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You should not panic, but you need to be treated


You can't hide from him. Sooner or later, every person meets him. Should I be afraid of him? Or maybe the infection is completely harmless? You shouldn't panic, but a frivolous attitude is a mistake.

Tula, Elena Gennadievna Koroleva, an infectious disease specialist at Clinic Expert, spoke about the Epstein-Barr virus.

- Elena Gennadievna, what is the Epstein-Barr virus?

- Among herpes viruses, there are 8 types that cause pathologies in the species Homo sapiens, that is, in humans. Epstein-Barr virus is a type IV herpes virus. After infection with the Epstein-Barr virus, the infection remains in the body forever and never leaves it.

Epstein-Barr virus is one of the most common herpes viruses in humans. A person's susceptibility to him is high. Many children become infected before they reach the age of one, and by the age of 40-50, almost everyone has an infection in their bodies.

- How does the Epstein-Barr virus get infected?

- The source of infection is virus carriers, as well as patients with typical (manifest) and erased forms of the disease. The most common route of transmission is airborne: with saliva particles when talking, sneezing, coughing. Transmission of the virus is possible during kissing (which is why in some sources the infectious mononucleosis caused by it is called "kissing disease"). A contact route of infection is also possible (for example, through household items).

The Epstein-Barr virus enters the body through the upper respiratory tract, and from there it spreads into the lymphoid tissue, causing damage to the lymph nodes, tonsils, spleen and liver.

When the Epstein-Barr virus multiplies in the body, it affects the immune system. The mechanism of action is complex, but in the end result, due to the defeat of B-lymphocytes and suppression of T-cell immunity, the production of interferon, a protein responsible for the antiviral defense of the body, is suppressed.

In the modern world, there is a surge in the incidence of diseases in children, especially in cities. Most likely to get infected in crowded places.

- Can an asymptomatic carrier be dangerous?

- Most often, a person becomes a source of infection in the acute stage of the disease. But transmission from an asymptomatic carrier is not excluded.

- What disease does the Epstein-Barr virus cause?

- The classic manifestation is infectious mononucleosis. It is characterized by general intoxication symptoms: high body temperature, drowsiness, lethargy, headaches, sore throat, swollen lymph nodes (or lymphoproliferative syndrome).

Lymphoproliferative syndrome combines:

  1. The defeat of the mouth, nasopharynx: acute pharyngitis with hypertrophy (increase) of the lymphoid tissue of the nasopharynx, acute adenoiditis and tonsillitis. This is manifested by difficulty in nasal breathing, snoring during sleep.
  2. The defeat of the peripheral lymph nodes (often the anterior cervical, submandibular and posterior cervical are affected).
    A pronounced increase in the cervical lymph nodes may be accompanied by puffiness of the face, pasty eyelids.
  3. Enlargement of the liver and spleen.

In a general blood test, the presence of atypical mononuclear cells is determined. What it is? Atypical mononuclear cells (their other name is "virocytes") are altered mononuclear blood cells. During the course of infectious mononucleosis, the amount of atypical mononuclear cells in the blood increases significantly (more than 10%). The total number of platelets and leukocytes may decrease, which indicates the severity of the infection.

There are features of the manifestation of the Epstein-Barr virus in children. Those infected fall into the category of "frequently ill children." Due to the weakening of immunity, diseases of the ENT organs regularly occur, difficulties in recovery (coughing, constantly red throat), there is snoring (due to the proliferation of tonsils). With such a course, by adulthood, the immune system learns to resist infection, adults do not get sick so often. Indications for surgical removal of adenoids in children are almost always associated with untreated Epstein-Barr virus. And this is very sad: there is nothing superfluous in the body, and with timely treatment, the removal could have been avoided.

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Knowing that a child is infected is important for another reason. The Epstein-Barr virus can change the reaction to some antibiotics, provoke a toxic-allergic reaction. Therefore, it is imperative to identify the virus in a timely manner and inform the attending physicians about it, they will select antibiotics taking this fact into account.

