virus is a potential source of infection for everyone with whom he comes into contact.

The most vulnerable categories for potential infection are:

• Women during pregnancy;
• HIV positive;
• Children under 10 years of age.

WEB transmission paths:

• Airborne - when sneezing, coughing, or communicating, the virus in the form of an aerosol spreads through the air and in this way ends up on the mucous membranes of a person nearby;
• Nutritional - WEB can theoretically be transmitted through food or drink. However, this path is not the main one;
• Contact and household - through close bodily contacts and intimate relationships. The probability of infection through household items is extremely low, because the virus quickly dies outside the carrier;
• Transmissible - during organ transplantation and blood transfusion from a sick person to a healthy one. When using non-sterile medical instruments;
• Transplacental - from mother to child. During feeding, childbirth, and also in utero.

Causes

The etiological factor of Epstein-Barr viral infection, as already indicated, is the Epstein-Barr Virus. First, let's consider the question: “Epstein Barr virus - what is it”?

EBV is one of the representatives of the herpes virus family and belongs to herpesvirus type four (HHV-4). Capable of persisting in the human body for life. It has an oncogenic and opportunistic effect. Being a lymphotropic agent, it causes diseases of the immune system, the leading syndromes of which are lymphoproliferation and immune deficiency.

The DNA of the herpes virus is a double-stranded molecule. The HHV-4 virion surrounds the viral nucleic acid, together with which it forms a protein icosahedral capsid with 25 faces. The diameter of the virus is 120-150 nm, the general appearance of the virus is shown below in the figure. The outer shell of the virus (supercapsid) has glycoprotein spikes that serve as the virus’s receptor apparatus.

Epstein–Barr virus

The outer shell of the virus (supercapsid) has glycoprotein spikes that serve as the virus’s receptor apparatus. The virus has a complex antigenic structure, including several groups of immunogenic proteins (antigens) - early, capsid, nuclear and membrane antigens.

Antigenic structure of EBV:

• VEA virus early antigen;
• VCA virus capsid antigen;
• VNA virus nucleolar antigen;
• VMA virus membrane antigen.

Epidemiology

Epstein-Barr virus has a global distribution. The source of the disease is the carrier or the sick person. Factors of transmission of the virus can be saliva, blood, vaginal secretions, semen, tears, donor tissue, breast milk, toys/household items contaminated with infected saliva. The virus is released throughout the entire period of the disease and after recovery (up to 6 months).

The virus is also found in healthy individuals (15-25%) in oropharyngeal washings and saliva. At the same time, with a decrease in immunity, the frequency of VB excretion increases sharply. The population's susceptibility to the EB virus is high. After infection with the virus, the synthesis of viral proteins begins within 2 hours, and within 8 hours it accumulates in maximum quantities and virions with infectious properties appear. The virus is extremely unstable in the external environment; it dies under the influence of UV rays, disinfectants and drying drops of saliva.

The leading route of transmission of the virus is airborne (through kissing, talking, sneezing, coughing), less often - through nutritional routes (through food/water), household contact (through household items, utensils), sexual, vertical route (from mother to fetus) and by blood contact (during blood transfusion). The entrance gate is the epithelium of the nasopharyngeal mucosa. After primary infection, the virus remains in the epithelium of the nasopharyngeal mucosa, tonsillar crypts and B lymphocytes throughout the incubation period.

The first infection with the virus in socially disadvantaged countries/families occurs in childhood, mainly before 3 years of age. In countries with developed economies and a high standard of living, the maximum incidence of infection occurs at the age of 15-18 years. Manifesting lesions are more often recorded among males. And reactivation of infection is facilitated by factors that reduce local/general immunity and can occur at any age.

Factors contributing to the activation of Epstein-Barr viral infection:

• Genetic predisposition.
• Long-term exposure to stress factors.
• Pathology of the ENT organs, frequent infectious diseases of the upper respiratory tract.
• Reducing the general/local immunological reactivity of the body.
• Chronic intoxication (alcohol abuse, emissions of harmful substances into the atmosphere).
• Chemotherapy/radiation.
• Vaccination.

How does infection occur in adults?

Stages of infection:

• Viral cells that have entered the mucous membranes begin to multiply rapidly , enter the circulatory system and, thus, affect the entire body;
• Immune cells (B lymphocytes) are affected. Moreover, when affected, their number does not decrease, but increases uncontrollably. T-lymphocyte cells begin to attack the affected ones. At this stage, external visible symptoms appear in the form of inflamed lymph nodes;
• With a low content of T-lymphocytes, the infection spreads uncontrollably and the course of the virus becomes chronic. Thus, damage occurs to the central nervous system, heart, spleen and liver;
• If a person has a strong immune system, then the virus may not manifest itself in any way . People who have antibodies to herpes simplex often have immunity to the Epstein-Barr virus. However, it often manifests itself in acute form as infectious mononucleosis.

Factors influencing immune CD8+ T cells

As we age, the number of CD8+ cells decreases, which is one of the reasons why autoimmune diseases develop as we age. []

Estrogen can also reduce the number of CD8+ T cells, which explains the high incidence of autoimmune diseases in women. []

Sunlight ( vitamin D ) is very important for the functioning of CD8+ T cells, which explains why more autoimmune diseases are reported in countries where residents receive less sunlight. []

Acute short-term stress increases the number of CD8+ T cells, but long-term (chronic) stress does not affect these cells. []

However, chronic stress can lead to reactivation (transition from dormant to active mode) of the Epstein-Barr virus, most likely due to the suppression of the Th1 immune response by this type of stress. [] Therefore, it is possible that stimulating the Th1 immune response may be beneficial in suppressing Epstein-Barr virus.

As soon as a viral infection is activated in the body, it begins to use the “mevalonate pathway” - the most important metabolic pathway of various microorganisms, necessary for the synthesis of many substances for life. In particular, viruses use this path to create their protective shell.

SUPPRESSION OF THE MELOVANATE PATHWAY IS ONE OF THE NEW WAYS TO FIGHT CANCER (https://clincancerres.aacrjournals.org/content/18/13/3524)

In response, our body begins to produce interferon with the help of immune cells to destroy this mevalonate pathway and suppress the construction of new viruses. But along with the production of interferon, the body begins to waste pregnenolone and coenzyme Q10. During an acute and short-term infection, it is not difficult for our body to produce enough interferon and suppress the infection, but with a prolonged release of interferon, a decrease in the levels (starvation) of coenzyme Q10 and pregnenolone may occur, which will lead to a decrease in the production of the hormone cortisol, and the immune system will not respond in time and reduce your activity sufficiently. The immune system will be , which will contribute to the development of autoimmune reactions.

