Is Epstein Barr virus dangerous? Epstein Barr virus - what to do and how to be? Epstein-Barr virus treatment with folk remedies

Epstein-Barr is very widespread in the human population. According to WHO, up to 90-95% of the population in various countries is infected with it. Once in the human body, the virus remains in it for life, because it cannot be completely destroyed, like other members of the herpes family. Due to the lifelong persistence of the virus in the body, an infected person is a carrier and source of infection until death.

The Epstein-Barr virus during primary infection penetrates the cells of the mucous membrane of the oropharynx, where it multiplies and enters the bloodstream. After entering the bloodstream, the Epstein-Barr virus begins to attack the cells of the immune system - B-lymphocytes. It is B-lymphocytes that are the main target for the Epstein-Barr virus.

After penetration into B-lymphocytes, the Epstein-Barr virus leads to the transformation of the cell, which begins to multiply intensively and produce two types of antibodies. Transformed B-lymphocytes produce antibodies to the virus and to themselves. Due to the intensive reproduction of transformed B-lymphocytes, their number increases, and the cells fill the lymph nodes and spleen, provoking an increase in their size. Then these cells die, and the viruses are released into the blood. Antibodies to Epstein-Barr viruses form circulating immune complexes (CIC) with them, which are carried by the blood to all organs and tissues. CECs are very aggressive compounds, because once they get into any tissue or organ, they provoke the development of autoimmune inflammation. The consequence of this type of inflammation may be the development of systemic autoimmune diseases, such as:

• Systemic lupus erythematosus;


• Rheumatoid arthritis ;


• Hashimoto's thyroiditis;

It is the development of autoimmune diseases that is one of the dangers of the Epstein-Barr virus.

The transformed lymphocytes themselves are destroyed by other types of immunocompetent cells. However, since B-lymphocytes themselves are cells of the immune system, their infection leads to immunodeficiency. This state of inferior immunity can lead to malignant degeneration of lymphocytic tissue, resulting in the formation of lymphomas and other tumors. In general, the danger of the Epstein-Barr virus lies in the fact that it affects the cells of the immune system, forming various conditions that can provoke the development of serious diseases. However, such severe diseases develop only if the cells that destroy infected B-lymphocytes cease to cope with their task.

So, the Epstein-Barr virus is dangerous because it can provoke the development of the following pathologies:

• Proliferative syndrome (Duncan's disease), in which a huge number of B-lymphocytes are formed, which can lead to rupture of the spleen, anemia, disappearance of neutrophils, eosinophils and basophils from the blood. Proliferative syndrome on the background of immunodeficiency, as a rule, leads to death. In other cases, it is possible to save people's lives, but they subsequently develop anemia and lymphomas;



• Angioimmunoblastic lymphadenopathy;


• hemophagocytic syndrome;


• Immune thrombocytopenic purpura;


• Aplastic or hemolytic anemia;


• DIC;


• thymoma;


• Hairy leukoplakia of the oral cavity;



• Burkitt's lymphoma;


• Nasopharyngeal carcinoma;


• undifferentiated cancer of the nasopharynx;



• Lymphomas of the central nervous system;




• Bell's syndrome;


• Guillain-Barré syndrome;

Any pathogenic microorganisms actively attack the human body. There is one among them whose name is not familiar to many, although almost everyone has encountered it at least once in their lives.

This is one of the herpesviruses (type 4) - the Epstein-Barr virus. How dangerous is it and can it be overcome?

Read about what the Epstein-Barr virus is and how it is transmitted.

Symptoms of infection Epstein-Barr virus (EBV) can manifest itself in different ways:

• for the first time, a sick person does not feel any signs of the disease, becomes a virus carrier, and the presence of EBV can only be detected using serological analysis;
• if the disease manifests itself in an acute form - infectious mononucleosis, then the symptoms resemble a cold;
• in severe (generalized) form, there are signs of serious damage to internal organs and body systems.

Already 5-6 days after infection, symptoms of the disease may appear, but the incubation period can be longer.

The clinical picture of infectious mononucleosis is characterized by:

A laboratory examination may detect the presence of atypical mononuclear cells (a type of lymphocyte similar to monocytes) in the blood.

If the quantitative indicator of these cells is more than 10%, then the diagnosis of infectious mononucleosis is considered confirmed.

Treatment of the acute form of EBV leads to an improvement in well-being, but exacerbation symptoms may occasionally return. This course of the disease indicates a weakness of the immune system.

A phenomenon known as chronic fatigue syndrome, indicates a sluggish infection and is accompanied by characteristic symptoms:

Chronic course of the disease may have an atypical form. Its signs are frequent recurrences of various infections - urinary tract, intestinal, acute respiratory infections (prolonged cough may bother). These infections are usually difficult to treat.

The active form of chronic EBV is manifested by recurrence of symptoms of mononucleosis, the addition of fungal and bacterial infections, problems of the gastrointestinal tract - nausea, indigestion, pain in the abdomen.

To date, there are no specific drugs for the treatment of Epstein-Barr infection, as well as a standard treatment regimen.

How and with what to treat a particular patient, the attending physician decides, depending on the:

1. Forms and stages of the disease.
2. States of immunity.
3. Associated diseases.

In general, EBV therapy consists of:

• countering the virus - weakening its negative impact;
• strengthening the immune system;
• treatment of associated diseases;
• prevention of possible complications.

Epstein-Barr infection should be treated by an infectious disease specialist. But, if such a specialist is not available, you can contact a therapist or pediatrician.

You may need a referral for a consultation with a neurologist, cardiologist, rheumatologist, otolaryngologist, pulmonologist.

How justified is the appointment of antiviral drugs, the attending physician decides.

Depending on the severity of the infection, it is possible to use:

The modern approach in medicine assumes that antiviral drugs should be prescribed in case of a complicated course of the disease, generalized by VIE.

If necessary, also appoint drugs with antiviral and immunomodulatory effects:

• Isoprinosine;
• Cycloferon;
• Interferon;
• Ingaron;
• Viferon;
• Groprinosin.

In case of exacerbation of chronic EBV infection and for recovery after infectious mononucleosis prescribed a number of immunoglobulins:

• Polygamy;
• Alphaglobin;
• Gammar-P;
• Pentaglobin.

EBV therapy is also used:

1. Antipyretic - Paracetamol, Nurofen, Ibuprofen.
2. Analgesics - Pentalgin, Tempalgin.
3. Corticosteroids - Dexamethasone, Prednisolone.
4. Local antiseptics - Ingalipt, Septolete, Kameton.
5. Antibiotics - Cefadox, Sumamed, Cefazolin, Lincomycin. Such funds for EBV are prescribed only if a bacterial infection has occurred against the background of a viral infection.

Any medicine is used with caution, taking into account the individual intolerance of the patient.

For some forms of Epstein-Barr infection, hospital treatment is recommended. But both in a medical institution and at home it is important to follow a number of rules:

• give up alcohol;
• avoid stress;
• since mononucleosis negatively affects the spleen and liver, a sparing diet is indicated (No. 5);
• drink plenty of fluids;
• exclude physical activity.

Folk remedies for VIEB are used as support for the main treatment. To soothe an inflamed throat, rinsing with decoctions of plantain, chamomile, and sage is suitable.

Drinks from rose hips, ginger, viburnum, with the addition of honey and lemon will help raise immunity. But the effectiveness of homeopathy in EBV has not been proven.

Respected by many parents, Dr. Komarovsky urges moms and dads not to dramatize this disease and its consequences.

According to the pediatrician, since it is impossible to get rid of the virus forever, then you need to calm down and live, realizing that the child's body gets used to fighting infections and developing immunity.

Evgeny Olegovich believes that EBV treatment should be symptomatic:

Children who do not suffer from pathologies of the immune system do not need antiviral drugs and immunostimulants, Yevgeny Komarovsky believes. In his opinion, the child's body is able to cope with the infection on its own.

Inpatient treatment is indicated only in cases where the disease is severe. At home, a sick baby needs to be watered more often, but you can’t force feed. The child himself will ask for food, but the dishes should be of a liquid consistency.

Dr. Komarovsky draws the attention of parents to the fact that in the acute form of EBV - infectious mononucleosis, doctors sometimes prescribe antibiotics of the penicillin group.

This happens when an infection is mistaken for a sore throat. But viral disease is not treated with antibiotics- this will not give an effect, besides, the child will have a rash.

Parents should be aware that with mononucleosis, unlike tonsillitis, children have nasal congestion and a runny nose.

CVEB-induced chronic fatigue syndrome cannot be cured by any vitamins and immunostimulants:

• the recovery process can be long, but it must be experienced;
• it is necessary to provide the child with proper rest and nutrition;
• often walk with the baby in the fresh air;
• and the main rule at the recovery stage is to limit contact with people so that a new infection does not get into a weakened body.

The specialist will add about the duration and treatment regimen for the Epstein-Barr virus (EBV) in children and adults:

If during the bearing of a child, the expectant mother became infected with the Epstein-Barr virus for the first time, the consequences of infection may be different, depending on the state of her immune system:

1. In a woman with strong immunity, the disease will be asymptomatic or symptoms of SARS will appear.
2. With a weakened immune defense of the body in pregnant women, infectious mononucleosis occurs.

The active course of the disease is dangerous for both mother and fetus.:

• there is a risk of miscarriage and premature birth;
• there is a risk of damage to the central nervous system and organs of vision of the unborn child;
• Newborns may have jaundice and respiratory problems.

Treatment of the Epstein-Barr virus is carried out with minimal risk to the health of expectant mothers and their babies. Possible appointment:

1. Antiviral agents, if the course of the disease is complicated.
2. Antibiotics if a bacterial infection is present.
3. Antipyretics and painkillers - as needed.
4. Cytostatics, interferon, immunoglobulins.
5. corticosteroid hormones.

Usually treatment lasts from 2 to 3 weeks. The latent form of the virus does not require specific therapy.

Disease prevention

So far, no one has been able to create a vaccine against EBV.

One hundred percent prevent infection is impossible - the virus is too common. So, you need to help your body resist the disease in order to transfer it as easily as possible.

BUT a strong immune system will help:

• you need to harden the body, often be in the fresh air;
• moderate but regular physical activity, walking, swimming, sports activities are useful;
• it is important to eat a balanced diet, excluding junk food, to observe the drinking regimen;
• the need for taking vitamins should be discussed with your doctor.

Contribute to disease prevention:

• personal hygiene;
• exclusion of close contacts with patients with EBV.

The following video will also tell about preventive measures for children:

Look for the main symptoms and signs, causes of occurrence, as well as treatment methods in this material.

Symptoms, treatment, photos of herpes sore throat in children are presented in the publication. Find out more!

Definition of the concept and description of the Epstein-Barr virus

Epstein-Barr virus infection is an acute or chronic human infectious disease caused by the Epstein-Barr virus from the herpes virus family (Herpesviridae). It has the peculiarity of damage to the lymphoreticular and immune systems of the body (1.6).

Epstein-Barr virus (EBV) is a DNA-containing virus from the Herpesviridae family (gamma-herpesviruses), is a type 4 herpesvirus.

Epstein-Barr virus is a low-contagious infection, since many have antibodies to this virus

Particular attention is drawn to such a property of the Epstein-Barr virus as "lifelong persistence in the body." Due to the infection of B-lymphocytes, in which it is present for life, these cells of the immune system acquire the ability to unlimited life activity (the so-called "cellular immortality"), as well as the ability to constantly synthesize heterophile antibodies (or autoantibodies, for example, antinuclear antibodies, rheumatoid factor, cold agglutinins) (6).

The virus has a spherical shape with a diameter of up to 180 nm. The structure consists of 4 components: core, capsid (the outermost shell), inner and outer shell.