Serious consequences arise if the primary infection occurs in a woman during pregnancy. The Epstein-Barr virus crosses the placental barrier, which threatens with fetal death or significant developmental defects.

“After the initial infection, some of these infections do not leave the body. They "sleep" in certain cells, if everything is in order with the immune system and it controls their "sleep" well. Quote from the material "Why are TORCH infections dangerous?"

- It is believed that the Epstein-Barr virus causes hepatitis and even lymphoma. It's true?

- Herpetic viruses are carried by the bloodstream throughout the body, affecting all groups of lymph nodes. Both the liver and spleen are enlarged in the acute course of mononucleosis. In this case, the course of the disease is usually favorable, the health of the liver is fully restored.

It cannot be argued that the Epstein-Barr virus necessarily leads to lymphoma. It is not enough to detect a virus: if almost the entire population of the planet is infected, of course, tests will detect the presence of a virus in the body, but not everyone gets sick with lymphoma. Of course, chronic suppression of the immune system can lead to various disorders, including cancer. But there is no reliable connection. And modern medicine is able to compensate for immune disorders.

You definitely shouldn't panic. But there is no need to hope for an independent cure. When a child is constantly sick, parents often fall into despair. And although it is impossible to get rid of herpes viruses forever, it is quite possible to alleviate the condition and significantly reduce the frequency of diseases. You can and should be treated.

Read more about hepatitis in our articles:

- What methods can be used to check whether the Epstein-Barr virus is present in the body? What analyzes reveal it?

- We have two methods in our arsenal: enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR). The advantage of the PCR method is the ability to determine the DNA of the virus in saliva, nasopharyngeal scrapings. Thanks to this, you can not take blood and not irritate the child. But if there is no exacerbation, such an analysis can give a false negative result. This means that there is a virus in the body, but it is "sleeping", and, accordingly, it may be absent in the nasopharyngeal smear. And since PCR is used to search for the virus itself, more precisely, its nucleic acids (DNA), then the analysis will be negative. There are also frequent distortions due to the fact that the smear is taken incorrectly.

The ELISA method is more precise, it will in any case show both the presence of infection and the severity of the infectious process. Conclusions in this case are made by the presence in the blood of specific immunoglobulins (antibodies) to the virus. For example, if class M immunoglobulins (IgM) are detected, we can talk about the acute phase of infection (primary infection or reactivation of a virus that once entered the body). If a certain fraction of immunoglobulin G (IgG) is found, this indicates that the body has already encountered an infection in the past. Therefore, a doctor's consultation is needed to determine the diagnostic method.

- What methods of treating the Epstein-Barr virus are available in modern medicine?

- This is a difficult task. While there are specific antiviral agents for herpes viruses I and II (herpes simplex viruses), no specific therapy has yet been developed for the Epstein-Barr virus and cytomegalovirus. With a mild course, the disease can go away on its own, but with a severe course with damage to the bone marrow, medical attention is needed. Treatment is aimed at stimulating immunity, interferons are used. The treatment regimen is chosen based on many factors; only a doctor should determine it.

Once cured, the virus continues to live in the body. Periodically, exacerbations may occur: due to hypothermia, prolonged exposure to the sun, stress, etc. Manifestations of infection are always a reason to go to the doctor.

Interviewed by Daria Ushkova

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For reference:

Koroleva Elena Gennadevna

In 1992 she graduated from the pediatric faculty of the Kyrgyz State Medical Institute.
From 1992 to 1993 - internship in children's infectious diseases.
She worked in the republican infectious diseases hospital (Bishkek), first as a pediatric infectious disease specialist, then as a resuscitator in the intensive care unit for infectious patients.
In Tula, she worked for more than 10 years in the regional children's hospital, for 7 years she was in charge of the intensive care unit.
At present, he is a pediatric infectious disease specialist at Clinic Expert, Tula. Receives at the address: Tula, st. Boldin, 74.