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The infection is spread through kissing or other close contact with an infected person. Symptoms vary, but the most common are extreme fatigue, fever, sore throat, and swollen lymph nodes. blood test is done to confirm the diagnosis. cetaminophen or nonsteroidal anti-inflammatory drugs can relieve fever and pain.
!nfection with the Epstein-Barr virus "EB#$ is very common. !n the %nited States, about &'( of all children & years of age and nearly )&( of adults have had an EB# infection. *ost of these infections cause symptoms similar to those of a cold or other mild viral infections. Sometimes adolescents and young adults develop different and more severe symptoms from EB# infection. This disease is called infectious mononucleosis. !nfectious mononucleosis is named for the large numbers of white blood cells "mononuclear cells$ in the bloodstream. dolescents and young adults usually catch infectious mononucleosis by kissing or having other intimate contact with someone infected with EB#. fter the initial infection, EB# remains in the body, mainly in white blood cells, for life. !nfected people shed the virus periodically in their saliva. They are most likely to infect others during shedding, which usually causes no symptoms. +arely, EB# contributes to the development of several uncommon types of cancer, such as Burkitt,s lymphoma and certain cancers of the nose and throat. !t is thought that specific viral genes alter the growth cycle of infected cells and cause them to become cancerous. EB# does not cause chronic fatigue syndrome "see -isorders of %nknown .ause/ .hronic 0atigue Syndrome$, as was once suspected. Symptoms and .omplications EB# can cause a number of different symptoms, depending on the strain of the virus and several other, poorly understood factors. !n most children younger than &, the infection causes no symptoms. !n adolescents and adults, it may or may not cause symptoms. The usual time between infection and the appearance of symptoms is thought to be 1' to &' days. This interval is called the incubation period. The four main symptoms of infectious mononucleosis are
2ot everyone has all four symptoms. %sually, the infection begins with a general feeling of illness "malaise$ and fatigue that last several days to a week. These vague symptoms are followed by fever, sore throat, and swollen lymph nodes. The fever usually peaks at about 3'14 0 "about 1)4 .$ in the afternoon or early evening. The throat is often very sore, and puslike material may be present at the back of the throat. *ost commonly, the lymph nodes
of the neck are swollen, but any lymph node may be swollen. !n some people, the only symptom is swollen lymph nodes. 0atigue is usually most pronounced during the first 5 to 1 weeks and may last 6 weeks or more. The spleen is enlarged in about &'( of people with infectious mononucleosis. !n most infected people, an enlarged spleen causes few if any symptoms, but it may rupture, particularly if in7ured. The liver may also enlarge slightly. 8ess commonly, 7aundice and swelling around the eyes occur. Skin rashes develop infre9uently. :owever, people with an EB# infection who take the antibiotic ampicillin usually develop a rash. ;ther very rare complications include sei<ures, nerve damage, behavioral abnormalities, inflammation of the brain "encephalitis$ or tissues covering the brain "meningitis$, anemia, and blockage of airways by the swollen lymph nodes. :ow long symptoms last varies. fter about 5 weeks, symptoms subside, and most people can resume their usual activities. :owever, fatigue may persist for several more weeks and, occasionally, for months or longer. -iagnosis The symptoms of infectious mononucleosis also occur in many other viral and bacterial infections. Therefore, infectious mononucleosis is often unrecogni<ed. %sually, a simple blood test known as a heterophil antibody or monospot test is done to confirm the diagnosis. Sometimes early in the infection or in young children, the monospot test is negative, and other specific antibody blood tests are necessary to confirm the diagnosis. ;ften, a complete blood cell count is also done. 0inding many characteristic mononuclear white blood cells "atypical lymphocytes$ may be the first clue that the diagnosis is infectious mononucleosis. Treatment There is no specific treatment. =eople with infectious mononucleosis may be as active as they want. :owever, because of the risk of rupturing the spleen, heavy lifting and contact sports should be avoided for 3 month, even if the spleen is not noticeably enlarged. Before such activities are resumed, doctors may wish to confirm that the spleen has returned to normal si<e. cetaminophen or nonsteroidal anti-inflammatory drugs "2S !-s, such as aspirin or ibuprofen $ can relieve fever and pain. :owever, aspirin should not be given to children because of the risk of +eye,s syndrome, which can be fatal. Some complications, such as severe swelling of the airways, may be treated with corticosteroids. .urrently available antiviral drugs have little effect on the symptoms of infectious mononucleosis and should not be used.