The core includes DNA, consisting of two strands, including up to 80 genes. A virus particle on the surface also contains dozens of glycoproteins necessary for the formation of virus-neutralizing antibodies.

The virus particle contains the following specific antigens (proteins required for diagnosis):

• capsid antigen (VCA);
• early antigen (EA);
• nuclear or nuclear antigen (NA or EBNA);
• membrane antigen (MA).

Significance, the timing of their appearance in various forms of EBVI is not the same and has its own specific significance in terms of assessing the phase of the course of the disease during a laboratory examination of a patient (6).

The Epstein-Barr virus is relatively stable in the external environment, it quickly dies when dried, exposed to high temperatures, as well as the action of common disinfectants.

In biological tissues and fluids, the Epstein-Barr virus is able to feel favorably when it enters the bloodstream of a patient with EBVI, brain cells of a completely healthy person, cells during oncological processes (lymphoma, leukemia, and others).

The sources of infection in Epstein-Barr virus infection are the patient with a clinically pronounced form and the virus carrier.

The patient becomes contagious in the last days of the incubation period, the initial period of the disease, the height of the disease, as well as the entire period of convalescence (up to 6 months after recovery), and up to 20% of those who have been ill retain the ability to periodically secrete the virus (that is, remain carriers) (6.7) .

Mechanisms of Epstein-Barr virus infection:

• it is aerogenic (airborne transmission), in which saliva and mucus from the oropharynx are contagious, which is released when sneezing, coughing, talking, kissing;
• a contact mechanism (contact-household transmission), in which salivation of household items (dishes, toys, towels, etc.) takes place, however, due to the instability of the virus in the external environment, it is unlikely to be important;
• the transfusion mechanism of infection is allowed (during the transfusion of infected blood and its preparations);
• alimentary mechanism (water-food transmission route);
• currently proven transplacental mechanism of infection of the fetus with the possibility of congenital Epstein-Barr virus infection (1,6).

Despite the variety of ways of infection, there is a good immune layer among the population - up to 50% of children and 85% of adults are infected with this virus. Many become infected from carriers without developing symptoms of the disease, but with the development of immunity. That is why it is believed that for the environment of a patient with an Epstein-Barr virus infection, the disease is not very contagious, since many already have antibodies to the Epstein-Barr virus.

Infectious mononucleosis

Epstein-Barr virus can cause acute infectious process, chronic forms of infection and asymptomatic carriage (7).

The classic manifestation of an acute Epstein-Barr virus infection is infectious mononucleosis - an acute viral disease characterized by fever, damage to the pharynx, lymph nodes, liver, spleen, and peculiar changes in the clinical blood test.

The clinical picture of the disease was first described in 1885 by N. F. Filatov and was considered as an idiopathic inflammation of the lymph glands.

The association of the disease with the Epstein-Barr virus was proven in the late 1960s (1, 10). The disease develops mainly in young adults, but it can occur in all patients from children to the elderly. The incubation period is 5-12 days, but can reach 30-45 days, as a rule, it is not possible to associate the disease with contact with the patient.

The disease is accompanied by an increase in temperature to 38-39 degrees, although in some patients the disease occurs at normal temperature. The duration of the febrile period can reach 1 month or more.

Enlargement of lymph nodes (viral lymphadenitis) is the most constant symptom of the disease. Earlier than others, and most clearly, the lymph nodes in the head and neck are enlarged, a bilateral enlargement of the lymph nodes is characteristic, and rarely, unilateral lesions.

Less often, axillary, inguinal, ulnar lymph nodes, lymph nodes of the mediastinum and abdominal cavity are involved in the process. The most striking and characteristic sign of infectious mononucleosis is the defeat of the pharynx, which develops from the first days of the disease, sometimes later.

Angina with infectious mononucleosis can be of various shapes and in some cases even be accompanied by the formation of fibrinous films resembling diphtheria. A pronounced increase in the palatine tonsils, the presence of small hemorrhages (petechiae) on the back of the pharynx, which distinguishes the disease from other viral pharyngitis, but not from streptococcal tonsillitis, may be accompanied by swelling of the palatine uvula. Often, the nasopharyngeal tonsil is involved in the process, in connection with which patients develop difficulty in nasal breathing, nasality and snoring in their sleep.

At elevated temperature and enlarged lymph nodes, first of all, you need to consult a therapist

Enlargement of the liver and spleen are natural manifestations of the disease. Liver dysfunction - moderate icterus of the sclera, changes in the biochemical analysis of blood are more typical for older people. Rarely (in 3-25% of patients), a skin rash may occur - maculopapular, hemorrhagic, roseolous, prickly heat-type rash (1,10).

There are characteristic changes in the clinical analysis of blood - moderate leukocytosis, a decrease in the number of neutrophils, lymphocytosis and the appearance of specific cells - atypical mononuclear cells that appear on the 2nd-3rd day of illness and last up to 4 weeks (1.10).

To diagnose the disease, in addition to the general and biochemical blood tests, specific serological diagnostics are used - the determination of IgG and IgM antibodies to the capsid proteins of the Epstein-Barr virus.

The so-called heterophile antibodies are also determined - autoantibodies that are synthesized by infected B-lymphocytes. These include antinuclear antibodies, rheumatoid factor, cold agglutinins.

For treatment, antiviral drugs from the group of acyclic nucleosides, interferon preparations and interferon inducers are used. Symptomatic therapy of existing disorders of internal organs is carried out.

Rarely, with a pronounced increase in the tonsils, the occurrence of a number of complications, glucocorticosteroids are used.

Hospitalization of the patient is carried out according to clinical indications.

For this disease, no anti-epidemic measures are taken, and specific prevention has not been developed (1,7, 8, 10).

Chronic forms of Epstein-Barr virus infection

Chronic EBV infection is formed no earlier than 6 months after an acute infection, and in the absence of acute mononucleosis in history - 6 or more months after infection. Often, a latent form of infection with a decrease in immunity turns into a chronic infection. Chronic EBV infection can occur in the form of: chronic active EBV infection, EBV-associated hemophagocytic syndrome, atypical forms of EBV (recurrent bacterial, fungal and other infections of the digestive system, respiratory tract, skin and mucous membranes) (7).

Chronic active EBV infection is characterized by a long course and frequent relapses.

Symptoms

• weakness,
• fatigue,
• excessive sweating,
• prolonged low temperature up to 37.2-37.5 °,
• skin rashes,
• sometimes articular syndrome,
• pain in the muscles of the trunk and limbs,
• heaviness in the right hypochondrium,
• feeling of discomfort in the throat,
• slight cough,
• nasal congestion,
• some patients have neurological disorders - causeless headaches, memory impairment, sleep disturbances, frequent mood swings, a tendency to depression, patients are inattentive, decreased intelligence.
• Often, patients complain of an increase in one or a group of lymph nodes, an increase in internal organs (spleen and liver) is possible.

Along with such complaints, when questioning the patient, the presence of recent frequent colds, fungal diseases, and the addition of other herpetic diseases is revealed. For example, herpes simplex on the lips or genital herpes and more.

In confirmation of clinical data, there will also be laboratory signs (changes in blood, immune status, specific tests for antibodies).

Hemophagocytic syndrome associated with EBV manifests itself in the form of anemia or pancytopenia (decrease in the composition of almost all blood elements associated with inhibition of hematopoietic sprouts).

Patients may experience fever (wave-like or intermittent, in which both sharp and gradual rises in temperature are possible with recovery to normal values), swollen lymph nodes, liver and spleen, abnormal liver function, laboratory changes in the blood in the form of a decrease in both red blood cells and and leukocytes and other blood elements.

Erased (atypical) forms of Epstein-Barr virus infection: most often it is a fever of unknown origin lasting for months, years, accompanied by an increase in lymph nodes, sometimes joint manifestations, muscle pain; another option is secondary immunodeficiency with frequent viral, bacterial, fungal infections (7)

Considering all of the above, patients with prolonged fever or lymphadenopathy are referred by doctors for a consultation with an allergist-immunologist to exclude erased forms of the Epstein-Barr virus infection. However, the consultation of this specialist is necessary only after the exclusion of other causes that have a more serious prognosis (oncological diseases, tuberculosis, etc.) or are more common (chronic foci of bacterial infection).

In the presence of a prolonged fever or enlargement and soreness of the lymph nodes, the examination should begin with a consultation with a therapist (5).

One of the forms of chronic Epstein-Barr virus infection is the so-called "chronic fatigue syndrome" - a condition characterized by constant fatigue that does not go away after a long and proper rest.

Patients with chronic fatigue syndrome are characterized by muscle weakness, periods of apathy, depressive states, mood lability, irritability, and sometimes outbursts of anger and aggression.

Patients are lethargic, complain of memory impairment, decreased intelligence. Patients do not sleep well, and both the falling asleep phase is disturbed, and intermittent sleep is observed, insomnia and drowsiness during the day are possible. At the same time, vegetative disorders are characteristic: trembling or tremor of the fingers, sweating, periodically low temperature, poor appetite, joint pain.

The disease can develop at any age, women predominate among patients. At risk are workaholics, people with increased physical and mental work, people who are both in acute stressful situations and in chronic stress.

There is a high prevalence of the syndrome among ethnic and racial minorities and people with low socioeconomic status.

Unfortunately, even foreign publications note an insufficiently serious attitude to the patient's complaints in this condition and the non-recognition of chronic fatigue syndrome as a real problem caused by a biological process (7, 11).

To diagnose chronic forms of Epstein-Barr virus infection, in addition to the above-mentioned serological tests, the determination of virus DNA by PCR in blood, saliva, oropharyngeal swabs and other biological materials, and the assessment of immune status are used (8, 9).

Complications and severe forms of diseases caused by the Epstein-Barr virus

Acute and chronic forms of Epstein-Barr virus infection can lead to serious complications. In addition, the infection itself, under certain circumstances, can occur in the form of diseases with a serious prognosis for life and health.

So with infectious mononucleosis, an excessive increase in the palatine tonsils is possible, which can lead to obstruction of the upper respiratory tract, rupture of the spleen, in rare cases - encephalitis, lymphoma.

In children, Epstein-Barr virus infection can lead to the development of a fulminant form of hepatitis with the development of acute liver failure, but the incidence of this complication is very low (13).

For elderly patients, liver damage from infectious mononucleosis can lead to cholestasis (10).

In countries with a tropical and subtropical climate, Epstein-Barr virus infection can cause the development of malignant neoplasms (Burkitt's lymphosarcoma - aggressive B-cell, nasopharyngeal carcinoma, and others), often with metastases to various organs (6, 15).

In countries with a temperate climate, in addition to the infectious mononucleosis and chronic forms of infection described above, Epstein-Barr virus can cause the development of autoimmune diseases (rheumatic diseases, vasculitis, ulcerative colitis) (6).

A rare complication of Epstein-Barr virus infection is viral arthritis, which manifests itself as polyarthralgia or, much less commonly, monoarthritis of the knee joint, the formation of a Baker's cyst with possible rupture (14).

Effect of Epstein-Barr virus on the immune system

The defeat of the immune system by the Epstein-Barr virus is an integral part of the pathogenesis of the Epstein-Barr virus infection.

Epstein-Barr virus has been found to have a large set of genes that enable it to elude the human immune system to some extent. In particular, it produces proteins - analogues of a number of human interleukins and their receptors that change the immune response.

During the period of active reproduction, the virus produces interleukin - 10-like protein, which suppresses T-cell immunity, the function of cytotoxic lymphocytes, macrophages, disrupts all stages of the functioning of natural killers (that is, the most important antiviral defense systems).

Another viral protein (BI3) can also suppress T-cell immunity and block the activity of killer cells (through downregulation of interleukin-12).