It is known that statins (or red yeast rice) are able to block this mevalonate pathway , which has an antiviral effect in a direct dose-dependent manner.

Symptoms of the disease

Most often, people become infected with EBV early in life (childhood or adolescence), since it has many routes of infection through contact with an infected person.

In adults, the Epstein-Barr virus is reactivated and does not cause acute symptoms.

Symptoms of primary infection:

• Body temperature from 38 degrees and above;
• Stuffy nose;
• The tonsils become inflamed as with a sore throat;
• Rash of different nature and appearance: pimples, peeling, inflammation, bruising, etc.;
• Fast fatiguability;
• Enlargement of the anterior, posterior cervical, submandibular, occipital, supraclavicular, subclavian, axillary, ulnar, femoral, inguinal lymph nodes . Their size becomes larger in diameter up to 2 centimeters; on palpation they are similar to dough, somewhat painful, and not fused with nearby tissues or with each other. Without changing the texture and color of the skin. This manifestation remains for up to 2 weeks;
• The spleen enlarges and returns to normal after 14-20 days;
• Sometimes the liver becomes enlarged . In this case, yellowing of the urine or jaundice may occur;
• Damage to the central nervous system is possible , fortunately this happens less frequently. This manifestation can manifest itself as: serous meningitis, meningoencephalitis, encephalomyelitis, polyradiculoneuritis. As a rule, everything ends in absolute regression of focal lesions.

The chronic course of the Epstein-Barr virus is characterized by prolonged manifestation of symptoms of various types and levels of intensity.

Namely:

• Fatigue and general weakness;
• Heavy sweating;
• Difficulty in nasal breathing;
• Pain in joints and muscles;
• Periodic mild cough;
• Constant headaches;
• Aching pain in the right hypochondrium;
• Mental disorders, emotional instability, depressive states, poor concentration and memory loss;
• Sleep disorders;
• Inflammatory diseases of the respiratory tract and gastrointestinal disorders.

Photos of virus manifestations:

Rash on the body

Bruising

Enlarged lymph nodes

Rashes on mucous membranes

Infectious mononucleosis

In three out of four cases, infection of the body with the Epstein-Barr virus is accompanied by the development of infectious mononucleosis.

The clinical picture of this disease is quite diverse, and therefore in many cases it can be confused with symptomatically similar diseases.

The incubation period of the disease lasts 1-1.5 months. Only after this the first symptoms appear:

• fever;
• angina;
• swollen lymph nodes;
• sore throat;
• enlarged spleen and liver;
• general malaise;
• headache;
• chills;
• digestive disorders;
• jaundice;
• periorbital edema;
• rash on the body.

The temperature during mononucleosis increases slightly, but lasts for two to four weeks. During the disease, mainly the lymph nodes on the back of the head and neck become inflamed, and in especially severe cases, they enlarge throughout the body.

In the first weeks of the disease, most of its symptoms resemble those of streptococcal sore throat. To distinguish them, it is necessary to carry out special diagnostics. In addition, in medical practice there are often cases when mononucleosis is mistaken for rubella, acute respiratory infections, pseudotuberculosis, diphtheria, hepatitis, leukemia and even HIV.

With an atypical course of the disease, many symptoms may not appear at all, while others may be expressed in an excessively hypertrophied form. Sometimes with mononucleosis, patients develop a severe rash on the body. When taking antibiotics, these rashes are most pronounced.

During laboratory examination of patients with mononucleosis, they are diagnosed with leukocytosis, lymphocytosis, neutropenia and thrombocytopenia. Almost half of the patients experience an increase in bilirubin concentration, and 90% of patients are diagnosed with changes in biochemical parameters of liver function.

Note: due to the increase in the size of the spleen, which is the main depot of lymphocytes in the body, patients with mononucleosis are strictly prohibited from exposing themselves to physical activity. If the muscle strain is severe, the patient's spleen may rupture, and if he is not taken to the surgical department within half an hour, death will occur.

But in general, infectious mononucleosis is not a deadly disease. Fatal outcomes with it are an extremely rare occurrence, occurring mainly in patients with immunodeficiencies.

Typically, three to four weeks after symptoms appear, the disease goes away on its own, even without treatment. Relapses almost never occur, but in some cases, after mononucleosis itself, various complications may appear. Among them:

• Lesions of the nervous system - encephalitis and meningitis. Most often found in children;
• Damage to the cranial nerves leading to the development of Bell's syndrome, neuropathy, Guillain-Barré syndrome and myelitis;
• Autoimmune hemolytic anemia, sometimes accompanied by jaundice and hemoglobinuria;
• Obstructive airway disease;
• Hepatitis, sometimes with lightning-fast progression;
• Myocarditis and pericarditis.

The last three diseases rarely accompany mononucleosis, but lead to quite serious consequences.

Why is Epstein-Barr virus dangerous in adults?

With a single infection, Epstein-Barr remains in the human body forever. In good health, the course of the infection has no obvious symptoms or minimal symptoms.

When the immune system of an infected person is weakened by other factors, then, as a rule, the Epstein-Barr virus affects the following organs and systems:

• Mucous membranes of the upper respiratory tract and ENT organs;
• Epithelial cells;
• Nerve fibers;
• Macrophages;
• NK cells;
• T lymphocytes.

The Epstein-Barr virus is extremely dangerous for HIV-positive people. Infection with it can be fatal for them.

What diseases can the Epstein-Barr virus cause in adults?

Complicated consequences:

• Anemia;
• Bacterial or viral pneumonia;
• Encephalitis or meningitis;
• Sepsis;
• Hepatitis;
• Blood clotting disorder;
• Diseases of the spleen.

Development of oncopathologies:

• Lymphoma;
• Lymphogranuloma;
• Cancer of the tonsils, neoplasms of the ENT organs;
• Gastrointestinal cancer.

Epstein-Barr cells are found in most biopsy specimens along with malignant cells. It is not the main cause of cancer, but acts as a provoking factor along with other pathologies.

Autoimmune system diseases:

• Diabetes;
• Multiple sclerosis;
• Arthritis.