http://www.merckmanuals.com/home/infections/viral_infections/epsteinbarr_virus_ebv_infection.html
are usually the primary reservoir for person-to-person transmission. 0or this reason, transmission of the virus is almost impossible to prevent. The clinical diagnosis of infectious mononucleosis is suggested on the basis of the symptoms of fever, sore throat, swollen lymph glands, and the age of the patient. %sually, laboratory tests are needed for confirmation. Serologic results for persons with infectious mononucleosis include an elevated white blood cell count, an increased percentage of certain atypical white blood cells, and a positive reaction to a @mono spot@ test. There is no specific treatment for infectious mononucleosis, other than treating the symptoms. 2o antiviral drugs or vaccines are available. Some physicians have prescribed a &-day course of steroids to control the swelling of the throat and tonsils. The use of steroids has also been reported to decrease the overall length and severity of illness, but these reports have not been published. !t is important to note that symptoms related to infectious mononucleosis caused by EB# infection seldom last for more than > months. ?hen such an illness lasts more than 6 months, it is fre9uently called chronic EB# infection. :owever, valid laboratory evidence for continued active EB# infection is seldom found in these patients. The illness should be investigated further to determine if it meets the criteria for chronic fatigue syndrome, or .0S. This process includes ruling out other causes of chronic illness or fatigue. DIAGNOSIS OF EBV INFECTIONS !n most cases of infectious mononucleosis, the clinical diagnosis can be made from the characteristic triad of fever, pharyngitis, and lymphadenopathy lasting for 3 to > weeks. Serologic test results include a normal to moderately elevated white blood cell count, an increased total number of lymphocytes, greater than 3'( atypical lymphocytes, and a positive reaction to a @mono spot@ test. !n patients with symptoms compatible with infectious mononucleosis, a positive =aul-Bunnell heterophile antibody test result is diagnostic, and no further testing is necessary. *oderate-to-high levels of heterophile antibodies are seen during the first month of illness and decrease rapidly after week >. 0alse-positive results may be found in a small number of patients, and false-negative results may be obtained in 3'( to 3&( of patients, primarily in children younger than 3' years of age. True outbreaks of infectious mononucleosis are extremely rare. substantial number of pseudooutbreaks have been linked to laboratory error, as reported in .-.,s Morbidity and Mortality Weekly Report, vol. >', no. 15, on ugust 36, 3))3. ?hen @mono spot@ or heterophile test results are negative, additional laboratory testing may be needed to differentiate EB# infections from a mononucleosis-like illness induced by cytomegalovirus, adenovirus, or Toxoplasma gondii. -irect detection of EB# in blood or lymphoid tissues is a research tool and is not available for routine diagnosis. !nstead, serologic testing is the method of choice for diagnosing primary infection. EBV-Specific Laboratory Tests
8aboratory tests are not always foolproof. 0or various reasons, false-positive and false-negative results can occur for any test. :owever, the laboratory tests for EB# are for the most part accurate and specific. Because the antibody response in primary EB# infection appears to be 9uite rapid, in most cases testing paired acuteand convalescent-phase serum samples will not demonstrate a significant change in antibody level. Effective laboratory diagnosis can be made on a single acute-phase serum sample by testing for antibodies to several EB#-associated antigens simultaneously. !n most cases, a distinction can be made as to whether a person is susceptible to EB#, has had a recent infection, has had infection in the past, or has a reactivated EB# infection. ntibodies to several antigen complexes may be measured. These antigens are the viral capsid antigen, the early antigen, and the EB# nuclear antigen "EB2 $. !n addition, differentiation of immunoglobulin A and * subclasses to the viral capsid antigen can often be helpful for