Another property of the Epstein-Barr virus, like other herpes viruses, is its high mutability, which allows it to avoid the effects of specific antibodies (produced against the virus before its mutation) and cells of the host's immune system for a certain time (7). Thus, the reproduction of the Epstein-Barr virus in the human body can be the cause of the occurrence, manifested by the addition of other herpetic, bacterial and fungal infections. For example, herpes labialis, genital herpes, thrush, inflammatory diseases of the upper respiratory tract and gastrointestinal tract.

On the other hand, the course of this infection in patients with secondary immunodeficiency contributes to a more severe course of the infection, the development of chronic forms, and the occurrence of complications.

Classical examples of severe forms of Epstein-Barr virus infection in patients with secondary immunodeficiency occur in HIV-infected patients. In this group of patients, the infection occurs in the form of specific forms:

• "Hairy leukoplakia" of the tongue and oral mucosa, in which whitish folds appear on the lateral surfaces of the tongue, as well as on the mucous membrane of the cheeks, gums, which gradually merge, forming white plaques with a heterogeneous surface, as if covered with furrows, cracks, erosive surfaces. As a rule, there is no pain in this disease.
• Lymphoid interstitial pneumonia, which is a polyetiological disease (there is also a connection with the Epstein-Barr virus infection) and is characterized by shortness of breath, an unproductive cough against the background of temperature and symptoms of intoxication, as well as progressive weight loss in patients. The patient has enlarged liver and spleen, lymph nodes, enlarged salivary glands. X-ray examination of bilateral lower lobe interstitial foci of inflammation of the lung tissue, the roots are expanded, non-structural.
• In persons with severe immune deficiency, generalized forms of EBV infection may occur with damage to the central and peripheral nervous systems (development of meningitis, encephalitis, cerebellar ataxia, polyradiculoneuritis), as well as damage to other internal organs (development of myocarditis, glomerulonephritis, lymphocytic interstitial pneumonitis, severe forms of hepatitis). Generalized forms of EBV infection are often fatal (7).

Also, Epstein-Barr virus infection can cause lymphoproliferative diseases in transplanted organs after transplantation and subsequent immunotherapy in individuals who have not been exposed to Epstein-Barr virus before transplantation and who do not have immunity to it at the time of intervention (12).

Epstein-Barr virus infection and pregnancy

In recent years, a transplacental mechanism of infection of the fetus has been proven and a congenital Epstein-Barr virus infection has been described that occurs in the fetus during the primary infection of a pregnant woman with the Epstein-Barr virus.

It has been established that the risk of it in primary EBVI during pregnancy is 67%, with reactivation - 22%.

It is characterized by possible damage to the internal organs of the child in the form of interstitial pneumonia, encephalitis, myocarditis and others. Possible prematurity, premature birth.

In the blood of a born baby, both maternal antibodies to the Epstein-Barr virus (IgG to EBNA, VCA, EA antigens) and a clear confirmation of intrauterine infection - the child's own antibodies (IgM to EA, IgM to the VCA antigens of the virus) can circulate (7).

Effect of Epstein-Barr virus on the course of allergic diseases

Since the immune system is involved in the pathogenesis of Epstein-Barr virus infection, the virus may influence the occurrence of a number of allergic diseases.

A classic example of the debut of an allergic disease in Epstein-Barr virus infection is the occurrence of a generalized one when taking penicillin antibiotics for the treatment of tonsillitis caused by the Epstein-Barr virus.

The appearance of a rash on aminopenicillins is not an IgE-dependent reaction, so the use has neither a preventive nor a therapeutic effect. After recovery, repeated reactions to penicillin antibiotics may not be observed. Perhaps the development of multiform exudative erythema, in severe cases - Stevens-Johnson syndrome and. The latter cases are characterized by an extremely severe course and a high risk of death (2). Therefore, self-administration of penicillin antibiotics for angina without a preliminary medical examination and a general blood test is very dangerous.

In recent years, the possible influence of Epstein-Barr virus on the occurrence of chronic relapsing (4) has been studied. The possibility of developing exudative erythema multiforme against the background of Epstein-Barr virus infection has been shown without regard to medication (16).

The study of the Epstein-Barr virus in recent years has radically changed the idea of ​​​​everything related to health. It exhausts the human body in full, causing a variety of and sometimes unrelated pathologies.

It turned out that the Epstein-Barr virus, from the category of those diseases that no one had previously considered diseases, causes significant harm to humans, and is also the root cause and trigger of many unpleasant and even dangerous health problems.

This infection is not amenable to complete extermination and continues to spoil a person's life from the moment it enters the body, causing the most unpredictable consequences. According to statistics, the Epstein-Barr virus lives in the body of 60% of children under the age of 5 years and in almost 100% of the adult population of the planet Earth.

What is this disease?

This virus is from the herpetic family, namely herpes type 4. The Epstein-Barr virus strikes at the immune system, the central nervous system, as well as all human systems and organs.

Penetrating through the mucous membranes of the mouth and nose, it enters the bloodstream and spreads throughout the body. That is why EBV is very diverse and can have various manifestations, ranging from mild discomfort to extremely serious health problems.

There are cases when the carrier of the Epstein-Barr virus never suffers from its manifestations. Many famous doctors consider him the culprit of all existing diseases among mankind.

In medical literature, for better visual perception, the Epstein-Barr virus is abbreviated VEB or WEB.

Disease prevalence

WEB is one of the most common viruses in the world among the population. According to WHO (World Health Organization) statistics, 9 out of 10 people are carriers of this herpes infection.

Despite this, his research began quite recently, so it cannot be said that he is well studied. Babies often become infected with EBV in utero or in the first few months after birth.

Recent studies show that it is the Epstein-Barr virus that is the provoking factor in other pathologies that cannot be completely cured.

Namely:

• Rheumatoid polyarthritis;
• Autoimmune thyroidin;
• Diabetes.

However, the infection does not lead to diseases on its own, but interacting with other viral lesions.

If a person is prone to chronic fatigue syndrome and it seems to him that he does not get enough sleep, there is a lack of vitamins in the body, or a reaction to weather conditions, then it is possible that it is the Epstein-Barr virus that provokes all of the above symptoms.

Often it is the cause of the decline in vitality.

Ways of infection

Sources of EBV infection are:

• Those who have it in active form since the last days of the incubation period;
• People who contracted the virus more than six months ago;
• Any carrier of the virus is a potential source of infection for everyone with whom it comes into contact.

The most vulnerable categories for potential infection:

• Women during pregnancy;
• HIV positive;
• Children under the age of 10 years.

WEB transmission paths:

How does infection occur in adults?

Stages of infection:

Symptoms of the disease

Most often, people become infected with EBV during early childhood (childhood or adolescence), because it has many routes of transmission through contact with an infected person.

In adults, the Epstein-Barr virus is reactivated and does not have acute symptoms.

Symptoms of primary infection:

The chronic course of the Epstein-Barr virus is characterized by a long-term manifestation of symptoms of various types and levels of intensity.

Namely:

• Rapid fatigue and general weakness;
• Strong sweating;
• Difficulty in nasal breathing;
• Pain in the joints and muscles;
• Periodic mild cough;
• Persistent headaches;
• Aching pain in the right hypochondrium;
• Mental disorders, emotional instability, depressive states, deterioration in concentration and memory lapses;
• sleep disorders;
• Inflammatory diseases of the respiratory tract and gastrointestinal disorders.

Photos of the manifestations of the virus:

Why is the Epstein-Barr virus dangerous in adults?

With a single infection, Epstein-Barr remains forever in the human body. In good health, the course of the infection has no pronounced symptoms or with minimal manifestations.

When the immune system of an infected person is weakened by other factors, then, as a rule, the Epstein-Barr virus affects the following organs and systems:

• Mucous membranes of the upper respiratory tract and ENT organs;
• epithelial cells;
• Nerve fibers;
• macrophages;
• NK cells;
• T-lymphocytes.

The Epstein-Barr virus is extremely dangerous for HIV-positive people. Infection with them can lead to death for them.

What diseases can provoke the Epstein-Barr virus in adults?

Complicated consequences:

Development of oncopathologies:

• Lymphoma;
• Lymphogranuloma;
• Gland cancer, neoplasms of ENT organs;
• Cancer of the gastrointestinal tract.

Epstein-Barr cells are found in most biopsy samples along with malignant cells. It is not the main cause of cancerous tumors, but acts as a provoking factor along with other pathologies.

Diseases of the autoimmune system:

• Diabetes;
• Multiple sclerosis;
• Arthritis.

The Epstein-Barr virus, along with other cell-damaging viruses, leads to impaired immune responses. Immunity perceives its own cells as enemy cells and begins to attack them, thus damaging them.

Immunity disorders:

Diseases of the circulatory system:

Among other things, the presence of EBV can provoke the development of bacterial and fungal diseases. As well as damage to the central nervous system and a decrease in the general tone of the body, as a result of which chronic fatigue syndrome develops.

Diagnostic Measures

If EBV infection is suspected, the patient turns to a general practitioner who conducts an on-site examination and analysis of the patient's complaints.

Research methods to detect the Epstein-Barr virus:

• ELISA- allows you to determine the presence of antibodies to various Epstein-Barr antigens, this helps to identify the form of infection: chronic, acute, asymptomatic;
• PCR- using this method, it is possible to find out if a person has a virus. It is used for children whose immature immune system does not produce antibodies to EBV. Also, this method is used for clarifying purposes in case of doubtful ELISA results.

Decryption of PCR analyzes:

• The main criterion makes it possible to find out about the presence of a virus in the body;
• The result can be positive or negative;
• At the same time, a positive result does not in any way indicate the presence of an acute or chronic process, despite the presence of EBV in humans;
• A positive test result means that the patient has already contracted EBV;
• With a negative analysis, it can be said with confidence that EBV has never penetrated into the human body.

Explanation of ELISA analyzes:

• For all antigens, ELISA, in addition to a positive or negative result, is still doubtful;
• In case of a doubtful result, the analysis must be retaken after 7-10 days;
• In the case of a positive result, the Epstein-Barr virus is present in the body;
• According to the results, which antigens were detected, one can judge the stage of infection (asymptomatic, chronic, acute).

This analysis allows you to determine the presence of an antigen in the human body:

• lgG to VCA capsid antigen- in case of a negative result, the human body has never encountered EBV. But at the same time, there may be the presence of EBV cells in the body if the infection occurred 10 to 15 days ago. A positive result indicates the presence of the virus in humans. But he cannot say what stage the infection is in and when exactly the infection occurred. Results:
  • from 0.9 to 1 - the analysis is required to be retaken;
• gG to EBNA nuclear antigen- with a positive result, a person is immune to EBV, but this does not indicate a chronic course of the infection, with a negative analysis, a virus of this type has never entered the patient's body. Results:
  • up to 0.8 - the result is negative;
  • from 1.1 - the result is positive;
  • from 0.9 to 1 - the analysis requires a retake;
• lgG to EA early antigen- in the case when lgG to the anti-lgG-NA nuclear antigen is negative, then the infection has occurred recently, is the primary infection. Results:
  • up to 0.8 - the result is negative;
  • from 1.1 - the result is positive;
  • 0.9 -1 - the analysis requires a retake;
• lgM to VCA capsid antigen- with a positive result, we are talking about a recent infection (up to three months), as well as reactivation of the infection in the body. A positive indicator of this antigen can be present from 3 months to a year. Close-to-positive anti-lgM-VCA may also indicate a chronic infection. In the acute course of Epstein-Barr, this analysis is looked at in dynamics so that one can judge the adequacy of treatment. Results:
  • up to 0.8 - the result is negative;
  • from 1.1 and above - the result is positive;
  • from 0.9 to 1 - the analysis requires a retake.