The Epstein-Barr virus, along with other cell-damaging viruses, leads to impaired immune response. The immune system perceives its own cells as enemy cells and begins to attack them, thus damaging them.

Immunity disorders:

• Serious allergic manifestations;
• Immune deficiency, constant colds and acute respiratory viral infections, their long course with subsequent complications;
• Increased likelihood of sepsis due to bacterial lesions.

Diseases of the circulatory system:

• Anemia of varying degrees of malignancy;
• Blood cancer;
• Own immune cells affect the formed elements of the blood - hemophagocytic syndrome;
• And other hematological pathologies.

Among other things, the presence of EBV can provoke the development of bacterial and fungal diseases. As well as damage to the central nervous system and a decrease in the overall tone of the body, as a result of which chronic fatigue syndrome develops.

Epstein Barr symptoms

Currently, a number of syndromes and diseases are associated with EBV. Let's consider only the main, most common diseases. There is a primary acute manifesting infectious process - infectious mononucleosis (synonyms: Filatov's disease or Filatov's symptom) and chronic EBV infection. Clinical variants of primary Epstein-Barr viral infection can occur in an asymptomatic form, in the form of respiratory syndrome or infectious mononucleosis. Chronic EBV infection - in the form of erased forms and chronic active Epstein-Barr viral infection.

Symptoms of Epstein-Barr virus in adults

In adults, Epstein-Barr virus infection most often occurs in the form of infectious mononucleosis (IM). The latent (incubation) period of the disease varies between 4-7 weeks. In most cases, the disease begins acutely with a rise in temperature to febrile levels and an increase in symptoms of intoxication. The clinical symptom complex includes several characteristic syndromes - lymphoproliferative (nasopharynx lesion, acute adenoiditis , tonsillitis , pharyngitis with hypertrophy of lymphoid tissue); lymphadenopathy (lymph node disease syndrome) and hepatosplenomegaly . Their formation takes on average 5-8 days.

• Nasopharyngeal lesion syndrome. Its early manifestation is pharyngitis with pronounced hypertrophy of the nasopharyngeal lymphoid tissue, manifested by adenoiditis , difficulty breathing through the nose, snoring during sleep, and sore throat. A characteristic symptom of MI is tonsillitis , manifested by hyperemia of the mucous membrane of the soft palate, and hyperplasia of the lymphoid follicles of the pharyngeal ring. It can occur in a catarrhal, lacunar or ulcerative-necrotic form with long-term persistence of plaque (up to 7-14 days), sometimes of a fibrinous nature. In cases of secondary infection, ulcerative and ulcerative-necrotic plaques are observed on the surface of the tonsils, the hyperplasia of which reaches grades II-III.
• Lymph node involvement syndrome. It manifests itself as a predominant and typical enlargement of the anterior-posterior cervical lymph nodes. Less commonly, several groups of lymph nodes are involved in the process, including bronchial/mesenteric ones. The nodes are mobile, dense, painless/moderately painful, the skin over them is not changed, swelling around the lymph nodes of the subcutaneous tissue is not typical, in some cases there is tissue pastiness. Cervical lymphadenopathy in some patients may be accompanied by lymphostasis , manifested by pasty eyelids or puffiness of the face.
• Hepatosplenomegaly syndrome . Splenomegaly develops from the second week of the disease, in approximately 50% of patients, and persists for a long time, and hepatomegaly is characteristic of most cases.
• Exanthema syndrome . It is registered in 10-18% of patients, appears on the 5-10th day of the disease and manifests itself as a profuse maculopapular or hemorrhagic rash, sometimes confluent and localized on the limbs, torso, and face. In some cases, swelling of the face and itching of the skin. The duration of the rash does not exceed 10 days, and the reverse development occurs gradually over 1-2 weeks of illness and may be accompanied by peeling.

Atypical forms of MI:

• Erased: occurs in the form of acute respiratory diseases with mild, quickly passing symptoms.
• Asymptomatic: occurs without symptoms and is diagnosed in saliva or lymphocytes using laboratory analysis methods - PCR.
• Visceral form: characterized by a severe course involving the central/peripheral nervous and cardiovascular systems, kidneys, and adrenal glands.

Recurrence of myocardial infarction is considered to be the resumption of clinical symptoms of the disease 30-60 days after the illness.

Symptoms of chronic EBVI are extremely polymorphic. More often they manifest themselves as weakness, prolonged low-grade fever of unknown origin, lymphadenopathy, arthralgia / myalgia , pain in the lymph nodes. Chronic fatigue is noted. The disease has an undulating course, and layers of opportunistic infections are often observed.

Chronic active EBVI is characterized by symptoms similar to infectious mononucleosis , but they are less severe, and the duration of the disease is more than 6 months. Much less often, chronic active EBVI is manifested by hepatitis , pneumonia , uveitis , and bone marrow hypoplasia In patients with severe immune deficiency, there is a risk of developing generalized forms of EBV infection, which are characterized by damage to the central nervous system ( encephalitis , meningitis , cerebellar ataxia ) and other internal organs ( glomerulonephritis , myocarditis , severe forms of hepatitis ).

Symptoms of Epstein Barr virus in children

In most cases, in children, the symptoms of Epstein-Barr viral infection consist of supporting clinical syndromes characteristic of adults. However, primary infection with the virus in almost 50% of children is asymptomatic. Infectious mononucleosis in children has similar characteristic syndromes, but the course of the disease has some features.

First of all, the incubation period is shortened to 10-20 days. The disease occurs with a more pronounced intoxication syndrome (high body temperature), an increase in adenoid vegetations, grade 3-4 tonsil hyperplasia, asthenovegetative disorders, and hypertrophy of the submandibular lymph nodes. In almost 40% of a third of children, acute EBVI occurs in the form of a mixed infection (with herpes , cytomegaloviruses , streptococci , staphylococci , Klebsiella , chlamydia or bacterial associations), which affects the clinical manifestations.

The clinical symptoms of chronic EBVI in children are characterized by a recurrent long-term course and are manifested by weakness, low-grade fever , difficulty in nasal breathing, sweating , pain in the joints/muscles, discomfort in the throat, rash, dizziness , headaches, cough, heaviness in the right hypochondrium, emotional lability, depression , sleep disturbance, severe asthenic syndrome. Epstein-Barr syndrome in children often occurs with the development of tonsillitis , adenoiditis , and hepatosplenomegaly of varying severity. In most cases, the symptoms have a wave-like manifestation.

