The Broad Spectrum of EBV Disease

Medical Author: Melissa Conrad Stoppler, MD
Medical Editor: William C. Shiel Jr., MD, FACP, FACR

The Epstein-Barr virus (EBV), a member of the herpesvirus family, is found throughout the world. Studies show that up to 95% of all adults have antibodies against this common virus, meaning that they were infected at some point in their lives. Even though most infections with EBV go unnoticed or produce only very mild symptoms, in some cases, it can be associated with the development of serious conditions, including several types of cancer. Even mild or non-life-threatening infection with EBV can, occasionally, be associated with the development of serious complications from the infection. Although the virus typically targets lymphocytes, a particular blood cell involved in the immune response, almost all organs systems can ultimately be affected by EBV infection.

EBV is transmitted by close person-to-person contact. Primary, or initial, infection with EBV may not produce symptoms or there can be a number of different symptoms, especially in young children. The manifestations of primary EBV infection include:

  • Infectious mononucleosis (IM): This is the most common medical condition associated with EBV. IM is characterized by extreme fatigue, tonsillitis and/or inflamed throat (pharyngitis), enlarged, tender lymph nodes in the neck, and moderate to high fever. Although the fever and sore throat typically resolve within two weeks, fatigue may persist for months after the infection.

  • Other mild childhood illnesses: EBV infection in young children has also been linked to ear infections, diarrhea, other gastrointestinal symptoms, and cold symptoms in addition to the classic symptoms of IM.

  • In rare cases, primary infection with EBV has been associated with neurologic disturbances including Guillain-Barre syndrome and meningoencephalitis. Other rare manifestations of primary infection are abnormalities of the blood or coagulation systems such as anemia, thrombotic thrombocytopenic purpura/hemolytic-uremic syndrome (TTP/HUS), and disseminated intravascular coagulation (DIC).

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