Deciphering the analysis on VEB

To accurately decipher the result of a laboratory test for EBV, it is advisable to use the table:

Stages of infection	anti-IgG-NA	anti-IgG-EA	anti-IgG-VCA	anti-IgM-VCA
No virus in the body	—	—	—	—
Primary infection	—	—	—	+
Primary infection in the acute stage	—	++	++++	++
Recent infection (less than six months)	—	++	++++	+
Infection happened in the past	+	-/+	+++	—
chronic course	-/+	+++	++++	-/+
The virus is in the stage of reactivation (exacerbation)	-/+	+++	++++	-/+
The presence of tumors provoked by EBV	-/+	+++	++++	-/+

Treatment Methods

VEB, like the rest, cannot be completely cured. EBV cells remain in the body for life, and their influence is controlled by the immune system. When immunity decreases, the virus becomes active.

General principles of treatment

These include the following basic principles:

• Infection activity is blocked by antiviral drugs and stimulation of the general resistance of the body. With all its capabilities, even modern medicine cannot help kill all the cells of the Epstein-Barr virus, or completely remove them from the body;
• Infectious mononucleosis being treated in a hospital or at home under the supervision of a specialist;
• Additionally, the patient is prescribed bed rest and a balanced diet. with limited physical activity. The patient is recommended to drink plenty of water, include fermented milk products in the diet, and eat enough protein. Exclusion of products that can cause allergic reactions;
• Chronic fatigue syndrome will help neutralize:
  • Compliance with sleep and rest;
  • Balanced diet;
  • Vitamin complexes;
  • Moderate physical activity;
• Drug treatment of EBV is complex and aimed at strengthening immunity, removal of symptomatic manifestations, reduction of their aggressiveness. It also includes preventive measures to prevent complications.

Medical treatment

For drug therapy, the following drugs can be prescribed.

Immunostimulating drugs - funds are used during periods of exacerbation of EBV and for recovery from infectious mononucleosis:

• Arbidol;
• Viferon;
• Interferon;
• Groprinasin;
• Laferobion.

Antiviral drugs - used in the treatment of complications caused by EBV:

• Gerpevir;
• Valvir;
• Valtrex.

Antibacterial drugs- are prescribed in cases of complications with bacterial infections, such as pneumonia, etc. Any antibacterial drugs can be used, except for penicillins.

For example:

• Cefodox;
• Lincomycin;
• Azithromycin;
• Ceftriaxone.

Vitamin complexes are used for recovery after the acute stage of EBV, as well as for the prevention of complications:

• Duovit;
• Complivit;
• Vitrum.

Sorbents - needed to alleviate the manifestations of infectious mononucleosis. Contribute to the removal of toxic substances:

• White coal;
• Atoxil;
• Polysorb;
• Enterosgel.

Supportive drugs for the liver (hepatoprotectors) - help support the liver after an acute period of EBV:

• Karsil;
• Essentiale;
• Gepabene;
• Darsil.

- are used to prevent complications that EBV can cause:

• Ketotifen;
• Cetrin;
• Eden;
• Suprastin;
• Diazolin.

Means for the treatment of the oral cavity - are used in preventive measures for the sanitation of the oral cavity:

• Decatylene;
• Inglalipt;
• Chlorophyllipt.

Anti-inflammatory - relieve symptoms of fever and general symptoms of malaise:

• Paracetamol;
• Nurofen;
• ibuprofen;
• Nimesulide.

The exception is Aspirin.

Glucocorticosteroids - help to deal with severe complications:

• Dexamethosone;
• Prednisolone.

Drug treatment is prescribed by the attending physician on a strictly individual basis in each case. Uncontrolled intake of medications can be not only useless, but also dangerous.

To combat chronic fatigue, which is caused by the presence of the Epstein-Barr virus in the body, the patient is prescribed a treatment consisting of taking:

• multivitamins;
• antidepressants;
• Antiherpetic drugs;
• Cardiovascular;
• Preparations supporting the nervous system:
  • Instenon;
  • Enciphabol;
  • Glycine.

Folk methods of treatment

Folk remedies have a good effect in the fight against many diseases, the Epstein-Barr virus is no exception. Folk methods perfectly complement traditional methods of treatment for the acute course of the virus and for infectious mononucleosis.

They are aimed at strengthening the overall immune qualities, relieving inflammation and avoiding exacerbation of the disease.

Echinacea:

• Echinacea infusion perfectly strengthens the immune system and helps to avoid exacerbations;
• It should be consumed daily, 20 drops per glass of water.

Green tea:

Ginseng tincture:

• Ginseng tincture is just a storehouse for the defenses of the human body;
• It should be added to tea, about 15 drops per glass of drink.

The consequences of the Epstein-Barr virus during pregnancy

In the case of pregnancy planning, a number of tests are prescribed for future parents in preparation.

In this case, special attention is paid to infections.

They can influence the conception, the course of pregnancy and its favorable completion with the birth of a healthy child.

Among these infections, EBV is quite significant.

It belongs to the "TORCH" series:

• T - toxoplasmosis (toxoplasmosis);
• O - others (others): listeriosis, chlamydia, measles, syphilis, hepatitis B and C, HIV;
• R - (rubella);
• C - cytomegalovirus (cytomegalovirus);
• H - herpes (herpes simplex virus).

Infection of any of the TORCH infections during pregnancy can be detrimental to the child, cause serious health problems, deformities and pathologies incompatible with life.

That is why the passage of this analysis, through an unpleasant procedure - taking blood from a vein is mandatory. Timely therapy and constant monitoring of specialists can minimize the risks to the health of the fetus.

Such an analysis in the expectant mother is carried out not only during planning, but also twice during the gestation period, namely at 12 and 30 weeks.

According to the results of the analyzes, it is customary to draw conclusions regarding the following points:

• In the absence of antibodies to EBV in the blood it is required to actively observe and protect yourself from possible infection as much as possible;
• In the presence of positive immunoglobulin class M with the birth of a child, it is necessary to wait until the production of antibodies to this type of virus;
• Blood contains class G immunoglobulins- this means the presence of antibodies in the body of the expectant mother, which means that her immunity will protect the baby as much as possible.

When the Epstein-Barr virus is detected in an active acute form in a pregnant woman, this requires urgent hospitalization and treatment in a hospital under the supervision of specialists.

The measures are aimed at neutralizing the symptoms and supporting the immune system of the expectant mother by introducing antiviral drugs and immunoglobulins.

It is impossible to say for sure exactly how EBV will affect the course of pregnancy and the health of the fetus. However, it is reliably known that babies whose mothers carry the active form of the Epstein-Barr virus during pregnancy often have malformations.

At the same time, its presence in a woman's body in a primary or acute form does not exclude the birth of a healthy child, and its absence does not guarantee.

Possible consequences of EBV infection during pregnancy:

• miscarriages and stillbirths;
• premature birth;
• Developmental delay (IUGR);
• Complications in childbirth: sepsis, uterine bleeding, DIC;
• Violations in the development of the central nervous system of the baby. It is due to the fact that EBV affects nerve cells.

The prognosis is sick

As a rule, the entry of the Epstein-Barr virus into the body system is accompanied by various symptoms, from mild ailment to more serious manifestations.

With proper and adequate treatment and the normal state of the immune system, this virus does not cause significant damage to the body and does not interfere with the normal life of a person.

Prevention measures

Given the prevalence of EBV, and the ease of transmission, it is extremely difficult to protect yourself from infection.

Physicians around the world are faced with the task of inventing prophylactic agents to combat this virus, since it is a provoking factor in the development of oncological processes and other dangerous diseases.

Many research centers are now conducting clinical trials on this issue. It is impossible to protect yourself from infection, but you can get by with minimal consequences, having a strong body.

Therefore, EBV prevention measures are aimed at general strengthening of the protective functions of the human body:

The outcome of an acute infection caused by the Epstein-Barr virus (EBV) depends on the degree of immune system dysfunction and on hereditary predisposition to diseases associated with EBV. So, acute VEBI can end with the following options:

• Full recovery, as a result of which a person becomes simply a carrier of the virus;

Latent VEBI, in which a person does not get sick, but the virus multiplies in the body, and it becomes a source of infection for other people;

The development of oncological diseases;

Development of systemic autoimmune diseases.

Chronic VEBI can proceed according to the type of chronic infectious mononucleosis, in which the heart, kidneys and central nervous system are affected. In addition, chronic EBV can occur in an atypical form, which is characterized by a long and persistent increase in body temperature not higher than 37.5 o C and immunodeficiency, which provokes permanent and long-term bacterial, fungal and mixed infections of the respiratory tract, digestive tract, skin, etc. .d.

In addition to these consequences, the Epstein-Barr virus can lead to complications from various organs and systems. Currently, the following consequences of the Epstein-Barr virus, classified as complications, have been identified:

Dr. Komarovsky about the Epstein-Barr virus in children

The most common diseases among children are viral. The reason is that the child's immunity is still not strong enough, immature, and it is not always easy for him to withstand numerous threats from outside. But if a lot has been said and written about the flu and chickenpox, and everything is more or less clear to mothers with measles, then there are viruses in this world, the names of which alone bring sacred horror to parents.

One of these little-studied and very common is the Epstein-Barr virus. The well-known pediatrician and TV presenter Yevgeny Komarovsky is often asked about him.

What it is

EBV - Epstein Barr virus. One of the most widespread viruses on the planet. It was first found in tumor samples and described in 1964 by English professor Michael Epstein and his assistant Yvonne Barr. This is the herpes virus of the fourth type.

According to medical statistics, traces of the infection are found in the blood tests of half of children aged 5-6 years and in 97% of adults, and they themselves often do not even know about it, because in most people EBV goes unnoticed, without symptoms.

A child can become infected in different ways. Most often, EBV is excreted with body fluids, usually with saliva. For this reason, infectious mononucleosis caused by the virus is called "kissing disease".

Infection can occur during the transfusion of blood and its components, through things and toys shared with the patient, and the virus is also transmitted from an infected mother through the placenta to the fetus during pregnancy. EBV is easily spread by airborne droplets and from donor to recipient during bone marrow transplantation.

At risk are children under one year of age who actively learn the world around them through their mouths, trying to taste absolutely all objects and things that come to their fingertips. Another “problem” age is children from 3 to 6 years old who regularly attend kindergarten and have numerous contacts.

The incubation period is from 1 to 2 months, after which the children develop vivid symptoms that are characteristic of many viral infections.

However, the virus itself with a complex name is not so terrible, but the fact that its consequences are completely unpredictable. It can go completely unnoticed in one child, while in another it will cause the development of serious conditions and even oncological diseases.

Komarovsky on VEB

Evgeny Komarovsky urges parents not to create unnecessary hysteria around the Epstein-Barr virus. He believes that most children have already met with this agent in early childhood, and their immunity "remembered" him and is able to identify and resist.

And now let's listen to Dr. Komarovsky about infectious monoculosis.

The symptoms that make it possible to suspect EBV in a child are rather vague:

• Irritability, tearfulness, increased moodiness and frequent causeless fatigue.
• Slight or more noticeable enlargement of the lymph nodes. Most often - submandibular and behind the ear. If the infection is severe - throughout the body.
• Lack of appetite, digestive problems.
• Rash.
• High temperature (up to 40.0).
• Sore throat (as in sore throat and pharyngitis).
• Strong sweating.
• Slight enlargement of the liver and spleen. In a child, this may be manifested by aching pains in the abdomen.
• Yellowness of the skin. This symptom is extremely rare.

Komarovsky emphasizes that it is impossible to make a diagnosis on the basis of complaints alone and the presence of certain symptoms, since the child's condition will resemble a sore throat, enterovirus, and lymphogranulomatosis.

To confirm or refute the Epstein-Barr virus, laboratory diagnostics of the patient's blood samples is required, including biochemical analysis, serological testing, PCR, and it is also desirable to make an immunogram and conduct an ultrasound examination of the abdominal organs - the liver and spleen.