Diagnostic measures

If EBV infection is suspected, the patient consults a general practitioner, who conducts a face-to-face examination and analyzes the patient’s complaints.

Next, the doctor prescribes a number of examination measures, which include:

• Blood tests: general, biochemical, antibodies;
• Molecular diagnostics,
• Immunological research;
• Serological examination (antigens and antibodies);
• Culture method;
• Establishing the titer of specific antibodies.

Research methods to detect Epstein-Barr virus:

• ELISA - allows you to determine the presence of antibodies to various Epstein-Barr antigens, this helps to identify the form of infection: chronic, acute, asymptomatic;
• PCR - using this method it is possible to find out whether a person has the virus. It is used for children whose immature immune systems do not produce antibodies to EBV. This method is also used for clarifying purposes when the ELISA result is questionable.

Explanation of PCR tests:

• The main criterion makes it possible to find out about the presence of a virus in the body;
• The result can be positive or negative;
• Moreover, a positive result does not in any way indicate the presence of an acute or chronic process, despite the presence of EBV in a person;
• A positive test result means that the patient has already been infected with EBV;
• If the analysis is negative, we can say with confidence that EBV has never entered the human body.

Interpretation of ELISA tests:

• Regarding all antigens, ELISA, in addition to a positive or negative result, is still doubtful;
• In case of a doubtful result, the analysis must be retaken after 7-10 days;
• If the result is positive, the Epstein-Barr virus is present in the body;
• Based on the results, which antigens are identified, one can judge the stage of infection (asymptomatic, chronic, acute).

This test allows you to determine the presence of an antigen in the human body:

• IgG to the VCA capsid antigen - in case of a negative result, the human body has never encountered EBV. But there may be the presence of EBV cells in the body if the infection occurred 10 to 15 days ago. A positive result indicates the presence of the virus in a person. But he cannot talk about what stage the infection is at or when exactly the infection occurred. Results: up to 0.8 - the result is negative;
• from 1.1 - the result is positive;
• from 0.9 to 1 - the analysis needs to be retaken;

Decoding the analysis on VEB

To accurately decipher the result of a laboratory test for EBV, it is advisable to use the table:

Microbes and the immune system

The microbes mentioned and many others that are often used for latent pathogens have low virulence in common. Pathogens:

• can live inside a cell;
• infect blood leukocytes, which spread the infection throughout the body, and especially to the area of ​​inflammation;
• can remain in the body in a calm state for a long time;
• masterfully manipulate the immune system;
• can hide in the human body without causing disease;
• are found in all races throughout the world.

The more we delve into the topic, the more connections between chronic diseases and hidden microbes are revealed. However, after a while you realize that it is not so much the germs that are causing the problem. Namely, in the body's weakened immune system , which allows these microbes to multiply.

In other words, a whole army of hidden microbes can live in the human body - EBV, CMV, HHV-7, Borrelia, Bartonella, Mycoplasma, Chlamydia. But he won't get sick until then. as long as his immune system is functioning at full strength.

However, as soon as something weakens the immune system, like boiling milk from a pan on a hot stove, an explosive proliferation of microbes occurs, which causes disease.

Chronic immune dysfunction causes a coincidence of unfavorable circumstances

Our microbes are always in the body - our own obviously take root comfortably already from childhood. However, the disease does not occur until the coincidence of several unfavorable circumstances weakens the immune system. For some, such circumstances include years of chronic insomnia caused by a variable work schedule. This could be poor quality food eaten on the run or some small sources of stress.

Recovery still begins with getting rid of the original cause - chronic immune disorder.

The author of the article personally experienced the melon experience and began cataloging stressors. As a result, there were 7 groups associated with chronic diseases.

As incredible as it may seem, the author came to the conclusion that the causes of all chronic diseases point to these seven factors. We decided to call them body destroyers. This theory was tested for ten years, and it was always confirmed. Concrete scientific evidence was found for his theory.

Traditional methods of treatment

Folk remedies have a good effect in the fight against many diseases, the Epstein-Barr virus is no exception. Traditional methods perfectly complement traditional methods of treatment for the acute course of the virus and infectious mononucleosis.

They are aimed at strengthening general immune qualities, relieving inflammation and avoiding exacerbation of the disease.

Herbal decoction:

• Take chamomile, mint, coltsfoot, dum root, calendula in equal parts;
• Pre-grind and pour boiling water over it;
• Leave for about 2 hours;
• The decoction should be consumed in small sips throughout the day;
• Can be consumed morning and evening instead of tea or coffee.

Echinacea:

• Echinacea infusion perfectly strengthens the immune system and helps avoid exacerbations;
• It should be consumed daily, 20 drops per glass of water.

Green tea:

• Natural green tea has excellent antioxidant properties, invigorates well and cleanses the body of toxins;
• To make it even more effective and useful, you can add various recommended herbs to it: Centaury;
• Immortelle;
• Yarrow;
• Chamomile;
• Mullein;
• Linden flowers;
• Mint;
• Nettle.

Ginseng tincture:

• Ginseng tincture is simply a storehouse for the protective forces of the human body;
• It should be added to tea, about 15 drops per glass of drink.

Essential oils:

• Essential oils of juniper, sage and eucalyptus will help relieve inflammation and redness of the throat;
• They should be used to lubricate the oral cavity;
• A fairly effective way is to add these oils to an aroma lamp, this will help tidy up the respiratory system.

Diagnostics

A doctor diagnoses Epstein Barr virus in children and adults based on patient complaints, clinical signs and laboratory tests.

The doctor may prescribe a number of tests:

Atypical mononuclear cells during infection with infectious mononucleosis caused by the Epstein-Barr virus

1. Clinical blood test. It will reveal an increase in leukocytes, ESR, and the appearance of atypical mononuclear cells. Platelets and hemoglobin may be either higher or lower than normal.
2. Biochemistry of blood. The analysis will show high levels of bilirubin, liver enzymes and a number of other enzymes, acute phase proteins such as fibrinogen, C-reactive protein.
3. Immunological study , which will assess the patient’s immunity status.
4. Assess the amount and class of immunoglobulins using serological tests. In the acute course of the disease, lg M will predominate, and later, after 2-4 months, lgG will be detected, in this case, the form with test results will write Epstein-Barr virus igg positive.
5. DNA diagnostics . It is carried out using PCR and allows you to identify the pathogen in various biomaterials, including saliva, cerebrospinal fluid, smears from the respiratory mucosa, and biopsy samples of internal organs.

