Kiss Off, Kissing Disease!
Can you believe there is a herpesvirus that we haven’t talked much about? Yup, we have hardly delved into the world of Epstein Barr virus, or EBV, as us herpesvirologists like to call it.
You may not have heard of EBV, but chances are it is secretly living inside your body right now. And you most certainly have heard of the disease caused by EBV: infectious mononucleosis, or as pubescent giggling teens call it, the “kissing disease.” I’ll call it mono from here on out.
Since EBV has decided to grace my household with its presence in the form of a very tired, mono-stricken 9-year-old, I thought it was time that we covered this herpesvirus.
What is EBV? EBV was the fourth identified human herpesvirus and also has the auspicious name of human herpesvirus 4 (HHV-4; clever isn’t it?). EBV was named after Michael Anthony Epstein (University of Bristol) and Yvonne Barr (University of London), the co-discoverers of the virus.
EBV is one of the most common viruses in people. In the US, about 90-95% of the population has been infected with EBV – half of these before they turned 5 years old! Infection in younger children is often asymptomatic or it is just noted as one of the multitude of mild colds your kids experience.
However, when infection occurs in older, adolescent kids, they develop mono 35-50% of the time. As if they didn’t already have enough to deal with: pimples, surging hormones, awkward bodily changes, new odors and then wham! EBV packs a punch.
Signs and symptoms of mono. Kids with mono usually have a fever, sore throat and swollen glands. They are also very, very tired. Additionally, they can experience headaches, nausea and abdominal pain.
When Number 3 was struck, he had a low-grade fever for a couple of days, a sore throat, was very fatigued and was complaining of tummy pain. I thought for sure he had strep throat, but when I brought him to the pediatrician, he was strep negative. He continued for a few more days with these symptoms and just generally looked wiped out and pale. Another funny symptom we noted: he started having night terrors every night. I brought him back to the pediatrician and although his glands weren’t very swollen, they decided to test him for mono.
And the culprit was found.
A symptom of mono that is not easily seen by the naked eye is swelling of the spleen. In about 50% of infected people, EBV causes the spleen to enlarge. While not dangerous by itself, an enlarged spleen can rupture easily if the stomach is hit.
Symptoms usually subside in about 2 weeks, but recovering people can remain tired for longer periods of time (sometimes months).
How to treat mono. There are no vaccines or cures for mono. You have to let the body fend for itself throughout this infection. People with mono should be allowed to rest as much as needed and be encouraged to drink lots of fluid. They can be as active as they want and can go to school if they feel up to it. You can give them acetominophen or ibruprofen for pain and fever control (but never aspirin!).
Kids with mono should not participate in sports or gym until your doctor approves it. You don’t want to take the chance of them getting hit in the stomach.
How can you avoid getting EBV? Should you? It seems unlikely that you can avoid getting infected with EBV. The proof is the more than 90% of adults walking around with it!
EBV is transmitted very readily through saliva (thus the nickname). Infants are protected from infection through maternal antibodies acquired from their mother (while in utero and through breast milk). However, once these wear off, infection is probably inevitable.
Daycare centers with drooling, tooth-acquiring toddlers are a great place to pick up the virus. And teenagers in the throes of their first love are also great petri dishes.
Considering the disease is worse in teenagers, I am not sure avoidance is the best choice early on!
Other diseases caused by EBV. EBV likes to infect the B cells of your immune system. These cells are responsible for making antibodies that help you fight off infections. Once the initial infection is over, EBV hides out in your B cells for the rest of your life. This can cause trouble for some people later on.
Rarely (and I mean rarely) EBV can cause more serious diseases. The virus is associated with Hodgkin’s lymphoma, Burkitt’s lymphoma and other cancers of the nose and throat. The occurrence of these cancers is influenced by your genetics, environment and exposure to other pathogens. For example, Burkitt’s lymphoma primarily occurs in Africa in regions in which malaria is also endemic.
I tried to explain to Number 3 that if he had to get mono, perhaps it was better that he got it when he was younger and not as a teen. I suspect he is going to bounce back quicker!
But it is still hard seeing him lying around when he is usually a bundle of energy that can’t be stopped. So despite my fascination with herpesviruses, I think I would just like to tell this one to Kiss Off!