Komarovsky often compares VEB with chickenpox. Both diseases are more easily tolerated at an early age, the younger the person, the simpler the disease and the fewer consequences. The older the primary infection occurs, the greater the chances of severe complications.

Treatment according to Komarovsky

Evgeny Olegovich warns that the treatment with antibiotics of the penicillin group of one of the diseases associated with EBV - infectious mononucleosis can cause serious complications. Usually such an appointment is erroneous when the doctor takes mononucleosis for the usual bacterial tonsillitis. In this case, exanthema may develop.

Ordinary children who do not suffer from HIV and other severe disorders of the immune system, according to Yevgeny Komarovsky, do not need any antiviral treatment for mononucleosis caused by EBV, and even more so, they do not need to be urgently given immunostimulants. A well-known pediatrician is sure that the child's body is able to cope with this threat on its own.

If the course of the disease is severe, which, according to Komarovsky, is very rare, treatment in a hospital may be required. There, most likely, antiherpetic drugs will be used (quite justifiably).

In all other cases, symptomatic treatment is sufficient. It includes antipyretics (if the temperature is above 38.5-39.0), remedies that reduce sore throats (lozenges, antiseptics, rinses), ointments, gels and external sprays with antiseptics for severe skin rashes.

What is the Epstein-Barr virus, what are its symptoms in children and how is it treated, why is the disease dangerous?

Epstein-Barr virus is an infectious disease of herpetic origin, named after two scientists - researchers who discovered it in 1964, namely, Canadian professor and virologist Michael Epstein and Yvona Barr, who was his graduate student. Due to its nature, EBV is also called type 4 herpes. Recently, its prevalence (especially in children) has increased significantly and is up to 90% of the total population of the planet.

Epstein-Barr virus in children - what is it and why is it dangerous?

The Epstein-Barr virus is able to be present in the body for several years and not manifest itself in any way. In 25% of people who are its carriers, it can be throughout life. A weakened immune system can provoke its activation. After infection, a person develops permanent immunity to the disease in the future. At the same time, the virus continues to exist in the body, like its herpes counterparts.

According to statistics, children from a year and older are most susceptible to it, since it is during this period that babies begin to actively interact with other children. Until the age of three, the course of the disease often goes without severe symptoms and has much in common with a mild cold. The characteristic signs of the disease begin to appear in schoolchildren and adolescents.

The number of infected people after 35 years is minimal, and in cases where infection occurs, the pathology is not accompanied by its characteristic symptoms. This is due to the fact that adults already have immunity to the herpes group viruses.

As a result of the penetration of the virus into the body, acute infectious mononucleosis usually develops. However, this is not the only pathology that this type of pathogen can provoke. The Epstein-Barr virus is dangerous for the development of:

• respiratory infectious diseases of the respiratory tract;
• nasopharyngeal carcinoma, which is a malignant disease of the nasopharynx;
• Burkitt's lymphoma;
• multiple sclerosis;
• herpes;
• systemic hepatitis;
• lymphomas;
• tumors of the salivary glands and gastrointestinal tract;
• immune deficiency;
• Hodgkin's disease or lymphogranulomatosis;
• polyadenopathies;
• hairy leukoplakia of the oral cavity;
• chronic fatigue syndrome.

The table below shows the conditional classification of VEB according to certain criteria:

• congenital;
• acquired.

• typical, manifests itself as infectious mononucleosis;
• atypical, subdivided into erased, asymptomatic or affecting the internal organs.

• easy;
• average;
• heavy.

• spicy;
• protracted;
• chronic.

• active;
• inactive.

Ways of transmission of the virus and sources of infection

The main way in which viral pathogens are transmitted is through contact with an infected person or someone who is healthy but is a carrier of the virus. A person who has been ill with EBV, but is already absolutely healthy from a clinical point of view, in the period from 2 months to a year and a half after complete recovery and the disappearance of symptoms, is still isolating the infectious agent.

The largest accumulation of particles is in human saliva, which is exchanged by people kissing each other. It is for this reason that the Epstein-Barr virus is called the "kissing disease." In addition to close contact with a sick or carrier, there are other ways to become infected:

• in the process of blood transfusion - parenteral method;
• during transplantation;
• contact-household way, when people use the same utensils or household items and personal hygiene - this option is unlikely, because this type of herpes virus is unstable and does not live in the environment for a long time;
• airborne route, which is the most common;
• during sexual intercourse, if the causative agent of the disease is present on the mucous membrane of the genital organs.

As for children, they can be infected not only when communicating with a child infected with the virus, playing with his toys, but also in utero through the placenta. The virus can be transmitted to the baby during childbirth, when it passes through the birth canal.

Thus, the main source of the spread of the Epstein-Barr virus is an infected person. Of particular danger are those people in whom the disease is asymptomatic or in a latent form. The threat of infection from a patient with EBV becomes real a couple of days before the end of the incubation period.

Symptoms of the disease in a child

Due to the fact that most often the Epstein-Barr virus provokes the development of acute infectious mononucleosis, it is also characterized by the corresponding manifestations, which include four main signs of this disease:

• fatigue;
• increase in body temperature;
• the appearance of a sore throat;
• enlargement of the lymph nodes.

The incubation period of EBV can last from 2 days to 2 months. The active period of the disease is 1-2 weeks, after which a gradual recovery begins. The course of the pathological process occurs in stages. At the initial stage, an infected person develops a feeling of malaise, which can last about a week, and a sore throat. At this stage, the temperature indicators remain normal.

Epstein-Barr virus symptoms in children

At the next stage, there is a sharp increase in body temperature up to degrees. This symptom is accompanied by intoxication of the body and polyadenopathy - a change in the size of the lymph nodes, which reach 0.5 - 2 cm. The anterior and posterior cervical lymph nodes usually increase, but it is also possible to enlarge the lymph nodes located on the back of the head, under the jaw, above and below the collarbones, armpits, elbows, groin and thighs. On palpation, they become like dough, there are minor painful sensations.

In addition, the pathological process extends to the tonsils, which resembles the symptoms of angina. The tonsils swell, the back wall of the pharynx is covered with a purulent coating, nasal breathing is disturbed and a nasal voice appears.

In the later stages of development, the Epstein-Barr virus affects internal organs such as the liver and spleen. Liver damage is accompanied by hepatomegaly, its increase and heaviness in the right hypochondrium. Sometimes the urine becomes dark in color and mild jaundice occurs. The spleen also increases in size with EBV.

Another symptom of the Epstein-Barr virus, which is often observed in children, is a rash. The rash usually lasts up to 10 days. The degree of their severity is due to the use of antibiotics. They may look like:

Diagnostic methods

Symptoms of the Epstein-Barr virus have much in common with various diseases, including:

• cytomegalovirus;
• herpes no. 6;
• HIV infection and AIDS;
• anginal form of listeriosis;
• measles;
• viral hepatitis;
• localized diphtheria of the pharynx;
• angina;
• adenovirus infection;
• blood diseases.

For this reason, it is important to conduct a differential diagnosis in order to distinguish pathological processes from each other and prescribe the correct treatment. In order to accurately determine the causative agent of the virus, it is necessary to take blood, urine and saliva tests and conduct their laboratory tests.

Blood tests

An examination of blood for the presence of EBV in it is called an enzyme-linked immunosorbent assay (ELISA), during which the qualitative and quantitative indicators of antibodies to the infection are deciphered, which makes it possible to find out whether the infection is primary and how long ago it occurred.

Two types of antibodies can be detected in the blood:

1. Immunoglobulins or primary type M antibodies. Their formation occurs when the virus first enters the body or as a result of the activation of an infection that is in a "sleeping" state.
2. Immunoglobulins or secondary type G antibodies. They are characteristic of the chronic form of pathology.

According to the general blood test, the presence of mononuclear cells in the blood is also judged. This is an atypical form, which is acquired by 20-40% of lymphocytes. Their presence indicates infectious mononucleosis. Mononuclear cells can continue to be in the blood for several years after recovery.

PCR method

Epstein-Barr virus DNA is detected by examining the biological fluid of the body: saliva, mucus from the nasopharynx and oral cavity, cerebrospinal fluid, prostate secretion or secretions from the genital organs by PCR (polymerase chain reaction).

PCR is characterized by high sensitivity only during the period of reproduction of the pathogen of the virus. However, the method is effective in detecting herpes infections of types 1, 2 and 3. Sensitivity for herpes #4 is lower at only 70%. As a result, the PCR method of studying salivary secretions is used as a test that will confirm the presence of the virus in the body.

Features of the treatment of the disease in children

Epstein-Barr virus is a young and not yet fully understood disease, and treatments continue to improve. In the case of children, any medications are prescribed only after they have been carefully studied and all side effects have been identified.

Currently, antiviral drugs that would effectively fight this type of pathology and suit any age category of people remain at the development stage. Children can be prescribed a course of such funds in exceptional situations when the life of the baby is at risk.

The first thing that the parents of a child infected with EBV need to do is to provide healthy conditions for his body so that the baby can cope with the infection on his own, because he has the resources and defense mechanisms for this. Should:

• to cleanse the body of toxins with the help of sorbents;
• diversify the diet so that the baby receives good nutrition;
• provide additional support to the immune system by drinking vitamins that act as antioxidants, immunomodulators, cytokines and biostimulants;
• eliminate stress and increase the amount of positive emotions.

The second thing therapy comes down to is symptomatic treatment. In the acute form of the disease, it is necessary to alleviate the condition of the crumbs, reducing the severity of the symptoms present in him - give antipyretic drugs when raising a high body temperature or instill drops in the nose if there are breathing problems. With signs of a sore throat, it is required to gargle and treat the throat, and for hepatitis, drink drugs that support the liver.

Forecast of recovery and possible complications

In general, with proper and timely care, the acute form of the Epstein-Barr virus has a favorable prognosis. The person recovers and develops lifelong immunity to this type of herpes (or becomes an asymptomatic carrier). Otherwise, everything is determined by the severity of the course of the disease, its duration, the presence of complications and the development of tumor formations.

The main danger of this virus is that it spreads through the circulatory system of the human body, as a result of which, after a certain period of time, it is able to affect the bone marrow and any other internal organ.

The Epstein-Barr virus can cause the development of such serious and dangerous pathologies as:

• oncological diseases of various organs;
• pneumonia;
• immunodeficiency;
• damage to the nervous system that cannot be cured;
• heart failure;
• otitis;
• paratonsillitis;
• respiratory failure, which leads to the appearance of swelling of the tonsils and soft tissues of the oropharynx;
• hepatitis;
• rupture of the spleen;
• hemolytic anemia;
• thrombocytopenic purpura;
• liver failure;
• pancreatitis;
• myocarditis.

Another possible consequence of type 4 herpes infection is hemophagocytic syndrome. It is caused by an infection of T-lymphocytes, as a result of which blood cells, namely red blood cells, platelets and white blood cells, are destroyed. Anemia, hemorrhagic rash and problems with blood clotting are added to the known symptoms, which, in turn, is fraught with a fatal outcome.

The Epstein-Barr virus also negatively affects the functioning of the entire immune system. As a result of the inability of the body to recognize its own tissues, various autoimmune pathologies begin to develop, including:

• chronic glomerulonephritis;
• rheumatoid arthritis;
• autoimmune hepatitis;
• systemic lupus erythematosus;
• Sjögren's syndrome.

Among the oncological diseases, the impetus for the development of which EBV can become, there are:

1. Burkitt's lymphoma. Tumor formations affect the lymph nodes, the upper or lower jaw, ovaries, adrenal glands and kidneys.
2. Nasopharyngeal carcinoma. The localization of the tumor is the upper part of the nasopharynx.
3. Lymphogranulomatosis. The main signs are an increase in lymph nodes of different groups, including retrosternal and intra-abdominal, fever and weight loss.
4. Lymphoproliferative disease. This is a malignant proliferation of cells of the lymphoid tissue.