If there are indications, additional examinations may be prescribed:

• sonography of the abdominal cavity;
• X-ray of the chest and paranasal sinuses;
• coagulogram;
• consultation with an immunologist, otolaryngologist, oncologist, hematologist.

You can also glean some facts about the medical diagnosis of the virus from the video below.

Consequences of Epstein-Barr virus during pregnancy

In case of pregnancy planning, in preparation, future parents are prescribed a number of tests.

In this case, special attention is paid to infections.

They can influence conception, the course of pregnancy and its favorable completion with the birth of a healthy child.

Among such infections, EBV occupies quite a significant role.

It belongs to the “TORCH” series:

• T - toxoplasmosis;
• O - others: listeriosis, chlamydia, measles, syphilis, chickenpox, hepatitis B and C, HIV;
• R - rubella (rubella);
• C - cytomegalovirus;
• H - herpes (herpes simplex virus).

Infection with any of the TORCH infections during pregnancy can be disastrous for the child, causing serious health problems, deformities and pathologies incompatible with life.

That is why undergoing this analysis, through an unpleasant procedure - taking blood from a vein, is mandatory. Timely therapy and constant monitoring by specialists can minimize risks to the health of the fetus.

Such an analysis for the expectant mother is carried out not only during planning, but also twice during the gestation period, namely at 12 and 30 weeks.

Based on the results of the analyses, it is customary to draw conclusions regarding the following points:

• If there are no antibodies to EBV in the blood, you need to be actively monitored and protect yourself as much as possible from possible infection;
• If there are positive class M immunoglobulins, the birth of a child must be delayed until antibodies to this type of virus are produced;
• Blood contains class G immunoglobulins - this means the presence of antibodies in the body of the expectant mother, which means that her immunity will protect the baby as much as possible.

When the Epstein-Barr virus is detected in an active acute form in a pregnant woman, this requires urgent hospitalization and hospital treatment under the supervision of specialists.

The measures are aimed at neutralizing symptoms and supporting the immune system of the expectant mother by administering antiviral medications and immunoglobulins.

It is impossible to say for sure exactly how EBV will affect the course of pregnancy and the health of the fetus. However, it is reliably known that babies whose mothers carry an active form of the Epstein-Barr virus during pregnancy often develop developmental defects.

At the same time, its presence in a woman’s body in primary or acute form does not exclude the birth of a healthy child, and its absence does not guarantee.

Possible consequences of EBV infection during pregnancy:

• Miscarriages and stillbirths;
• Premature birth;
• Developmental delay (IUGR);
• Complications during childbirth: sepsis, uterine bleeding, DIC syndrome;
• Disturbances in the development of the baby's central nervous system. This is due to the fact that EBV affects nerve cells.

What helps increase the number of immune CD8+ T cells

• Resistant starch Experiments have shown that when the number of CD8+ T cells decreases during chronic viral infection, their number can be restored after receiving butyrate . This leads to an increase in the number of CD8+ T cells and mimics the effect of the proinflammatory cytokines IL-12 and interferon-alpha (IFN-α), which also increases CD8+ T cell activation and memory. []
• Astragalus (plant). []
• Andrographis paniculata (plant). Experiments have shown that andrographis contributed to an increase in the level of immune cells CD4+ (by 40-61%), CD8+ (by 23-31%) and CD56 (by 2-3%).
• Gynostemma pentafolia (plant). []
• Schisandra (plant). Prevents CD8+ decline from radiation. []
• Ashwagandha (plant). []
• Thymus glandular (extract)
• Glandular spleen (extract)
• Massotherapy []
• Aldosterone (hormone). However, its increased production may contribute to the worsening of autoimmune disease through the growth of Th17 immune cells. []

SCHEME OF DIVISION OF NAIVE T-CELLS INTO TH1 and TH17 (inflammatory) and TH2 and T0REG (anti-inflammatory)

Prevention measures

Given the prevalence of EBV and the ease of its transmission, it is extremely difficult to protect yourself from infection.

Doctors around the world are faced with the task of inventing prophylactic agents to combat this virus, since it is a provoking factor in the development of cancer and other dangerous diseases.

Many scientific research centers are now conducting clinical trials on this issue. It is impossible to protect yourself from infection, but you can get by with minimal consequences if you have a strong body.

Therefore, EBV prevention measures are aimed at generally strengthening the protective functions of the human body:

• Compliance with sleep and nutrition;
• A healthy lifestyle with the exclusion of all bad habits;
• Sufficient rest;
• Maintaining personal hygiene;
• Sufficient exposure to fresh air;
• Moderate and sufficient physical activity;
• Hardening;
• A complete diet with sufficient vitamins and minerals. Taking vitamin complexes;
• Timely and adequate treatment of existing diseases.

Identification of the pathogen in the body

To differentiate mononucleosis from similar diseases, as well as to detect the Epstein-Barr virus in the body in the early stages of its development, several basic diagnostic methods are used:

• Serological diagnosis, in which in the vast majority of cases the titer of IgM antibodies is determined. A titer of 1:40 is already diagnostically significant, especially with the symptomatic picture characteristic of mononucleosis;
• Determination of the titer of specific antibodies to the virus. This method is especially relevant for children who do not have heterophilic antibodies. After suffering from mononucleosis, the titer of specific IgG remains high for life;
• Linked immunosorbent assay;
• Polymerase chain reaction;
• Culture method.

The last three methods make it possible to find viral DNA or viral particles themselves in the blood or individual tissues. In the culture method, virions are grown on a culture of brain cells, Burkitt's lymphoma, or the blood of leukemia patients.

Methods of infection

The following routes of infection with this type of virus are distinguished:

1. Airborne. The causative agent of mononucleosis is transmitted from an infected person through saliva and the contents of the nasal cavity. Most often, infection occurs through hugs and kisses, which is why the disease is also called the kissing disease.
2. Contact and household. A baby can become infected with EBV when sharing household items or personal hygiene products with a carrier of the disease or an infected person.
3. Hemotransfusion (blood). Transmission of the herpes virus can occur during transfusion of blood and its components, medical procedures associated with violation of the integrity of the skin and mucous membranes due to insufficient sterilization of instruments.
4. During bone marrow transplantation, used for cancer and blood pathologies.
5. Intrauterine. The virus can enter the fetus through the placenta while in the womb.
6. During childbirth when passing through the birth canal.
7. Through mother's milk during breastfeeding.

