Epstein-Barr virus (EBV) is more prevalent than many people realize, as it is found in more than 90% of the world’s population. Also called human Herpes virus 4, EBV is one of the eight viruses in the herpes family. It is associated with a wide variety of illnesses ranging from benign and self-limiting illnesses to aggressive malignancies (cancerous growths). It is commonly transmitted through saliva and genital secretions and once it replicates, the virus spreads to salivary glands and lymphoid tissues, eventually infecting the liver, spleen, and B-lymphocytes (a type of white blood cells) of our immune system. When the virus’s initial lytic (or destructive) infection is brought under control, EBV persists in a “latent” state in the individual’s B cells for the rest of their life. This signifies that EBV can be reactivated later in life in times of decreased immunity or stress, and thus becomes a chronic viral infection.
The most common manifestation of a primary infection of EBV is acute infectious mononucleosis, a self-limiting syndrome that most frequently affects adolescents and young adults. Primary infection in children is often asymptomatic or accompanied by non-specific symptoms. EBV is associated with particular forms of cancer such as Burkitt lymphoma, Hodgkin lymphoma, and nasopharyngeal carcinoma, as well as conditions associated with human immunodeficiency virus (HIV), such as hairy leukoplakia and central nervous system lymphomas. Infection with EBV has been shown to cause an increased risk for developing certain autoimmune conditions, especially dermatomyositis, systemic lupus erythematosus, rheumatoid arthritis, Sjogren’s syndrome, and multiple sclerosis.
When we typically think of EBV, we think of infectious mononucleosis (or “mono”), the most common manifestation of the virus. The main symptoms of mono are an initial mild-flu like presentation for a few days, followed by fever, sore throat, swollen lymph nodes and fatigue. Initial testing that may indicate an underlying viral infection is a common blood test called a complete blood count (or cbc), that provides information concerning the number, size, type, and different makeup of our red blood cells, white blood cells, and platelets allowing for a basic understanding of any underlying deficiencies, diseases, or underlying chronic conditions in the body. If you have the characteristic symptoms of mono, and on your cbc have elevated lymphocytes (a type of white blood cell), a diagnosis of infectious mononucleosis can be suspected. To make a definitive diagnosis, it is necessary to first rule-out an infection with the bacteria Group A Streptococcus (which causes strep throat), then a streptococcal rapid antigen test with reflex to throat culture is performed and when negative, points toward infectious mononucleosis. Next, a heterophile antibody test (or Monospot) can be performed, which is less sensitive in young patients and older adults. When this test is negative but the diagnosis is still suspected, an EBV-specific serology can be run, which is a panel of four EBV antibodies, that can provide a definitive diagnosis.
Once the diagnosis has been confirmed, different treatment strategies can be implemented in order to address the viral infection while supporting the individual’s needs. In general, treatment of an acute or chronic viral infection should involve strengthening the body’s natural healing systems and vitality. Individualized treatment protocol should support the immune system, target eliminating the virus, facilitate proper elimination through the body’s different excretory routes, encourage a whole foods diet, plenty of hydration with mineral support, and proper time for rest and restoration. It is important to support each individual’s needs and to address their unique expression and relationship with the virus. Each protocol is tailored to their individual needs but may include anti-viral and/or immune supportive treatments including pharmaceuticals, herbs, homeopathic remedies, vitamins, and minerals.