Prevention of EBV in a child

To date, there are no specific preventive measures aimed at preventing Epstein-Barr virus pathogens from entering the body and their reproduction. First of all, it concerns vaccination. It is not carried out, since the vaccine has not yet been developed. Its absence is due to the fact that the proteins of the virus vary greatly in their composition - this is affected by the stage of development of the pathology, as well as the type of cells where pathogenic bacteria multiply.

Despite the fact that in the vast majority of cases of infection with this type of virus, the result of proper treatment is recovery, pathology is dangerous for its complications. In view of this, it is still necessary to think about any possible preventive measures. The main method of prevention is reduced to a general strengthening of immunity, because it is as a result of its decrease that activation of the disease can occur.

The normal functioning of the immune system in an adult or a child can be maintained in the simplest and most reliable way by following a healthy lifestyle, which includes:

1. Complete nutrition. The diet should be varied, providing a person with vitamins and useful minerals.
2. hardening. Reasonable tempering procedures are an effective way to improve health and immunity.
3. Physical activity. Movement is life, and in order for the body to fully function, it must be regularly maintained in good shape, play sports or take regular walks in the fresh air. It is important not to sit at home at the computer or in front of the TV all the time.
4. Reception of immunomodulators of plant origin. Examples of such drugs are Immunal and Immunorm. According to the instructions, they are taken 20 drops three times a day. They stimulate immune reactions and activate the regeneration of the mucous membranes of various organs and cavities in the human body. You can turn to folk remedies, namely, to herbal preparations.

Prevention of the Epstein-Barr virus in childhood consists not only in strengthening immunity, but also in minimizing the possibility of becoming infected by contact and household contact when communicating with other children. To do this, it is necessary from an early age to teach the child to follow the basic rules of personal hygiene, including washing hands after walking and before eating, and other sanitary procedures.

Signs and symptoms of the Epstein-Barr virus in children: general information about the disease and a selection of treatments

Due to weakened immunity, children suffer from various diseases much more often than adults. One of the causative agents of ailments is the Epstein-Barr virus, in most cases it provokes mononucleosis. The infection does not pose a particular danger to the life of the baby; specific treatment is required only in advanced cases complicated by HIV infection.

The virus was discovered relatively recently, poorly understood, but doctors know several features of the diseases that are caused by the pathogen. Young parents need to know the characteristic symptoms of pathology, what needs to be done in such a situation.

general information

The Epstein-Barr virus was discovered in 1964. As a result of research, the virus was assigned to the group of herperovirus, it is widely distributed among the world's population. According to statistics, about 50% of eighteen-year-olds are carriers of the virus. The situation is similar with children older than five years. Babies up to a year get sick very rarely, along with breast milk, the baby receives mother's antibodies (passive immunity), which protect the child's body from infection.

The main risk group is babies older than one year. They actively communicate with other children, gradually move from breastfeeding to good nutrition. It is worth noting that in children under three years of age, infection with the virus is almost asymptomatic, reminiscent of the common cold.

As a result of infection, the pathogen ensures the formation of stable immunity in the child, the virus itself is not destroyed, it continues to exist without causing any discomfort to its owner. However, this situation is typical for all types of herpes virus.

The Epstein-Barr virus is quite resistant to the environment, but it quickly dies when exposed to high temperatures, the action of disinfectants, and drying. The causative agent, when it enters the child's body, feels great in the patient's blood, brain cells, and in case of oncological diseases - lymph. The virus has a particular propensity to infect favored cells (lymphatic system, immune system, upper respiratory tract, digestive system).

The causative agent can provoke an allergic reaction, in 25% of sick children, angioedema, rashes on the body of the crumbs are noted. Particular attention should be paid to the special property of the virus - a lifetime stay in the body. Infection of the immune system gives cells an unlimited ability for active life, constant synthesis.

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Ways of transmission and infection

The source of the virus is an infected person. The patient becomes dangerous to others in the last days of the incubation period. Although a small amount of the pathogen is released at the beginning of the course of the disease, the period of its course, even six months after recovery. About 20% of all patients become carriers of the virus, which is dangerous to others.

Epstein-Barr virus transmission routes:

• airborne. Mucus and saliva secreted from the nasopharynx poses a danger to others (through coughing, kissing, talking);
• contact-household. Infected saliva can remain on toys, towels, clothing, household items. An unstable virus will not survive in the environment for a long time, this route of transmission of the pathogen is unlikely;
• during blood transfusion, its preparations;
• recent studies have shown that transmission from mother to fetus is possible, in which case the child is diagnosed with a congenital Epstein-Barr virus infection.

Despite the variety of ways of transmission of the pathogen, among the population there is a large group of people who are immune to the virus (about 50% of children, 85% of adults). Most people become infected without showing a clinical picture, but antibodies are produced, immunity becomes resistant to the pathogen. That is why the disease is considered low contagious, because many have already formed immunity to the Epstein-Barr virus.

What is dangerous disease

First of all, the virus is dangerous because it has a number of different manifestations. In view of this, parents, even experienced doctors, do not always immediately understand what they are dealing with, they confuse it with other diseases. Only when conducting the necessary studies (blood test, PCR diagnostics, DNA, biochemistry, serological manipulations) to reveal that the baby is infected with 4 herpes virus.

The disease is dangerous because the virus spreads along with the blood, multiplies in the bone marrow, and over time can affect any organ in the child's body. Pediatricians identify some of the most dangerous consequences of infection with the Epstein-Barr virus infection:

• oncological diseases of various organs;
• pneumonia;
• immunodeficiency;
• serious damage to the nervous system that cannot be treated;
• heart failure;
• gradual enlargement of the spleen, its further rupture.

Characteristic signs and symptoms

Children with strong immunity suffer infection in the form of a mild cold or are generally asymptomatic. The clinical picture in a baby with weak immunity is significantly different from a child with strong body defenses. The incubation period is about two months, after this period the following clinical picture is observed:

• swelling of the lymph nodes (in the neck), discomfort is felt on palpation;
• elevated body temperature, it lasts for a sufficiently long period of time. Antipyretic drugs work very little or do not help at all;
• the child is constantly worried about headaches, chronic fatigue and weakness;
• wavy pains in the throat are noted, felt by attacks;
• the body of the crumbs is covered with red rashes of unknown etiology;
• significantly increases the liver, spleen;
• have digestive problems (diarrhea, constipation, abdominal pain,);
• the baby loses his appetite, weight decreases uncontrollably;
• on the oral cavity there are rashes of a herpetic nature;
• against the background of chills, there are pains in the muscles, discomfort throughout the body;
• sleep is disturbed, increased anxiety of the child is noted.

Over time, the lack of proper treatment, each symptom provokes the emergence of various ailments (pneumonia, tonsillitis, infectious mononucleosis, lymphoma, multiple sclerosis, hepatitis, and others). Often, the disease is taken by doctors for other pathologies, the course becomes more complicated, the child becomes worse. If the problem is not identified in time, a sharply negative outcome is possible.

Diagnostics

To differentiate mononucleosis from other pathologies, a number of clinical studies are carried out:

• serological diagnostics, in which the antibody titer is determined, especially with a characteristic picture of infectious mononucleosis;
• detection of certain titers of antibodies to the pathogen. This method is relevant for children who do not yet have heterophile antibodies;
• cultural method;
• general blood analysis;
• polymerase chain reaction.

The above methods help to find viral particles or its DNA in individual tissues, blood. Only a qualified specialist can appoint the necessary range of studies, it is strictly forbidden to deal with the problem on their own, and it is strictly forbidden to make a diagnosis.

A selection of treatments

To date, there is no specific treatment for Epstein-Barr virus. Strong immunity copes with the pathogen, the disease is asymptomatic, without consequences. A complicated acute form of the disease requires complex therapy, hospitalization of a small patient. For the treatment of pathology, the following medicines are used:

• Zovirax, Acyclovir. Children under two years of age are prescribed 200 mg, babies from two to six years old - 400 mg, over six years old - 800 mg four times a day. The duration of treatment is no more than 10 days, the individual course is determined by the doctor;
• Viferon is used in the form of rectal suppositories (for children under 7 years old), tablets (for children over seven years old);
• use interferon inducers (Cycloferon, Arbidol);
• actively used human immunoglobulin. Preparations of this group increase the body's resistance to the virus, promote the elimination of toxins, and have an antibacterial effect;
• Additionally, the baby is shown multivitamin preparations.

Treatment tactics depend on the complexity of the situation, the condition of the child. During the period of temperature increase, the following actions are shown:

• plentiful drink (mineral waters, natural juices, fruit drinks, fresh fruit compotes);
• bed rest;
• nasal drops with a vasoconstrictive effect (Nafthyzin, Sanorin, Sofradex);
• gargling the throat, oral cavity with antiseptic agents: decoction of chamomile, calendula, Furacilin, Iodinol;
• taking antipyretic drugs (Paracetamol, Nurofen, Panadol);
• if necessary, the crumbs are given antihistamines.

Hospitalization of a small patient is necessary only in some cases with severe fever, high temperature. If necessary, prescribe drugs that support the normal functioning of the liver.

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Preventive measures

It is possible to avoid infection or protect the baby from the acute course of the disease from an early age by strengthening the immune system:

• accustom the baby to being in the water, water procedures;
• balance the diet (eliminate spicy, salty foods, limit the consumption of sweets);
• avoid stress;
• From childhood, teach your child to regular physical activity.

Epstein-Barr virus in children: symptoms and consequences

The Epstein-Barr virus, or EBV for short, is the most common virus in humans. This herpesvirus infection can affect young children, ranging from a year old, schoolchildren, adolescents and adults. If a baby encounters it after a year, the symptoms of the disease are mild, very similar to a mild flu. If the infection occurred after 2-3 years against the background of reduced immunity, the child develops a rich clinical picture. Epstein-Barr virus in adolescents occurs in the form of infectious mononucleosis. More than 90% of people on the planet are infected with this group of herpesviruses and are carriers of the disease. The risk of infection with this virus in children is manifested by disorders of the brain, lymphatic system, liver and spleen. Consider the main causes, symptoms and consequences of the development of the Epstein-Barr virus.

Introduction to the Epstein-Barr virus

The virus was first identified by Michael Anthony Epstein in 1964 in collaboration with graduate student Yvonne M. Barr. The virus was discovered after examining samples of Burkitt's lymphoma tumors. The samples were provided by surgeon Denis Parson. He studied the development of lymphoma in children younger than 7 years old living in Africa.

Epstein-Barr virus in children is transmitted by airborne droplets, through saliva, personal hygiene products, utensils, blood transfusions or transplants. After infection and recovery, a person usually develops strong immunity to this group of viruses.

Although neither a child nor an adult will be able to completely get rid of the presence of a virus in the body. Epstein-Barr virus in children and adults will be dormant after successful treatment.

Symptoms of the development of the virus

The first organs that become infected with the virus are the salivary glands, lymph nodes, and tonsils. In the first years of a child's life after infection with a virus, the clinical picture does not manifest itself in any way or mild symptoms are noticeable, which often resemble a cold. Therefore, pediatricians are more likely to treat a cold than a virus. If the infection enters the body of a child after 2 years, there may be an increase in lymph nodes, salivary glands, adenoids. In addition, the temperature rises to degrees, the child feels weak, unwillingness to sleep or eat, frequent abdominal pains appear, the nasopharynx swells, nasal discharge may appear.

Possible consequences and diagnosis of the Epstein-Barr virus

If the infection in the child's body was acute and fast, most likely there will be violations of the kidneys, liver, spleen, and immune system. Oncological processes can also develop in the lymph nodes, or other organs: cancer of the stomach, nasopharynx, colon or small intestine, oral mucosa. In addition, the development of EBV in children can be the cause of not only enlarged lymph nodes, the development of lymphadenopathy or lymphadenitis, but also permanent tonsillitis.