confirmation. ?hen the @mono spot@ test is negative, the optimal combination of EB# serologic testing consists of the antibody titration of four markers/ !g* and !gA to the viral capsid antigen, !g* to the early antigen, and antibody to EB2 . !g* to the viral capsid antigen appears early in infection and disappears within > to 6 weeks. !gA to the viral capsid antigen appears in the acute phase, peaks at 5 to > weeks after onset, declines slightly, and then persists for life. !gA to the early antigen appears in the acute phase and generally falls to undetectable levels after 1 to 6 months. !n many people, detection of antibody to the early antigen is a sign of active infection, but 5'( of healthy people may have this antibody for years. ntibody to EB2 determined by the standard immunofluorescent test is not seen in the acute phase, but slowly appears 5 to > months after onset, and persists for life. This is not true for some EB2 en<yme immunoassays, which detect antibody within a few weeks of onset. 0inally, even when EB# antibody tests, such as the early antigen test, suggest that reactivated infection is present, this result does not necessarily indicate that a patient,s current medical condition is caused by EB# infection. number of healthy people with no symptoms have antibodies to the EB# early antigen for years after their initial EB# infection. Therefore, interpretation of laboratory results is somewhat complex and should be left to physicians who are familiar with EB# testing and who have access to the entire clinical picture of a person. To determine if EB# infection is associated with a current illness, consult with an experienced physician. A itio!a" I!for#atio! abo$t EBV A!tibo y Tests a! I!terpretatio! ntibody tests for EB# can measure the presence andBor the concentration of at least six specific EB# antibodies. By evaluating the results of these different tests, the stage of EB# infection can be determined. :owever, these tests are expensive and not usually needed for the diagnosis of infectious mononucleosis. !t is not appropriate for .-. to interpret test results or to handle counseling for the
public. ?e suggest that 9uestions be directed to a local physician who is familiar with the patient,s history and laboratory test results. !n addition, .-. cannot recommend specific physicians for referral. ;ur general recommendation is for patients to consult with an infectious disease specialist or their local or state public health department. S%MMAR& OF INTER'RETATION The diagnosis of EB# infection is summari<ed as follows/ S$sceptibi"ity !f antibodies to the viral capsid antigen are not detected, the patient is susceptible to EB# infection. 'ri#ary I!fectio! =rimary EB# infection is indicated if !g* antibody to the viral capsid antigen is present and antibody to EB# nuclear antigen, or EB2 , is absent. rising or high !gA antibody to the viral capsid antigen and negative antibody to EB2 after at least > weeks of illness is also strongly suggestive of primary infection. !n addition, C'( of patients with active EB# infection produce antibody to early antigen. 'ast I!fectio! !f antibodies to both the viral capsid antigen and EB2 are present, then past infection "from > to 6 months to years earlier$ is indicated. Since )&( of adults have been infected with EB#, most adults will show antibodies to EB# from infection years earlier. :igh or elevated antibody levels may be present for years and are not diagnostic of recent infection. Reacti(atio! !n the presence of antibodies to EB2 , an elevation of antibodies to early antigen suggests reactivation. :owever, when EB# antibody to the early antigen test is present, this result does not automatically indicate that a patient,s current medical condition is caused by EB#. number of healthy people with no symptoms have antibodies to the EB# early antigen for years after their initial EB# infection. *any times reactivation occurs subclinically. C)ro!ic EBV I!fectio! +eliable laboratory evidence for continued active EB# infection is very seldom found in patients who have been ill for more than > months. ?hen the illness lasts more than 6 months, it should be investigated to see if other causes of chronic illness or .0S are present.