Infection with human herpes virus type 4 has a number of features:

• in most cases occurs in early childhood, for example, when kissing the mother;
• transmission of the pathogen is possible only through close contact of a healthy child with an infected person;
• The symptoms of the disease in children and adult patients are somewhat different.

Chronic EBV infection

If there is no response from the human immune system, the infection can develop into a chronic course. Doctors consider 4 types of chronic EBV infection:

1. Atypical. In this case, the patient experiences frequent relapses of infectious diseases of the intestines, genitourinary tract, as well as acute respiratory diseases. Such pathologies are difficult to treat and their course is always protracted.
2. Generalized. The infection affects the nervous system (encephalitis, meningitis or radiculoneuritis develops), the heart (myocarditis is diagnosed), the lungs (pneumonia progresses) or the liver (hepatitis develops).
3. Erased. This is the most indolent form of chronic EBV infection: periodically the patient’s temperature rises, often it remains within the subfebrile range (37-37.8 degrees), increased fatigue, constant drowsiness, pain in muscles and joints appear, and lymph nodes may enlarge.
4. Active. The patient will have the classic symptoms of infectious mononucleosis (fever, sore throat, swollen lymph nodes, etc.) - they often recur, complicated by the addition of a fungal or bacterial infection, or herpetic skin rashes. In the case of active chronic EBV infection, intestinal pathology may develop, and in this case, patients will complain of lack of appetite, nausea, intestinal colic, and stool disorders.

Please note: with chronic EBV infection, doctors can detect the virus itself in the patient’s saliva (by PCR), or they can detect antibodies to nuclear antigens, but they are formed only 3-4 months after the virus enters the body. In any case, this is not enough to make an accurate diagnosis, so virologists and immunologists conduct research on the entire spectrum of antibodies.

Diagnostic methods

If you suspect an EBV infection, you should visit your local pediatrician. The doctor will order laboratory tests. Based on the results, he will conduct treatment.

Rules for preparing and donating blood:

• the material is taken on an empty stomach;
• 72 hours in advance, eliminate fatty foods, sweets, and alcohol;
• stop drinking tea, coffee, carbonated drinks 24 hours before;
• Replace dinner the night before with a light meal.

Tests are taken from all family members living with the child.

General blood analysis

The pediatrician prescribes a general blood test. The diagnosis is confirmed by the following indicators:

• high level of leukocytes: > 9 G/l (main evaluation criterion);
• normal content of red blood cells (with prolonged infection they quickly settle);
• anemia (hemoglobin <90 g/l);
• a large number of modified monocytes (up to 40%).

If the last indicator is below 10% and the other three are present, the Epstein Barr virus is confirmed.

Blood chemistry

This type of diagnosis is more complete and informative. Reveals:

• acute phase protein components;
• content of aldolase, bilirubin;
• presence of AST, LDH, ALT.

The indicators of the second point in case of illness exceed the norm by 3 times. The existence of altered bilirubin indicates a complication: autoimmune anemia.

Immunogram

Material for analysis: blood, contents of mucous membranes (saliva), cerebrospinal fluid. The main requirement: do not eat food before donating the biomaterial.

The test examines the number of cells:

• CD8;
• lgM;
• CD16;
• IgG;
• CD3;
• cycling immune complexes;
• lgA;
• CD4/CD

A curve is being built. Indicators above the norm are determined. The doctor prescribes treatment to suppress the infection.

Serological analysis

The patient's blood contains specific antibodies. This test reveals them. The research material is biomaterial of the nasopharyngeal mucosa (saliva) or cerebrospinal fluid (rarely).

Indicators:

1. Relationship of IgG to early antigen. It is detected in the acute form of the disease. Upon subsequent detection, they speak of a chronic disease.
2. The ratio of lgM to capsid protein indicates early infection. Presence over a long period of time signals a chronic disease.
3. IgG/capsid antigen values ​​are detected many years after infection. The highest amount can be seen at 10 weeks after exposure to the virus.
4. The IgM/early antigen level is present before the first symptoms. Maximum in the first week of infection.
5. The IgG/nuclear antigen count is highest in the sixth week. Traces are discovered in the second year after recovery.

The doctor makes the exact decoding. Based on the results, a diagnosis is made and treatment is prescribed.

Serological testing is not the only diagnostic method in children. The immune system is immature. Additional tests are required.

PCR (polymerase chain reaction) method for DNA

The research material is blood. The liquid is placed in a 6% EDTA solution. The test detects the presence of viral DNA.

Immediately after infection, the indicator confirming the presence of the virus is within acceptable limits.

The doctor deciphers the results and compares them with other viruses. The test is ideal for diagnosing children.

Symptoms of infection

After an incubation period (which can last up to several months), symptoms of infection appear. The first signs of web infection in children look the same as all viral infections, namely:

• weakness in the body;
• increased fatigue;
• loss of appetite;
• swollen lymph nodes;
• a significant increase in temperature, which manifests itself a couple of days after the onset of weakness and poor health;
• pain in the liver area;
• in some cases, a rash appears all over the body;
• the development of fungal diseases is possible.

Epstein Barr virus in a child leads to various types of diseases. Today, a direct connection between the virus and infectious mononucleosis has been proven. Other diseases may also occur, in particular tonsillitis and herpetic sore throat.

Antiviral therapy is carried out only in cases of serious problems with the immune system.

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.

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Symptoms of EBV in children

The incubation period of herpetic infection in childhood is shorter - 4-9 weeks. As already mentioned, the signs of the disease may not make themselves felt, but the general symptoms are still identified.

How does herpesvirus type 4 manifest:

1. Constant drowsiness, fatigue, irritability, nervousness. The child is lethargic and capricious for reasons unknown to the parents.
2. Inflammation of the lymph nodes. Lumps appear in the neck and ears, which can be detected upon examination. In severe forms, there are bumps all over the body.
3. Lack of appetite, dysfunction of the digestive system. Refusal to eat, even your favorite foods. Rumbling in the stomach, bloating, problems with stool.
4. Rashes. Small rash, dot-shaped, red.
5. Pharyngitis, tonsillitis and a significant increase in temperature. The appearance of sore throat, pain and discomfort is accompanied by thermometer readings above 38 °C.
6. Stomach ache. The appearance of this symptom provokes an enlargement of the liver and spleen.
7. Breathing disorders. It becomes difficult to breathe due to a sore throat, and in the acute form, the adenoids become enlarged.
8. Jaundice. Very rare.