If the Epstein-Barr virus in children occurs in the form of infectious mononucleosis, the characteristic symptoms may be: vomiting, soreness in the abdomen, rare stools, pneumonia, swollen lymph nodes, weakness and headache.

A child who has had mononucleosis may experience enlarged lymph nodes and problems with the liver, kidneys and spleen for one and a half years, tonsillitis and pharyngitis may occur.

It is especially dangerous to send a child for vaccination if he is infected with a virus - the unpredictability of the reaction puts the baby's life at risk.

Attention! If the child has the above symptoms and manifestations, please kindly check the child for the presence of the Epstein-Barr virus!

How to diagnose a virus

To identify infection with a child's virus, it is necessary to donate blood and saliva for laboratory testing: complete blood count, biochemical blood test, immunogram, serological methods.

Epstein-Barr virus treatment

Effective methods of curing sick children infected with the Epstein-Barr virus do not exist today. Doctors can only eliminate the clinical manifestations and transfer the active infection to a latent phase, which is not terrible for the health of the child.

Infectious mononucleosis and virus-affected organs in the child's body are treated in a hospital. In addition, if there is still a chance that the virus may further affect the brain and vital organs, doctors prescribe antibiotics, antihistamines, and means to relieve acute manifestations: relieve swelling in the nose, normal lymph outflow.

If there are slight enlargements of the lymph nodes and a slight swelling in the nasopharynx, treatment can be carried out by a pediatrician. In all other cases, observation and treatment is carried out by an infectious disease specialist.

Epstein-Barr virus symptoms in a child and are there effective treatments

Epstein-Barr virus

If we add to all this its amazing potential for mimicking the symptoms of other diseases and the general secrecy of its presence in the body, we can say that this pathogen is indeed one of the most dangerous in the world.

• It is extremely widespread. Wider than its "brother" cytomegalovirus. Among the adult population of the planet, its carriers are up to 98% of adults and at least 50% of children under the age of five.
• He defends well. The virus has structures related to receptors on lymphocytes, so it is not recognized by the immune system. Instead, it is able to penetrate even these immune cells and multiply in them, which allows it to very successfully suppress the immune defenses of the captured organism.

Epstein-Barr virus in children: how to recognize

The question of how such a secretive pathogen manifests itself is a separate big topic, since even its most striking signs rarely seem disturbing to us. It is curious that the set of symptoms of the Epstein-Barr virus in a child depends most of all on his age. So, the younger he is, the easier the acute stage will be, and vice versa: in babies older than three years, EBV is much more pronounced than in one-year-olds or newborns.

Signs of infection with herpes type 4

In the vast majority of cases, EBV (Epstein-Barr virus) in children does not manifest itself at all or looks like a slight ailment, say, due to a cold. In this case, they may experience:

• moderate temperature (within 37-37.5 °С);
• sore throat;
• hoarseness of voice;
• cough;
• sometimes - swelling of the cervical lymph nodes.

Complications of the infection

The consequences of infection with it can be very different, but most often among them are the following.

Mononucleosis is the main acute form of infection (that is, in addition to conditions very similar to the common cold). It manifests itself in two groups of symptoms, one of which is familiar to everyone, but the second is not quite typical. The first group of signs of mononucleosis is characterized by:

• loss of strength;
• bronchitis;
• headache;
• aching joints and muscles;
• a temperature of about 37 C;
• angina;
• the appearance of a herpetic sore somewhere in the area of ​​\u200b\u200bthe lips.

It is not surprising that the first part of the signs of mononucleosis does not cause any suspicion either in children or in their parents, because it cannot be distinguished from a cold. But this is exactly until he begins to show persistence to treatment (including antibiotics and folk remedies) that is atypical for acute respiratory infections and the second group of symptoms appears. It includes the following.

• Inflammation of the lymph nodes. It is limited at first, but can show up anywhere on the body. Without specialized treatment, such a focus will not go away on its own. It spreads further over the next few months, turning one "ball" under the skin into a sequence of several "balls" connected by thin threads.
• Enlargement in the size of the spleen and liver. As a rule, this happens simultaneously, but scenarios are also possible when only one of these organs “swells”.

Malignant tumors

One of the most dangerous diseases that mononucleosis (with damage to the lymph nodes) or the Epstein-Barr virus infection itself can develop into is Burkitt's lymphoma. Another formidable complication is lymphogranulomatosis.

Breckitt's lymphoma

Burkitt's lymphoma is a type of non-Hodgkin's (no specific cells) lymphoma - that is, a malignant tumor of the lymphatic system. Lymphomas in general are characterized by rapid spread and resistance to any treatment, since cancer cells are carried with the lymph flow throughout the body (this is not a local tumor that can be removed). In the case of Burkitt's lymphoma, B-lymphocytes are regenerated - one of the types of immune cells of the lymph, which with great success affects the Epstein-Barr virus.

Lymphogranulomatosis

Unlike Burkitt's lymphoma, lymphogranulomatosis refers specifically to Hodgkin's lymphomas. The difference between these two types of lymphomas for doctors is much greater than for us, and it consists in whether there are giant cells in the lymph nodes affected by the process, unlike anything else. And for us, it is much more important that this is also a cancer of the lymphatic system, and it is impossible to remove it as a local tumor - due to uncertain localization.

However, the course of lymphogranulomatosis does not differ in such malignancy. And modern oncology already manages to achieve its five-year remission in the vast majority of cases. In addition to two types of lymphomas, a relationship has been established between the Epstein-Barr virus and nasopharyngeal cancer.

Ways of infection

EBV is poorly adapted to survive in the environment - it lives much more comfortably in immune, nerve and other cells. Therefore, children, like adults, become infected with it in the following way.

• On contact. This refers to direct physical contact with the carrier. For example, in everyday life, when using common household items. In adults, transmission often occurs during sexual intercourse.
• Through the blood. For example, through the circulatory system common with the mother's body during fetal development, especially if the mother became infected while already pregnant. But infection can also occur through blood transfusion.
• Airborne. Especially when kissing (including on the cheek) during the period of rashes of type 4 herpes on the lips. When coughing next to a child in the acute period of the disease.

Diagnosis and treatment of EBV

To diagnose this disease, a blood test for the herpes virus type 4 is used. More precisely, when testing blood for the Epstein-Barr virus in children, the laboratory assistant looks for antibodies to the so-called “capsid” antigen of the virus in the taken smear.

How exactly is the pathogen detected?

In general, the capture by the pathogen of all new cells leads to the appearance of three types of antigens in them:

And only then immune proteins to these antigens are formed in the blood. And the capsid antigen is especially valuable because both it and antibodies to it appear first - sometimes even before the onset of the first symptoms of the disease. These are antibodies of the IgM class. A positive result on them suggests that no more than a month has passed since the infection of the child.

Treatment

Unfortunately, all treatment of the Epstein-Barr virus in children comes down to taking antiviral drugs - especially those that have proven effective not only against type 4 herpes virus, but also its "brothers".

• "Acyclovir". It gives a good result in the treatment of herpes zoster.
• "Ganciclovir". Mainly because of its ability to suppress the activity of cytomegalovirus - a very close "relative" of the Epstein-Barr virus.
• Recombinant α-interferon. Interferons are universal protective proteins of cells, so their number increases in response to any infection. The only difficulty is that effective interferon preparations are produced only in the form of ampoules for intravenous injection.
• Immunoglobulin. Immunoglobulins, unlike interferons, are part of the immunity of blood, not cells. Therefore, preparations of these two proteins are often used simultaneously.

Is prevention possible?

Vaccines against the Epstein-Barr virus have not yet been developed, since the composition of its proteins is very variable and depends not only on the stage of its development, but also on the type of cells in which it multiplies. Therefore, in the absence of effective treatment and prevention by official medicine, we are completely free to choose tactics to protect against the virus.

The only thing we must understand is that the treatment of the Epstein-Barr virus in children at home and folk methods with one hundred percent probability will be as "effective" as in the hospital. The world learned about the existence of this pathogen only recently. And even the "people" could not create a method of treating what no one suspects. The same applies to his homeopathic treatment. That is why the only means of therapy and prevention of its complications at the moment is, perhaps, systematic work on strengthening the child's immunity. But if we are sure that it can be strengthened with the help of medicinal herbs or the "memory" of water, they can also be included in the therapeutic program.

Epstein-Barr virus (EBV): symptoms, treatment, what diseases it causes

Given the high infection of the adult population with the Epstein-Barr virus (up to 90% of people), there is an unfairly frivolous attitude towards this pathogen. Recently, a number of studies have been carried out, as a result of which it was revealed that this virus is involved in the occurrence of not only infectious mononucleosis, but also belongs to the group of oncogenic viruses. It can cause some tumors of the nasopharynx, as well as high-grade lymphoma.

Epstein-Barr virus (EBV) refers to representatives of herpes viruses. In 1964, this pathogen was discovered by Canadian scientists, after whom it was named. In its structure, this virus contains a DNA molecule that has a spherical shape. Initially, this virus was found in lymphoma cells. Upon further study of this microorganism, it turned out that it can cause many diseases, the clinical picture of which has different “masks”.

Diseases that the Epstein-Barr virus can cause:

• Infectious mononucleosis.
• Infection of the respiratory tract (respiratory infection).
• Nasopharyngeal carcinoma (malignant disease of the nasopharynx).
• Burkitt's lymphoma.
• Chronic Fatigue Syndrome.

How does a viral infection spread?

EBV is transmitted in the following ways:

1. Airborne (is the most common).
2. Contact (the virus is transmitted with saliva, infection is possible when kissing, when transferring toys from children, using the same dishes, towels).
3. Sexual way (the pathogen is found on the mucous membrane of the genital organs).
4. Infection of the child during childbirth when passing through the birth canal.
5. Transmission of the virus with blood (during the transfusion of blood components).
6. The penetration of the virus through the placenta in utero.

EBV or human herpesvirus type 4

Important! Human susceptibility to EBV is extremely high. By the age of 40, almost all people become infected with this pathogen. But this does not mean that a person will develop a certain disease. The likelihood of a particular pathology caused by this virus largely depends on our immune system. But the degree of viral load during the spread of infection is also very important. This means that the transmission of viral particles from a person suffering from the disease in the acute stage is hundreds of times greater than from a virus carrier who does not have any symptoms.

It is also interesting that a person who has had an acute EBV infection continues to excrete the pathogen for 2-18 months even after complete clinical recovery and the absence of any symptoms of the disease.

Infectious mononucleosis

Infectious mononucleosis is an infectious disease characterized by the spread and multiplication of a virus in human lymphoid tissue.

This disease most often affects children in adolescence, but can also occur in adults. For this pathology, seasonality is very characteristic with a pronounced autumn and spring peak.

• It has an incubation period of 15 days. During this time, no symptoms of the disease are observed. Rare cases have been reported when the incubation period lasted about 2 months.
• Fever worries 93% of patients. In the vast majority of patients, the temperature reaches 39-40ºС. In children, fever is more pronounced than in adults.
• Most often, the first symptom is a sore throat, since the tonsils of the oropharynx are the first "entrance gates" when the virus enters the body. The tonsils sharply increase in size, become red and swollen. Often, a yellowish coating appears on their surface in the form of “islands and stripes”. This symptom occurs in almost all patients with mononucleosis (99.5%).
• Inflammation of the throat (pharyngitis). The mucous membrane of the oropharynx becomes edematous. The patient complains of sore throat when swallowing.
• Difficulty in nasal breathing is more typical for children, since the enlargement of the tonsils in the nasopharynx makes it difficult to inhale. In this regard, children often begin to breathe through their mouths.
• The defeat of almost all lymph nodes (behind the ear, mandibular, pharyngeal, supraclavicular, subclavian, axillary, inguinal). On palpation of the nodes, an increase in their size is noted, as well as the appearance of a sharp pain.
• Enlargement of the liver and spleen occurs in 98% of patients by the end of the first week of illness. The edge of the liver on palpation becomes dense, painful. Sometimes the patient can see the yellowness of the skin and sclera of the eyes. The spleen enlarges somewhat faster than the liver. So by the 4th day of the disease, it is already possible to reliably palpate the enlarged spleen.
• Increased heart rate.
• Less commonly, symptoms appear: swelling of the face, runny nose, diarrhea.

