A virus of the herpes family

EBV. Three letters, for a little-known, but extremely widespread virus. And in the vast majority of cases, completely harmless. “It is a member of the herpesviridae family, which is present only in humans,” adds Professor Vincent Dubée, infectious disease specialist at the University Hospital of Angers. “It infects lymphocytes (white blood cells) of the immune system and certain cells in the lining of the mouth and pharynx. “

His origins

It was discovered in 1964 by British pathologist Michael Anthony Epstein, hence its name. We carry it – almost all of us. “It is extremely widespread, with an estimated 95% of humans all over the planet being infected. This infection usually occurs during childhood, adolescence, or entering adulthood. »There is a peak in frequency between 15 and 25 years. Once entered, the virus does not come out. It will remain in the body until death, totally asleep. This is also a point in common that he has with other members of his family, such as oral herpes viruses – the famous cold sore – and genital herpes.

“Often, nothing happens,” reassures Professor Dubée. But sometimes the virus can cause infectious mononucleosis. This disease occurs during first contact with the virus. Symptoms – when present – appear after an incubation period of four to seven weeks.

Infection in children

In children, the infection goes unnoticed most of the time. But it still gives them immunity for life, since symptoms or not, they have developed antibodies against the virus.

Infection in adolescents and adults

In adolescents and adults, mononucleosis often causes “a lot of fatigue, high fever, swollen tonsils, which makes eating, or even swallowing saliva, very painful. »The lymph nodes in the neck become larger, there may be muscle pain and headaches. Symptoms go away after two weeks, but fatigue can last for months.

The virus is transmitted through saliva. “This is what has earned infectious mononucleosis the nickname kissing disease. But it’s not just by kissing your loved ones that you can infect them. The virus is also spread when you share a drink or cutlery, cough or sneeze.

Contagion is greatest during the acute phase of the disease, when the person has a fever. If you have just been infected, you must be careful to wash your hands regularly, not to kiss your loved ones, not to lend your toothbrush… and to be patient. Because once healed, a person remains contagious for at least six months.

The main risk of mononucleosis is a ruptured spleen. A rare but possible medical emergency. Indeed, this organ located in the upper left corner of the abdomen, becomes larger during a virus infection. As a precaution, shocks must be avoided. Sports that are too intense, or can cause a fall, such as rugby or skiing, are therefore prohibited in the first month of the disease, such as lifting heavy loads. 

“The Epstein Barr virus can also be the cause of serious complications,” laments Professor Dubée. It is therefore involved in the development of some cancers, such as Burkitt’s lymphoma and certain cancers of the nose and throat. “It happens more frequently in people who have a failing immune system, and it’s still exceptional. “

It is based on an interview of the patient, and a blood test, which will show an increase in lymphocytes, and can confirm recent contact with the virus, by looking for anti-EBV antibodies. If he suspects mononucleosis, the doctor will check to see if the lymph nodes in the neck are larger. He will also make sure that the patient’s spleen has not swelled.

“There is no treatment, even when you have infectious mononucleosis. Indeed, since mononucleosis is of viral origin, antibiotics are completely unnecessary. “They can even be deleterious. Penicillin, when prescribed to a subject with mononucleosis, frequently triggers a rash, ”adds Professor Dubée. “We just treat the symptoms.”

The fever and pain will be relieved with paracetamol or nonsteroidal anti-inflammatory drugs. The most important thing is to keep hydrated despite the pain in the throat, and to rest, the disease often causing a lot of fatigue. As for the vaccine, “there is none, because there is no interest. In the vast majority of cases, it does not matter. The Epstein-Barr virus should not worry: it is almost a necessary step. “