If a child experiences the symptoms described above for 1-2 weeks for unknown reasons, then you should consult a doctor (pediatrician, ENT (otolaryngologist), dentist or dermatologist). The specialist will conduct an examination, collect anamnesis and write out a referral for tests to confirm or refute the presence of the virus in the body.

Refusal to eat and drowsiness are common signs of a viral infection.

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: (we recommend reading: what is infectious mononucleosis in children and how is it treated?)

• fatigue;
• increased body temperature;
• the appearance of a sore throat;
• enlarged lymph nodes (we recommend reading: what to do if a child has 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.

At the next stage, there is a sharp increase in body temperature to 38-40 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:

• spots;
• points;
• papules;
• hemorrhages;
• roseola

Possible complications

How dangerous is infection?

• the hidden presence of the virus in the child’s body weakens the immune system, and the development of any pathology is possible;
• routine vaccination causes complications (in case of a chronic disease);
• chronic mononucleosis is a consequence of the virus;
• a prolonged constant increase in temperature (about 37.5o) creates a danger for a fragile organism;
• triggers oncological processes (cancer of the small intestine, stomach, oral mucosa);
• is the cause of chronic fatigue (the statement of some doctors).

To prevent serious consequences, parents should bring their child for routine medical examinations. Forewarned is forearmed!

Fighting the virus and treating associated diseases

Today there is no specific treatment for Epstein-Barr infection. With strong immunity, the disease usually goes away on its own without consequences.

In case of a complicated course of the disease, the patient is prescribed antiviral drugs: Acyclovir or Zovirax (which is practically the same thing). Children under 2 years old - 200 mg, from 2 to 6 years old - 400 mg, and over 6 years old - 800 mg 4 times a day for 7-10 days.

In complex treatment, interferon-type drugs are most often used. Of them:

• Viferon-1 is prescribed in rectal suppositories at a dose of 150,000 IU for children under 7 years of age;
• Viferon-2 - 500,000 IU for children from 7 to 12 years old;
• Viferon-3 1,000,000 IU for children over 12 years of age and adults in the morning and evening for 10 days.

Additionally, patients are prescribed interferon inducers: Arbidol and Cycloferon. The latter is given to children from 4 to 7 years old 150 mg, from 7 to 14 years old - 300 mg, children over 14 years old and adults - 450 mg once on 1, 3, 5, 8, 11, 14, 17, 20. 23 and 26 days of illness. In addition, 5% Cycloferon ointment is effective for treating purulent plaque.

For children under 4 years of age, Cycloferon is administered parenterally at a dose of 6–10 mg/kg.

Human immunoglobulin is traditionally used in therapy against the Epstein-Barr virus. For children over 3 years old, it is administered intramuscularly at 3 ml, for adults - at 4.5 ml 4-5 times with an interval of 48 hours. Polyoxidonium, which has a detoxifying and immunomodulatory effect, is prescribed 6-12 grams intramuscularly for adults, 0.1-0.15 mg/kg for children once a day. Usually 5-7 injections are enough.

During the period of convalescence, Lykopid is indicated - a modern immunomodulator of the latest generation, as well as natural adaptogens: echinacea, eleutherococcus, Rhodiola rosea and nootropics. In case of protracted course of the disease, continue taking Cycloferon for 2-3 months with an interval of 5 days.

For the treatment of chronic active infection, recombinant alpha interferons are beginning to be used: Intron A, Roferon-A, Reaferon-EC.

The management of a patient with infectious mononucleosis depends on the severity of the disease. For mild forms, treatment is carried out on an outpatient basis. During the period of rising temperature it is necessary:

• bed rest;
• plenty of warm, fortified drinks;
• vasoconstrictor nasal drops - Furacilin with adrenaline, Sofradex, Naphthyzin, Sanorin;
• gargling with antiseptic solutions - the same Furacilin, as well as Iodinol, chamomile or sage decoctions;
• taking vitamins B, C, P, antipyretic and painkillers (Nurofen, Panadol, Paracetamol, Brufen);
• use of antihistamines - Claritina for children from 2 to 12 years old, 5 ml of syrup once a day, for children over 12 years old - 10 mg per day, as well as Fenistil, Tavegil, Diazolin, Zyrtek.

In rare cases, with mononucleosis, there is a need for hospitalization of the patient. Indications for this are high fever, severe intoxication, threat of asphyxia, and the development of complications. In the hospital, infusion therapy is carried out with 0.9% sodium chloride solution, 5% glucose solution with vitamins C and B1. If necessary, hepatoprotectors are prescribed: for children over 5 years old, Karsil at the rate of 5 mg/kg of body weight per day, as well as Essential, Galstena.

In case of complications or the addition of a secondary bacterial infection, the use of 3rd generation cephalosporin antibiotics is indicated:

• Cefotaxime for children weighing up to 50 kg – intravenously or intramuscularly 50–180 mg/kg for 4–6 injections;
• Ceftriaxone for children at the rate of 50–80 mg/kg body weight per day for 2 administrations;
• antiprotozoal drugs Metronidazole.

Patients with hematological complications and airway obstruction are prescribed glucocorticoids: Prednisone, Dexamethasone, Prednisolone at a dose of 0.14 mg per kg of body weight per day in 3-4 doses in a short course.

How does the disease develop?

Epstein-Barr virus most often enters the upper respiratory tract through airborne droplets. Under the influence of infectious agents, epithelial cells of the mucous membrane of the nose, mouth and pharynx are destroyed and pathogens penetrate in large quantities into the surrounding lymphoid tissue and salivary glands. Having penetrated B-lymphocytes, the pathogens spread throughout the body, primarily affecting the lymphoid organs - tonsils, liver and spleen.

In the acute stage of the disease, viruses infect one out of every thousand B-lymphocytes, where they multiply intensively and potentiate their division. When B lymphocytes divide, viruses are transmitted to their daughter cells. By integrating into the genome of infected cells, viral particles cause chromosomal abnormalities in them.

