The Epstein-Barr virus got a lot of publicity in the 1980’s. It seemed like every time I looked in a magazine or turned on the TV, another celebrity was relaying their tale of woe about this strange new malady that was robbing them of their energy and attacking their bodies with aches and pains. According to the media, it was assaulting “yuppies” in epidemic proportions. Researchers have learned a lot about this virus in the last 20 plus years, and have found that it is associated with much more than just fatigue-related illnesses. One of the most commonly found viruses in all of humankind, Epstein-Barr is responsible for conditions ranging from mononucleosis to several types of cancer. What do we know about this prolific virus and how can we protect ourselves from its attacks?
What is the Epstein-Barr Virus?
The Epstein-Barr Virus (EBV) was named after the British researchers that discovered it in 1964: Michael Epstein and Yvonne Barr, along with assistance from Bert Achong. EBV is technically known as human herpesvirus 4 (HHV-4) and is a member of the herpesvirus family which includes the herpes simplex virus. It is found worldwide, and most of the world’s population is infected with it at some point in their lives. It is estimated that up to 95% of all Americans aged 35-40 are infected. Infants are susceptible to infection shortly after birth, as soon as maternal antibodies disappear. In developed countries such as the United States and the European Union, infection usually does not come on until adolescence or young adulthood. In other parts of the world, it is more common for infected children to be found. Often these infections show no symptoms or are hard to distinguish from normal childhood illnesses such as a cold or flu. 35-50% of the time, infected adults will develop mononucleosis, which is the most common manifestation of EBV.
What is Mononucleosis?
Mononucleosis (mon-oh-noo-klee-OH-sis) is known by a variety of names including: mono, infectious mononucleosis, glandular fever, “the kissing disease,” and “Pfeiffer’s Disease.” Mononucleosis is caused by EBV and is a contagious viral disease found mostly in teens and young adults. It is also most common in developed nations. The primary symptoms are fever, sore throat, and swollen glands, especially in the neck. Some patients may also experience nausea and vomiting, skin rash, headaches, and joint pain. Tonsils may also become swollen.
The standard incubation period, from the onset of infection to the appearance of symptoms, is about 4 to 6 weeks. During this time, the patient is contagious, but mono can only be spread by intimate contact with the saliva of another person. This usually occurs by kissing, coughing, sneezing, or sharing of drinking or eating utensils. Once symptoms have appeared, the illness usually runs its course within several weeks to a month. However, some people will experience fatigue and not feel back to normal for several months. Infected individuals will keep the EBV in their systems for life, but most people only develop mono once.
Mono cannot be cured. During the course of the illness, patients should get plenty of rest and drink large amounts of water fresh fruit juices if desired. Some folks choose to take acetaminophen or ibuprofen for sore throat and fever, but make sure you never give aspirin to children. Aspirin can cause a condition called “Reye’s Syndrome” in children. Reye’s Syndrome is an upper respiratory tract infection that can lead to brain and liver damage. It is fatal in some cases.
Most of the time, mono is not a serious illness. Occasionally, certain complications may develop:
- Sore throat may progress into a streptococcal infection (strep throat), which is caused by bacteria and not a virus
- Severely swollen throat may rarely cause the patient to have difficulty breathing due to obstruction of the airway
- Enlargement of the spleen is something to watch out for. It is recommended that patients don’t rush the recovery process, as this may increase the risk of spleen complications. It may take up to a month or more to safely return to normal activities. (When I had mono as a child, I had to miss six weeks of school. What a pity.) In rare cases, the spleen may even rupture, which is a serious medical condition needing immediate care. Symptoms of a ruptured spleen may include:
ü Sharp pain on the left side of the abdomen
ü Dizziness or light headedness
ü Difficulty breathing
ü Rapid heartbeat
- Inflamed liver
- Heart or brain complications. While extremely rare, these may be life-threatening
- Any subject with a compromised immune system, such as AIDS patients or organ transplant recipients, are at greater risk of complications
How Do I Know If I Have Mononucleosis?