http://www.cdc.gov/ncidod/diseases/ebv.htm
=eople may not reali<e that they are carrying the Epstein-Barr virus in their bodies because the active virus may cause no symptoms, the virus may be dormant or people may think that they are suffering from a cold or influen<a when the Epstein-Barr virus is making them ill. ?hen teenagers and young adults are infected by the Epstein-Barr virus they have a thirty five to fifty percent chance of developing mononucleosis, which is also called mono, glandular fever or the kissing disease. *ononucleosis may sometimes develop in people of other ages. The term Eglandular feverF refers to the fact that the lymph glands under the arms, in the groin and especially in the neck become swollen, and to the fact that the person develops a high temperature. Someone suffering from mononucleosis may also experience a sore throat, swollen tonsils, headache, chills, muscle aches, loss of appetite, a spotty rash, extreme fatigue and a general feeling of illness and discomfort, which is known as Emalaise.F There may also be swelling of the eyelids. The blood usually contains more white blood cells than normal, and they may have an unusual appearance. !n about fifty percent of mononucleosis cases, the spleen may become enlarged. There may also be hepatitis and 7aundice "a yellow color to the skin and the white part of the eyes$. #ery rarely, the heart, lungs or nervous system may be affected. *ononucleosis symptoms develop about four to six weeks after the initial infection by EB#. cute mononucleosis symptoms last for around two to four weeks, but the fatigue may be experienced for several months. *ononucleosis may sometimes occur in a chronic state that lasts for much longer or that reappears at intervals for years. The Epstein-Barr virus causes or contributes to some kinds of cancer, including BurkittDs lymphoma, nasopharyngeal carcinoma and some cases of :odgkin "or :odgkin,s$ lymphoma. !t may also cause some cases of chronic fatigue syndrome and multiple sclerosis, although this is less certain.
!n adolescents and young adults, the Epstein-Barr virus can cause mononucleosis, which is a more serious illness. Epstein-Barr virus infection has also been linked to the development of certain rare cancers including Burkitt,s lymphoma and nasopharyngeal carcinoma. Epstein-Barr virus is very contagious and spreads from person to person through intimate contact with the saliva of a person who has the Epstein-Barr virus. bout )&( of all adults have had an Epstein-Barr virus infection at some point in their lives, according to the .enters for -isease .ontrol and =revention "Source/ .-.$. Treatment of most viral diseases begins with preventing the spread of the disease with basic hygiene measures. :owever, controlling the spread of the Epstein-Barr virus is extremely difficult because it is so common and because it is possible to spread the Epstein-Barr virus even when a person does not appear sick. *any healthy people who have had an Epstein-Barr virus infection continue to carry the virus in their saliva, which means they can spread it to others throughout their lifetimes. :owever, avoiding contact with another person,s saliva by not sharing drinking glasses or toothbrushes is still a good general disease prevention measure. There is currently no specific cure for an Epstein-Barr virus infection. Treatment includes measures to help relieve symptoms and keep the body as strong as possible until the disease runs its course. This includes rest, medications to ease body aches and fever, and drinking plenty of fluids. =eople who are in good health can generally recover from an Epstein-Barr virus infection at home with supportive care, such as rest, fluids and pain relievers. .orticosteroids may be prescribed in some cases of mononucleosis. ntibiotics are ineffective against the Epstein-Barr virus, but may be prescribed if a secondary bacterial infection develops, such as bacterial tonsillitis. Serious or life-threatening complications, such as encephalitis, ruptured spleen, or hepatitis, may develop in some cases of Epstein-Barr virus infection or mononucleosis, which is often caused by the Epstein-Barr virus. See- pro#pt #e ica" care if you, or your child, have symptoms of mononucleosis, such as extreme fatigue, swollen lymph nodes, or a cold- or flu-like illness that is not getting better. See- i##e iate #e ica" care .ca"" /001 if you, or someone you are with, have life-
threatening symptoms, such as shortness of breath, sei<ure, confusion or delirium, or a change in alertness or consciousness.