Some of the infected B-lymphocytes are destroyed as a result of the multiplication of viral particles in the acute phase of the disease. But if there are few viral particles, then B-lymphocytes do not die so quickly, and the pathogens themselves, persisting for a long time in the body, gradually infect other blood cells: T-lymphocytes, macrophages, NK cells, neutrophils and vascular epithelium, which leads to the development secondary immunodeficiency.

Pathogens can reside in the epithelial cells of the nasopharyngeal region and salivary glands for a long time. Infected cells remain in the crypts of the tonsils for quite a long time (from 12 to 18 months), and when they are destroyed, viruses are constantly released into the external environment with saliva.

The pathogens persist (stay) in the human body for life and subsequently, with a decrease in the functioning of the immune system and hereditary predisposition, become the cause of the development of chronic Epstein-Barr virus infection and a number of severe oncological pathologies of a lymphoproliferative nature, autoimmune diseases and chronic fatigue syndrome.

In HIV-infected people, EBVI manifests itself at any age.

How can you get infected?

There are four variants of infection with the Epstein-Barr virus:

1. By airborne droplets. Herpes type 4 is transmitted by airborne droplets only when the source of infection is an acute form of Epstein-Barr virus infection. In this case, when sneezing, Epstein virus particles can easily become airborne and enter a new body.
2. Household contacts. In this case, we are primarily talking about all everyday contacts with an infected person, including shaking hands. And at the same time, it is not necessary that the carrier has an acute form of the disease, since another year and a half after the acute Epstein-Barr viral infection, the carrier can easily infect others through contact.
3. Sexual intercourse and kissing. Herpes type 4 is easily transmitted through all types of sexual interaction, as well as through kissing. It is believed that in a third of all infected people, Epstein-Barr can live in the saliva for the rest of their lives, so it is very easy to become infected with it.
4. From pregnant woman to child. If a pregnant woman has Epstein-Barr in her blood, then it can easily be transmitted from her to the fetus through the placenta, and in the future to the child.

Of course, understanding how easily it is possible to become infected with the Epstein-Barr virus, the question arises, what about blood transfusions or organ transplants. Naturally, it is also easy to get Epstein-Barr during transfusions and organ transplants, but the above transmission routes are the most common.

Methods of infection

Kissing is one of the ways to become infected with EBV.

Most infections with the virus occur in childhood. About 90% of people who come into contact with a child can infect him. The risk group includes newborns under 1 year of age. According to statistics, 50% of children in developing countries receive the virus from their mother during infancy. And by the age of 25 this figure increases to 90%. Most often, EBV is diagnosed between four and fifteen years of age.

The way the disease manifests itself does not depend on gender or race: both boys and girls suffer from it to the same extent and with equal frequency. But it is worth knowing that in areas where low-income populations predominate, the herpes virus is more common, but occurs in a latent form for almost 3 years.

• contact. With saliva through hugs or kisses. The largest number of viral particles are located in cells next to the salivary glands and are released along with it;
• airborne. The pathogen collects in the mucous membranes of the pharynx, nose and nasopharynx and the upper respiratory tract and is released to the surface when sneezing, yawning, coughing, screaming and even just talking;
• with blood transfusion from a donor. This manipulation is not so rare. Already in the maternity hospital, the baby may be prescribed it if anemia (low hemoglobin) is detected or the child is born earlier than the expected date under certain circumstances;
• during bone marrow transplantation from a donor. The technique is used not only for cancer, but also for diseases associated with human blood (anemia, hemorrhagic diathesis).

It is important to understand that 25% of carriers have the virus in their saliva constantly. This, in turn, suggests that they are carriers and sources of infection even in the absence of obvious symptoms throughout their lives.

Treatment method for EBV infection↑

There is no single protocol for treating EBV infection, because it is impossible to completely remove it from the body, at least at the current level of medical development. The infection is in a latent stage and does not require treatment. In the presence of stable immunity to the virus and a somewhat healthy lifestyle, the return of infectious mononucleosis is possible only with a significant weakening of the immune system.

In cases of infectious mononucleosis, drug therapy is indicated. The same drugs are used to treat children and adults, only the doses differ.

Important : When treating symptoms of EBV infection, the use of ampicillin and amoxicillin is unacceptable. They cause a rash to appear all over the skin, which will not go away for several months.

Forecast and preventive measures

With timely treatment, the child's health is preserved. Observation by a pediatrician prevents the development of complications and relapses.

Parents should explain simple preventative techniques to their children:

• adherence to daily routine;
• maintaining a healthy lifestyle;
• alternating mental and physical activity;
• ability to overcome stress;
• strengthening the immune system (walking, exercise, diet);
• maintaining personal and social hygiene;
• hygiene of intimate life (for teenagers).

Compliance with such simple preventive measures will strengthen the child’s immunity. After all, only a strong immune system will prevent the virus from becoming acute and keep it suppressed.

Routes of transmission of the virus and sources of infection

The main route by which viral pathogens are transmitted is through 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.

READ ALSO: how and with what to treat herpesvirus type 6 in a child?

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 in a latent form. The threat of becoming infected with EBV from a patient becomes real a couple of days before the end of the incubation period.

How dangerous it is for children

Primary infection occurs unnoticed. It is not always possible to make a diagnosis right away. For infectious mononucleosis caused by EBV, there are 2 ways:

• cure with lifelong presence of the virus in the body;
• transition of the disease to a chronic form.

If a child has an immunodeficiency, EBV provokes the development of:

• nasopharyngeal cancer;
• hepatitis A;
• herpetic sore throat;
• Hodgkin's disease;
• Alice in Wonderland syndrome;
• infectious mononucleosis;
• Burkitt's lymphoma.

Diseases caused by the virus are complicated by otitis media, liver failure, and splenic rupture.

Little has been written about this virus, and the unknown scares parents. What is dangerous for a child is not the presence of EBV in the body, but the consequences.

In more than half of 5-year-old children, a blood test shows traces of the disease. Mothers are often unaware of the illness they have had; it is asymptomatic.

Children's immunity is young. It is not always possible to quickly cope with the infection. The consequences cannot be foreseen. In some children, infection causes complications, in other cases it proceeds without consequences.

Doctor of the highest category Evgeniy Komarovsky says:

“Most adults were infected with EBV during childhood. They don't suspect it and feel great. The panic around a virus with a fancy name is unfounded.”