Epstein-Barr Virus

Symptoms of an Epstein-Barr virus infection vary greatly among individuals. Toddlers and adults may experience no symptoms at all, but are still capable of spreading the infection.

Symptoms of an Epstein-Barr virus infection are often mild, vague, and similar to symptoms of a cold or the flu. Symptoms include:

• Body aches

• Cough

• Fatigue

• Headache

• Low-grade fever

• Malaise

• Runny or stuffy nose or nasal congestion

• Sneezing

• Sore throat

• Swollen tonsils

In adolescents and young adults who develop mononucleosis, which is often caused by the Epstein-Barr virus, symptoms generally begin about four to six weeks after exposure to the virus. Early symptoms are similar to symptoms of a cold or the flu. As mononucleosis progresses, symptoms become more severe and can include:

• Enlarged spleen

• Extreme fatigue

• Painful swollen glands (lymph nodes) in the neck, armpits or groin

• Rash

In rare cases, an Epstein-Barr virus infection or mononucleosis can result in serious or life-threatening complications, such as meningitis, hepatitis or ruptured spleen. Seek immediate medical care (call 911) if you, or someone you are with, have any of the following symptoms:

• Change in alertness or level of consciousness or passing out

• Dizziness

• High fever (higher than 101 degrees Fahrenheit)

• Left upper abdominal pain (possible rupture of spleen)

• Lethargy or unresponsiveness

• Rash of small reddish purple spots

• Respiratory or breathing problems, such as shortness of breath, difficulty breathing, labored breathing, wheezing, not breathing, or choking

• Seizure

• Stiff neck

• Yellowing of the skin and whites of the eyes (jaundice)

Epstein-Barr virus is a member of the herpesvirus family of viruses. The Epstein-Barr virus is contagious and spreads from person to person through intimate contact in which saliva is exchanged. This is why mononucleosis, which is often caused by the Epstein-Barr virus, is commonly referred to as “the kissing disease.”

The Epstein-Barr virus can spread from person to person by such activities as:

• Kissing

• Sharing unwashed water bottles, drinking glasses, eating utensils and dishes, and personal items used in and around the mouth, such as toothbrushes and lip balm

• Spitting in the face near or in the mouth, or on the lips

The Epstein-Barr virus can occur in any age group or population. Almost everybody will develop an Epstein-Barr virus infection at some point during their lives, but a number of factors increase the risk of catching the disease.

Risk factors include any activity that exposes you to the saliva of a person who carries the Epstein-Barr virus. Carriers of the Epstein-Barr virus may not appear ill but can still spread the disease. Risk factors include:

• Kissing

• Sharing unwashed water bottles, drinking glasses, eating utensils and dishes, and personal items used in and around the mouth, such as toothbrushes and lip balm

• Spitting in the face near or in the mouth, or on the lips

The Epstein-Barr virus is an extremely common virus that infects most people at one time or another during their lifetimes. In addition, many people who have had an Epstein-Barr virus infection may carry the virus in their saliva after they are no longer sick, which means they can continue to spread the infection.

Because of this, there is little that can be done to prevent its spread. However, avoiding contact with another person's saliva by not sharing unwashed water bottles or drinking or eating utensils and toothbrushes is still a good disease prevention measure. Washing hands frequently throughout the day with soap and warm water for at least 15 seconds is a good habit that can help prevent the spread of infectious diseases in general.

There is currently no cure for an Epstein-Barr virus infection. Treatment includes measures aimed at relieving symptoms so that you are comfortable enough to get the rest you need to keep up your strength and recover without developing complications. Treatment of an Epstein-Barr virus infection includes:

• Acetaminophen (Tylenol) or ibuprofen (Advil or Motrin), which reduce fever and minimize other symptoms of infection, such as headache, sore throat and body aches

• Corticosteroid drugs, which reduce the swelling of the tonsils and throat that can occur in mononucleosis

• Drinking extra fluids

• Getting extra rest and sleep

Antibiotics are not prescribed for Epstein-Barr virus infections because they are ineffective against viruses. However, antibiotics may be prescribed if a person develops a secondary bacterial infection as a complication of an Epstein-Barr virus infection, such as bacterial tonsillitis. Antiviral drugs that are currently available also have no effect in treating Epstein-Barr virus.

Children and teenagers with an Epstein-Barr virus infection or other viral infection should not use aspirin or products that contain aspirin because of the risk of developing a rare but life-threatening condition called Reye syndrome. Reye syndrome most commonly affects children and teenagers and has been linked to taking aspirin during a viral illness, such as an Epstein-Barr virus infection, the common cold, or the flu.

Complementary and traditional treatments will not cure an Epstein-Barr virus infection but may help to increase comfort, promote rest, and maintain strength during an Epstein-Barr virus infection. Treatments include:

• Chicken soup, which can help break up nasal congestion and provides easy-to-digest nutrients and extra fluids to help keep up your strength

• Supplements or products that contain vitamin C, echinacea or zinc

Rarely, Epstein-Barr virus infection or mononucleosis caused by the Epstein-Barr virus can cause serious, even life-threatening complications. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of an Epstein-Barr virus infection or mononucleosis include:

• Anemia

• Behavioral abnormalities

• Blockage of airways by the swollen lymph nodes

• Certain cancers, such as Burkitt's lymphoma and nasopharyngeal carcinoma

• Fatigue that lasts for weeks or months

• Hepatitis

• Meningitis (inflammation of the tissues covering the brain) and encephalitis (inflammation of the brain)

• Nerve damage

• Ruptured spleen

• Secondary bacterial infection such as bacterial tonsillitis

• Seizure