Extremely rarely (in 0.1% of cases), patients experience a rupture of the spleen as a result of a significant increase in this organ. The spleen capsule cannot withstand the tension and ruptures. A clinical picture of intra-abdominal bleeding develops (a sharp drop in pressure, tachycardia, fainting, a sharp pain in the abdomen, positive peritoneal phenomena, muscle tension of the abdominal wall on the left side in the hypochondrium). In such a situation, an emergency operation is needed to stop the bleeding.

In addition to the typical form of the disease with a vivid clinical picture, infectious mononucleosis can occur atypically:

1. Erased form. It is characterized by the presence of symptoms, but mild. The patient practically does not complain. Also, the erased form can manifest itself as an acute respiratory disease.
2. The asymptomatic form proceeds completely without any signs of the disease. The person in this case is only a carrier of the virus.
3. The visceral form is characterized by severe damage to internal organs (kidneys, adrenal glands, liver, heart, etc.)

Diagnosis of mononucleosis

This disease is characterized by:

1. The appearance of inflammatory changes in the blood (a moderate increase in leukocytes, an increase in the erythrocyte sedimentation rate (ESR), a decrease in segmented and an increase in stab neutrophils).
2. The most characteristic is the appearance in the blood of cells specific for this disease - wide-plasma mononuclear cells. They are present in 100% of patients and differ from other cells in their large size, as well as a wide light "belt" around the dark cell nucleus.
3. Decreased platelet count. This process is associated with the production of antiplatelet antibodies in the body, as well as with additional destruction of platelets in the enlarged spleen.

With what diseases it is necessary to carry out differential diagnostics?

The clinical symptoms of some diseases (especially diphtheria and lacunar tonsillitis) are very similar to infectious mononucleosis. In order to distinguish them and make the correct diagnosis, you need to know some of the features of these diseases.

Treatment of infectious mononucleosis

With a mild form of the disease, treatment is exclusively symptomatic, that is, it is aimed only at eliminating and alleviating the main symptoms of the disease. However, in severe form, the treatment regimen is different. Given the viral nature of the infection, the main treatment is aimed at reducing the activity of the virus.

• Antiviral drugs. To date, there are a large number of drugs with antiviral activity on the pharmacological market. However, few of them are active against the Epstein-Barr virus. So, for example, despite the fact that EBV belongs to the family of herpes viruses, the drug Acyclovir (Zovirax) has practically no effect on it. Good efficacy against EBV-associated infections was shown by the drug "Isoprinosine" ("Inosine pranobex"), which stimulates a person's own immunity. It is important that this drug can be used in children older than 3 years. In addition, the drug is well tolerated and practically does not cause unwanted reactions. Decent results were shown by the complex use of "Isoprinosine" with recombinant alpha-interferons. These drugs include: "Roferon-A", "Intron-A", "Viferon"
• Local treatment in the form of gargling with antiseptic solutions (with severe sore throat, 2% Lidocaine solution, which has a local anesthetic effect, can be added to the solution).
• Hepatoprotectors ("Essentiale") with the appearance of icteric syndrome.
• Given the prolonged fever, the appointment of antipyretic drugs is justified. For children, the appointment of "Nurofen" in drops, as well as rectal suppositories "Cefekon" is effective. For adult patients with prolonged high, debilitating fever, the administration of the drug "Perfalgan", which is administered intravenously, is effective.
• In immunodeficiency states, the appointment of the drug "Polyoxidonium", as well as vitamins of group B, is justified.
• In rare cases, infectious mononucleosis occurs with an exacerbation of a fungal infection (especially in immunocompromised individuals). In such cases, it is necessary to add antifungal drugs (Fluconazole, Nystatin) to the treatment regimen. If the fungal infection is resistant to these drugs, Cancidas can be used.
• Prescribing antibiotics for mononucleosis is not always justified. Many doctors are inclined to the fact that the appointment of this group of drugs is allowed only in cases where a bacterial infection occurs, or if the disease was initially caused by a mixed infection (several pathogens at the same time). The most commonly used antibiotics in this situation are Cephalosporins (Cefotaxime), Macrolides (Macropen).

Important! The introduction of the penicillin group of antibiotics in infectious mononucleosis is contraindicated due to the risk of developing an allergic reaction.

The key to success in the treatment of infections caused by the Epstein-Barr virus is the complex prescription of drugs that enhance the effect of each other.

Disease outcome and prognosis

In most cases, infectious mononucleosis proceeds without complications. After 4 weeks, as a rule, the symptoms of the disease disappear. But it is impossible to talk about a complete recovery, since the Epstein-Barr virus continues to be in the body in the lymphoid tissue. However, its reproduction (replication of the virus) stops. It is for this reason that antibodies remain in the body of those who have recovered from mononucleosis for life.

Rehabilitation after infectious mononucleosis

1 month after the disappearance of the symptoms of the disease, it is necessary to take a general blood test. After 6 months, you need to check the viral load in the body. For this, an ELISA is taken with the determination of antibody titers. While maintaining the activity of the virus in the body, it is necessary to take maintenance antiviral therapy in small doses. Patients with chronic EBV infection in remission need to take vitamin-mineral complexes to maintain immunity.

Video: Epstein-Barr virus in children, mononucleosis - Dr. Komarovsky

chronic fatigue syndrome

This disease began to be talked about more than 30 years ago, when the Epstein-Barr virus was found in most people suffering from similar symptoms.

Symptoms of the disease

1. Feeling of "itchiness" in the throat.
2. Slight enlargement of the lymph nodes, especially the cervical and occipital.
3. Constant temperature, often low.
4. Great weakness in the muscles.
5. A significant decrease in overall performance by more than 50% of the original.
6. Constant feeling of fatigue, weakness.
7. Violation of the daily routine, insomnia.
8. Memory disorder.
9. Pain and dryness in the eyes.
10. Irritability.

Features of treatment

In addition to the appointment of antiviral therapy, in the treatment of chronic fatigue syndrome, it is important to apply an individual approach. Unfortunately, there is no strictly developed treatment regimen for this condition.

However, the following methods are effective:

• General strengthening therapy (immunomodulatory drugs, physiotherapeutic methods of treatment, vitamin therapy).
• In cases of depression on the background of this disease, it is necessary to consult a psychiatrist.

Disease prognosis

In most cases, patients report an improvement in their condition after 1-2 years of treatment. But, unfortunately, the full restoration of working capacity practically does not occur.

Cancers caused by EBV infection

Nasopharyngeal carcinoma

Nasopharyngeal carcinoma is a malignant disease of the nasopharynx.

It has been proven that the main trigger for the development of nasopharyngeal carcinoma is the long-term presence of EBV infection in the body.

1. Difficulty in nasal breathing.
2. One-sided hearing loss is possible (during the transition of a malignant oncological process to the Eustachian tube).
3. Patients often experience nosebleeds.
4. Bad breath and breath.
5. Pain in the nasopharynx.
6. Unhealed sores in the throat.
7. Pain when swallowing.

Treatment Methods

Nasopharyngeal carcinoma is an example of a long-term neglected chronic viral infection that caused an oncological process.

Among the methods of treatment, the fight against malignant formation comes to the fore:

1. Surgery. Quite good results were shown by the use of "Cyber-knife" in the early stages of the disease.
2. Radiation and chemotherapy are complementary to the surgical method. The use of this type of treatment before and after surgery improves the prognosis for the patient.
3. Antiviral treatment is prescribed after surgery for a long time in order to minimize the activity of oncogenic viruses.

Burkitt's lymphoma

Burkitt's lymphoma is a malignant disease that affects the lymphoid tissue. In advanced stages, the oncological process can spread to other organs and tissues.

In 95% of cases, the Epstein-Barr virus is involved in the occurrence of this disease.

1. Most often, the disease begins with the defeat of the lymph nodes of the nasopharynx and oropharynx, mandibular, behind the ear, supraclavicular lymph nodes. It is for this reason that the first symptoms are a violation of nasal breathing, pain when swallowing.
2. The disease progresses quite quickly, involving new groups of lymph nodes in the pathological process.
3. At advanced stages of the oncological process, the organs of the chest and abdominal cavity are affected.

Treatment

Given the high malignancy of the disease, the surgical method is used simultaneously, as well as radiation and chemotherapy. This disease has a high risk of recurrence. With the reappearance of symptoms of the disease in the patient's blood, a high titer of antibodies to the Epstein-Barr virus can be detected. It is for this reason that antiviral therapy is necessary.

The prognosis for the patient is poor, given the high malignancy of Burkitt's lymphoma. In the early stage of the disease, with timely complex treatment, the prognosis improves.

Diagnosis of diseases, antibodies to the Epstein-Barr virus

Given the variety of diseases caused by this virus, diagnosis is often difficult.

If symptoms suspected of EBV infection appear, additional laboratory methods should be used to detect this pathogen.

The Epstein-Barr virus is recognized by our body due to the presence of the following foreign components (antigens) in its structure:

The immune system of the body responds to the presence of a virus in the body by producing specific proteins against this microorganism. These proteins are called antibodies, or immunoglobulins (Ig). When the virus first enters the body, class M immunoglobulins are formed within 3 months, and when the infection becomes chronic and the pathogen remains in the body tissues for a long time, class G immunoglobulins are synthesized.

In order to confirm the involvement of this virus in the disease, it is necessary to detect specific antibodies (immunoglobulins) in the blood using the ELISA method (enzymatic immunoassay):

• Antibodies to an early antigen indicate an early stage of the disease and a primary lesion (class M immunoglobulins - IgM)
• Antibodies to the capsid and nuclear antigen are an indicator of a long-standing infection and the chronic nature of the disease (class G immunoglobulins - IgG).

What to do if antibodies to EBV are detected during pregnancy?

Despite the fact that EBV is able to cross the placenta to the baby, the presence of positive antibodies is not always dangerous.

When should you not be concerned?

1. If a low titer of class G immunoglobulins is detected, then this probably indicates the presence of a virus in the body in an inactive stage.
2. Absence of any clinical manifestations of a viral infection.

When is antiviral therapy needed during pregnancy?

• When a high titer of class G immunoglobulins is detected, even in the absence of symptoms of the disease, it indicates the presence of a chronically occurring EBV infection, which can be dangerous for the development of the child.
• Detection of class M antibodies (IgM) means an exacerbation of EBV infection.

The presence of IgM antibodies is dangerous for the baby, and also creates a risk for the course of this pregnancy. It has been proven that the presence of EBV infection in the body of a pregnant woman leads to gestosis, the threat of interruption, placental pathology, premature birth, impaired blood flow, and fetal hypoxia.

It is necessary to approach the appointment of antiviral treatment during pregnancy individually. It is also obligatory to consult an infectious disease specialist and an immunologist. The appointment of any drug must be justified and have an evidence base.

Such a wide distribution of the Epstein-Barr virus, as well as a significant variety of "masks" that this infection takes, contribute to increased attention to this microorganism. Unfortunately, at the moment, there is no single and clear treatment regimen for this infection. Moreover, the complete disposal of this virus is impossible, since it continues to be in the body in an inactive stage. However, despite all these difficulties, today there are drugs that successfully help fight the symptoms of this disease.

It is important to remember that antiviral treatment should not be neglected, since a neglected EBV infection can cause malignant oncological processes that are very difficult to treat.