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 .ough 0atigue :eadache 8ow-grade fever *alaise +unny or stuffy nose or nasal congestion Snee<ing Sore throat Swollen tonsils
!n 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. s mononucleosis progresses, symptoms become more severe and can include/
Enlarged spleen Extreme fatigue =ainful swollen glands "lymph nodes$ in the neck, armpits or groin +ash
!n rare cases, an Epstein-Barr virus infection or mononucleosis can result in serious or lifethreatening complications, such as meningitis, hepatitis or ruptured spleen. See- i##e iate #e ica" care .ca"" /001 if you, or someone you are with, have any of the following symptoms/
.hange in alertness or level of consciousness or passing out -i<<iness :igh fever "higher than 3'3 degrees 0ahrenheit$ 8eft upper abdominal pain "possible rupture of spleen$ 8ethargy or unresponsiveness +ash of small reddish purple spots +espiratory or breathing problems, such as shortness of breath, difficulty breathing, labored breathing, whee<ing, not breathing, or choking Sei<ure Stiff neck Gellowing of the skin and whites of the eyes "7aundice$
Hissing 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
+)at are t)e ris- factors for catc)i!* t)e Epstei!-Barr (ir$s,
The Epstein-Barr virus can occur in any age group or population. lmost everybody will develop an Epstein-Barr virus infection at some point during their lives, but a number of factors increase the risk of catching the disease.
+isk factors include any activity that exposes you to the saliva of a person who carries the Epstein-Barr virus. .arriers of the Epstein-Barr virus may not appear ill but can still spread the disease. +isk factors include/
Hissing Sharing unwashed water bottles, drinking glasses, eating utensils and dishes, and personal items used in and around the mouth, such as toothbrushes and lip balm Spitting in the face near or in the mouth, or on the lips
The Epstein-Barr virus is an extremely common virus that infects most people at one time or another during their lifetimes. !n addition, many people who have had an Epstein-Barr virus infection may carry the virus in their saliva after they are no longer sick, which means they can continue to spread the infection. Because of this, there is little that can be done to prevent its spread. :owever, avoiding contact with another person,s saliva by not sharing unwashed water bottles or drinking or eating utensils and toothbrushes is still a good disease prevention measure. ?ashing hands fre9uently throughout the day with soap and warm water for at least 3& seconds is a good habit that can help prevent the spread of infectious diseases in general.
cetaminophen "Tylenol$ or ibuprofen " dvil or *otrin$, which reduce fever and minimi<e other symptoms of infection, such as headache, sore throat and body aches .orticosteroid drugs, which reduce the swelling of the tonsils and throat that can occur in mononucleosis -rinking extra fluids Aetting extra rest and sleep
ntibiotics are not prescribed for Epstein-Barr virus infections because they are ineffective against viruses. :owever, antibiotics may be prescribed if a person develops a secondary bacterial infection as a complication of an Epstein-Barr virus infection, such as bacterial tonsillitis. ntiviral drugs that are currently available also have no effect in treating EpsteinBarr virus. =eople with an Epstein-Barr virus infection or other viral infection should not use aspirin or products that contain aspirin because of the risk of developing a rare but life-threatening condition called +eye syndrome. +eye syndrome has been linked to taking aspirin during a viral illness, such as an Epstein-Barr virus infection, the common cold or the flu.
.omplementary and traditional treatments will not cure an Epstein-Barr virus infection but may help to increase comfort, promote rest, and maintain strength during an Epstein-Barr virus infection. Treatments include/
.hicken soup, which can help break up nasal congestion and provides easy-to-digest nutrients and extra fluids to help keep up your strength Supplements or products that contain vitamin ., echinacea or <inc
nemia Behavioral abnormalities Blockage of airways by the swollen lymph nodes .ertain cancers, such as Burkitt,s lymphoma and nasopharyngeal carcinoma 0atigue that lasts for weeks or months :epatitis *eningitis "inflammation of the tissues covering the brain$ and encephalitis "inflammation of the brain$ 2erve damage +uptured spleen Secondary bacterial infection such as bacterial tonsillitis Sei<ure
http://www.bettermedicine.com/article/epstein-barr-virus