Sometimes it is difficult to tell because the symptoms for mono also may accompany a number of other illnesses. Generally, if cold symptoms persist for longer than two weeks, mono may be suspected. There is a blood test that can be given to determine the absence or presence of antibodies to EBV. It is called a “monospot test.” However, this is not always a precise indicator of current mono. Most people have at least minimal levels of EBV antibodies in their blood, unless they have never been exposed to it, which is the exception rather than the rule. EBV in a person’s body normally goes through cycles of activity and dormancy. During the active cycles, the antibody counts will be higher. During dormancy, they will drop. There is always some presence of EBV antibodies, no matter how minimal. Researchers have discovered they like to hide in the bone marrow. In some cases of bone marrow transplants, patients who previously tested positive for EBV showed negative results after a transplant from a negative donor.
What Other Conditions Can EBV Cause?
These other conditions are most commonly found in people whose immune systems are already compromised by another condition:
- Burkitt’s lymphoma and nasopharyngeal carcinoma are two forms of rare cancer seldom found in the United States. Burkitt’s is a non-Hodgkins type of lymphoma that usually affects the jaw. Nasopharyngeal carcinoma affects the respiratory tract, and is commonly found in North Africa, Southern China, and the Arctic. It is thought to be related to the high consumption of smoked fish in these cultures. It is not clear the exact role EBV plays in these cancers, but the cause is thought to be from multiple factors, EBV being one of them.
- Hodgkins Disease. There is not a lot known about the role of EBV in Hodgkins, a form of cancer, but it certainly is a factor.
- Herpes simplex virus (same family as EBV)
- Stevens Johnson Syndrome. This is an upper respiratory tract illness. Not much is known at this point about EBV’s role, only that there appears to be a link.
- Multiple Sclerosis. A recent study (April 2006) indicates that EBV may in some way alter the immune system and make a person at greater risk of developing MS. Some believe that infection with EBV may actually double the risk of getting MS 15-20 years later. Considering most of us have been infected, this may be something we want to watch as researchers learn more
What Can Be Done to Treat Mononucleosis and the Effects of EBV?
EBV-related illnesses, most commonly mononucleosis, are primarily immune system disorders. There are many natural ways to boost the immune system:
- First and foremost, eat a diet rich in whole foods, including ample amounts of fresh fruits and vegetables. Choose organic and locally grown if you can find them. These foods are high in antioxidants. They attack free radicals and help to keep our immune systems strong and efficient.
- Drink 8-10 glasses a day of fresh, clean water. All of the body’s systems need water to operate at their best, and this is especially true of the immune system. Water flushes the body of waste and helps keep the blood healthy, which is the heart of the immune system.
- Vitamins A, C, and B-complex are excellent for the immune system, and they help to increase energy levels as well. Load up on vitamin A in yellow vegetables and fruits and leafy green veggies like: carrots, sweet potatoes, squash, broccoli, spinach, apricots, and mangoes. Fish oil is a good source too. B-complex is found in eggs, cheese, fish, kidney, and liver. Vitamin C sources include: citrus fruits, berries, cherries, and guavas. Vitamin C is lost easily from foods that sit on the shelf too long or are overcooked, so think fresh and raw!
- Certain herbs can be helpful too:
ü Astragalus: Good for overcoming weakness. Rich in amino acids and trace minerals
ü Echinacea: Immune system fighter. Boosts white blood cell production
ü Garlic: Combats viral infections
ü Goldenseal: Good for sinus congestion. Antibiotic properties. Caution: poisonous in large amounts; do not use if pregnant (stimulates uterus)
ü Elder flower: Fever reducer
ü Yarrow: Fever reducer
ü Cleavers: Lymphatic system cleanser
ü Wild Indigo: Lymphatic system cleanser
ü St John’s Wart: Treats depression and anxiety
ü Vervain: Treats depression, anxiety, and helps with jaundice
ü Slippery Elm Bark and Licorice: Gargling with these soothes sore throats
ü Aromatherapies: Use oils of bergamot, eucalyptus, and lavender to relieve fatigue, headaches, congestion, and boost the immune system
- Exercise is one of those common-sense remedies, like eating right and drinking plenty of high-quality water, which helps the immune system to fight its battles more effectively. Regular, consistent cardiovascular exercise 4-5 times a week (for 20-30 minutes each time) will keep our energy levels up and when we do come down with a bug, it will help us to recover faster. Exercise also encourages us to breathe more deeply and delivers more oxygen and nutrients to our organs. I once heard someone say that if a person were to simply walk, drink ample amounts of water, and learn to breathe properly, that just about any health condition could be improved or eliminated.
- Massage can also be a useful tool to help the body cleanse itself of impurities and will help with muscle aches and pains associated with many conditions, including mononucleosis