What Is Epstein Barr Virus (EBV)? Causes, Diagnosis and Treatment

The Epstein-Barr virus (EBV) is one of the most common human viruses in the world.

Most people contract it in early childhood and young adulthood; however, anyone can get the virus, at any age and from anyone. 

While you may not be familiar with EBV specifically, you likely know one about an illness it causes: infectious mononucleosis, commonly known as mono. 

In this article, we’ll explore what exactly EBV is. We’ll also look at what symptoms of EBV to look out for, learn how it spreads, and look at the various treatment options available for EBV today. 

What is Epstein-Barr Virus (EBV)?

Also known as human herpesvirus 4, Epstein-Barr virus (EBV) is a very common virus that is part of the herpes virus family.

It is highly likely that you will be infected with EBV at some point in your life but for most people, it is not a cause for worry. 

EBV spreads most commonly and quickly through saliva and other bodily fluids like semen and blood.

The Epstein-Barr virus can cause infectious mononucleosis (mono) and other illnesses and diseases.

However, while EBV can cause mono, it is not true that everyone infected with EBV does get mono; for some people, mono never develops. 

Symptoms of Epstein-Barr Virus (EBV)

Most people are exposed to and infected by EBV at a young age and will not even know that they have it.

Many of the symptoms of EBV overlap with influenza and the common cold, and sometimes children don’t show symptoms of EBV for a long time.

Symptoms of EBV may include:

• Fatigue, malaise, and general discomfort
• Fever
• Inflamed or sore throat
• Swollen lymph nodes in the neck or under the arms
• Enlarged spleen or liver swelling
• Rash and itchy skin

It can take several weeks after exposure for symptoms to show, so many people may spread EBV to others without knowing it.

If you think you have been exposed to EBV or any other contagious virus, it is important that you isolate yourself even if you don’t immediately show signs or symptoms.

Diseases Caused by EBV

Named after Sir Michael Anthony Epstein and Ms. Yvonne Barr, the two scientists who first discovered the virus in 1964, the virus was initially linked to a variety of lymphomas including Hodgkin’s lymphoma, diffuse large B cell lymphoma, and plasmablastic lymphoma.

Studies show that EBV can be linked to posttransplant lymphoproliferative disease (PTLD) and that EBV-associated PTLD cases have increased in recent years.

EBV increases the risk of developing nasopharyngeal carcinoma (NPC), a rare tumor that can affect the head, neck, and throat. Treating EBV to help cure this virus-associated cancer is being researched.

More recently, a connection between EBV and multiple sclerosis (MS) has been the subject of research, with scientists hoping that targetting EBV at a young age could lead to the prevention—or even cure of—MS. 

Other complications, diseases, or illnesses EBV could cause include chronic fatigue syndrome and other autoimmune issues, as well as hemolytic anemia.

However, as we discussed above, most people will not have serious complications after EBV infection. People of different ages, lifestyles, and immunity levels react differently to any virus, EBV included. 

How It Spreads

Most often, EBV spreads through bodily fluids like saliva.

In some circumstances, EBV can also spread through blood and semen during sexual contact, blood transfusions, and organ transplantations. 

If EBV or mono is spread during sexual contact, it would be considered a sexually transmitted disease (STD).

To prevent any STI or STD, it is advisable to take precautions like wearing a condom when taking part in sexual activity. 

Transmission

EBV can be passed around through the sharing of objects, such as a toothbrush or utensils, that an infected person has used.

The virus can survive on an item if there are traces of moisture, so keeping your things dry—especially in a humid environment—is important. 

Once the virus is in your body, it can remain there in an inactive state without symptoms for a while.

Since EBV will always be in your body, the possibility of spreading the virus to others, no matter how much time has passed since the initial infection, will always exist.

Prevention

There is no vaccine for the prevention of EBV, but with proper care and precautions in place, you can minimize the risk of contracting the virus. 

Some safety measures you can take include:

• Refraining from kissing anyone who’s been exposed 
• Not sharing personal items like toothbrushes, cutlery, and utensils that have come in contact with other people’s saliva
• Washing your hands regularly 
• Cleaning objects efficiently and keeping them dry 
• If you think you have been exposed to EBV, observing a quarantine period even if no symptoms show; if symptoms do present, ask your provider how long you should remain isolated after they subside

Diagnosis

Diagnosing an EBV infection can be difficult because the symptoms are similar to other ailments such as the seasonal flu. 

A doctor or healthcare professional can confirm an EBV infection with a blood test that detects antibodies.

Due to the ubiquitous nature of the virus, nine out of ten adults will show blood work evidence of a current or past EBV infection.

According to the CDC, laboratory testing can help assess virus susceptibility and classify a recent or past EBV infection using viral capsid antigen (VCA), early antigen (EA), EBV nuclear antigen (EBNA), or monospot tests.

Treatment

Even though there is no vaccine or drug to cure EBV, there are a variety of steps you can take to ease your symptoms and provide your body with relief. 

If you have EBV symptoms, we recommend that you: 

• Get plenty of rest and sleep so your body can recover 
• Drink plenty of fluids, especially water, to keep your body hydrated
• Gargle with salt water to help soothe a sore throat
• Use over-the-counter pain killers such as ibuprofen (Advil) or acetaminophen (Tylenol) to relieve body aches and bring down a fever

Avoid strenuous activity and anything stressful that might hinder your recovery.

Find out from your healthcare provider how long you should remain isolated after your symptoms lift.

Even after you feel better, refrain from sharing anything with others that your body fluids would have come in contact with. 

When To Seek Medical Attention

If you’re experiencing symptoms of EBV, make an appointment with your doctor or medical professional to get an accurate diagnosis.

Most of your symptoms should begin to ease within 2-4 weeks.

If your condition does not improve after two weeks, or if your symptoms worsen, reach out to your doctor.

Go to the hospital or call 911 immediately if you experience intense pain in the upper left side of your abdomen or other unbearable pain in the body.

How K Health Can Help

Did you know you can get affordable primary care with the K Health app? If you suspect you or a family member was exposed to EBV recently and would like to know more about next steps, we have a team of medical professionals available to you 24/7.

Download K Health to check your symptoms, explore conditions and treatments, and if needed text with a provider in minutes. K Health’s AI-powered app is based on 20 years of clinical data.