Epstein-Barr Virus (EBV) Infection

The infection tends to be mild in infants and young children with flu-like symptoms. Teens and adults are more likely than children to experience symptoms, which can include:

• Fever
• Extreme tiredness or fatigue
• Sore throat
• Swollen lymph nodes in the neck or under-arm area
• Stomach pain in the upper left side, which could indicate an enlarged spleen
• Headache
• Swollen tonsils (tonsillitis)
• Skin rash

Grown-ups who get infectious mononucleosis as a result of EBV may also get:

• Swollen eyelids
• Mild jaundice

Usually, patients get better in two weeks to one month. However, fatigue can last longer in people who get this infection as teenagers or as adults.

Researchers are looking into the reasons why adolescents and adults tend to get more severely affected. One theory is that they have a more developed immune system than babies and young children. This is significant because lymphocytes, more specifically the B-cells of our immune system, are one of the main hosts for the virus in the human body.

Epstein-Barr virus, previously known as the human herpesvirus 4, can cause mild primary infection and infectious mononucleosis or mono (kissing disease).

To be sure, EBV isn't the only virus that can cause mono—cytomegalovirus can also cause this disease. (Read more: Cytomegalovirus infection)

The virus spreads mainly through swapping saliva with an infected person. But other bodily fluids like blood and semen can also transmit the pathogen. Droplet transmission—through sneeze and cough droplets from an infected person—is also possible.

Children usually pick up the infection from their peers in the playground (play gym) or playschool. Sharing cups, spoons, chew toys, etc., can spread the virus.

In teens and grown-ups, kissing is an additional way in which the virus can spread.

The virus may also get reactivated in some adults who had the infection as children. Although the exact cause for this isn't known, medical researchers say it has a correlation with compromised immunity.

Epstein-Barr virus (EBV) infection is actually very common all over the world. Many patients tend to be asymptomatic. Where symptoms do show up, they can take up to six weeks after someone contracts the infection to become evident. As such, it is difficult to identify sick people to maintain distance from them or to avoid infection.

The best precautionary advice for this infection is to avoid sharing utensils and drinks with other people and maintain hygiene.

Diagnosis of Epstein-Barr virus (EBV) infection is difficult because the symptoms—when they do show up—tend to be non-specific. That said, a doctor would do the following to reach a diagnosis:

• Ask about your symptoms
• Do a physical examination to check for swollen tonsils or lymph nodes in the neck. He or she would also check for any swelling in the spleen by pressing on your abdomen to check if it hurts anywhere
• Run an antibody test for EBV-specific antibodies in the blood. Research has also shown that grown-up patients tend to have increased CD8+ cytotoxic lymphocytes (a type of antiviral immune cell) in their blood.

Treatment for primary Epstein-Barr virus (EBV) infection typically involves getting lots of rest, drinking lots of fluids and taking over-the-counter medication to ease the pain and fever.

• Difficulty breathing due to airway obstruction. This obstruction could be because of swelling in the oropharyngeal area (back of the throat)
• Meningoencephalitis or swelling in the meninges or membranes of the brain
• Haemolytic anaemia: A condition in which red blood cells are destroyed faster than the body can make them, leading to anaemia
• Thrombocytopenia or low platelet count.
• Maculopapular rashes: These are skin lesions that are sometimes caused by viral infections

EBV infection can also have implications for organ transplant—recipients may be at risk for post-transplant lymphoproliferative disorder (PTLD), a type of cancer that can occur after organ transplant.

Research has also linked EBV infection to increases risk of:

• Nasopharyngeal cancer
• Systemic lupus erythematosus, an autoimmune disorder which affects the connective tissues in the skin, joints, blood vessels, brain, lungs and kidneys, among other organs of the body. 
• Multiple sclerosis, an autoimmune condition that depletes the protective covering of the nerve cells.
• Juvenile idiopathic arthritis, an autoimmune disease in which people develop arthritis or joint inflammation before the age of 16 years.
• Inflammatory bowel disease, in which there is constant inflammation of the gut
• Type 1 diabetes, or insulin-dependent diabetes