Epstein barr virus symptoms consequences. Questions. Clinical examination of patients with acute and chronic forms of EBVI

Diet for mononucleosis

Blood analysis

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

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

What it is

EBV - Epstein Barr virus. One of the most common 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 fourth type of herpes virus.

By medical statistics, traces of a past 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 proceeds unnoticed, without symptoms.

A child can become infected in different ways. Most often, EBV is released through biological fluids, usually through saliva. For this reason, infectious mononucleosis, caused by a virus, is called the “kissing disease.”

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

At risk are children under one year of age who are actively learning the world through the mouth, trying to taste absolutely every object and thing they could get their hands on. 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 children develop vivid symptoms characteristic of many viral infections.

However, the virus itself with a complex name is not so scary as the fact that its consequences are completely unpredictable. It may go completely unnoticed in one child, but in another it will cause the development of severe conditions and even cancer.

Komarovsky about VEB

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

Now let's listen to Dr. Komarovsky about infectious monoculosis.

The symptoms that allow one to suspect EBV in a child are quite vague:

Irritability, tearfulness, increased moodiness and frequent causeless fatigue.
Mild or more noticeable increase lymph nodes. Most often - submandibular and behind-the-ear. If the infection is severe, it spreads throughout the body.
Lack of appetite, digestive problems.
Rash.
High temperature (up to 40.0).
Sore throat (as with sore throat and pharyngitis).
Heavy sweating.
Slight increase in the size of the liver and spleen. In a child, this may manifest itself as aching pain in the abdomen.
Jaundice skin. This symptom is extremely rare.

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

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

Komarovsky often compares EBV to 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

Evgeniy Olegovich warns that treatment with penicillin antibiotics for one of the diseases associated with EBV, infectious mononucleosis, can cause serious complications. Typically, such a prescription is erroneous when the doctor mistakes mononucleosis for an ordinary bacterial sore throat. In this case, exanthema may develop.

Ordinary children not suffering from HIV and other severe disorders immune system, according to Evgeniy Komarovsky, do not need any antiviral treatment for mononucleosis caused by EBV, and even more so they do not need to be given immunostimulants urgently. The famous pediatrician is confident 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. This includes antipyretic drugs (if the temperature is above 38.5-39.0), drugs that reduce sore throats (lozenges, antiseptics, gargles), ointments, gels and external sprays with antiseptics for severe skin rashes.

Definition and description of Epstein-Barr virus

Epstein-Barr viral infection - acute or chronic infection human, caused by the Epstein-Barr virus from the family of herpes viruses (Herpesviridae). It has the peculiarity of damaging the lymphoreticular and immune systems of the body (1.6).

Epstein-Barr virus (EBV) is a DNA virus from the Family Herpesviridae (gammaherpesviruses), and is a type 4 herpesvirus.

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

Special attention The Epstein-Barr virus has such a property as “lifelong persistence in the body.” Thanks to infection of B-lymphocytes, in which it is present for life, these cells of the immune system acquire the ability for unlimited life activity (so-called “cellular immortality”), as well as the ability to constantly synthesize heterophilic 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 (outermost shell), inner and outer shell.

The core contains two strands of DNA containing up to 80 genes. The viral particle on the surface also contains dozens of glycoproteins necessary for the formation of virus-neutralizing antibodies.

The viral particle contains the following specific antigens (proteins necessary for diagnosis):

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

The significance and timing of their appearance in different forms of EBVI are not the same and have their own specific meaning in terms of assessing the phase of the disease in laboratory examination patient (6).

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

In biological tissues and fluids, the Epstein-Barr virus can feel beneficial when it enters the blood of a patient with EBVI, brain cells are completely healthy person, cells during oncological processes (lymphoma, lecemia and others).

Sources of infection in Epstein-Barr viral infection are a patient with a clinically pronounced form and a virus carrier.

The patient becomes infectious 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 recovered from the disease retain the ability to periodically secrete the virus (that is, they remain carriers) (6,7) .

Mechanisms of Epstein-Barr virus infection:

it is aerogenic ( airborne transmission), in which saliva and mucus from the oropharynx, which is released when sneezing, coughing, talking, kissing, is contagious;
contact mechanism (contact-household transmission route), in which salivation of household items (dishes, toys, towels, etc.) occurs, but due to the instability of the virus in the external environment, it is of unlikely significance;
a transfusion mechanism of infection is allowed (during the transfusion of infected blood and its preparations);
nutritional mechanism (water-food transmission route);
Currently, the transplacental mechanism of infection of the fetus with the possibility of developing congenital Epstein-Barr viral infection has been proven (1,6).

Despite the variety of routes 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 if a patient is surrounded by an Epstein-Barr viral infection, the disease is less contagious, since many already have antibodies to the Epstein-Barr virus.

Infectious mononucleosis

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

The classic manifestation of acute Epstein-Barr viral infection is infectious mononucleosis - this is 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 idiopathic inflammation of the lymph glands.

The connection of the disease with Epstein-Barr virus was proven in the late 1960s (1, 10). The disease develops predominantly 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 a 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.

Enlarged lymph nodes (viral lymphadenitis) - the most persistent symptom diseases. The lymph nodes in the head and neck area enlarge earlier than others and most clearly; bilateral enlargement of the lymph nodes is typical; unilateral lesions are rare.

Less commonly, the 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 damage to the pharynx, which develops from the first days of the disease, sometimes later.

Sore throat in infectious mononucleosis can be different in form and in some cases even accompanied by the formation of fibrinous films reminiscent of diphtheria. Characterized by a pronounced enlargement of the palatine tonsils, the presence of small hemorrhages (petechiae) on the back wall of the pharynx, which distinguishes the disease from other viral pharyngitis, but not from streptococcal tonsillitis, swelling of the uvula may occur. Often the nasopharyngeal tonsil is involved in the process, causing patients to experience difficulty in nasal breathing, nasal sounds and snoring during sleep.

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

An enlarged liver and spleen are natural manifestations of the disease. Liver dysfunction - moderate yellowness of the sclera, changes in biochemical blood tests are more typical for older people. Rarely (in 3-25% of patients) a skin rash may occur - maculopapular, hemorrhagic, roseola, or miliaria-type rash (1.10).

There are characteristic changes in the clinical blood test - moderate leukocytosis, a decrease in the number of neutrophils, lymphocytosis and the appearance of specific cells - atypical mononuclear cells, which appear on the 2-3rd day of the disease and persist for up to 4 weeks (1.10).

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

So-called heterophilic 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 treatment of existing disorders is carried out internal organs.

Rarely, when there is a pronounced enlargement of the tonsils or a number of complications occur, glucocorticosteroids are used.

The patient is hospitalized according to clinical indications.

For of this disease Anti-epidemic measures are not carried out, specific prevention has not been developed (1.7, 8, 10).

Chronic forms of Epstein-Barr viral infection

Chronic EBV infection develops no earlier than 6 months after an acute infection, and in the absence of a history of acute mononucleosis - 6 or more months after infection. Often, the 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, hemophagocytic syndrome associated with EBV, atypical VEB forms(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,
increased 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 area,
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.
Patients often complain of enlargement of one or a group of lymph nodes, and possibly enlargement of internal organs (spleen and liver).

Along with such complaints, when questioning the patient, the presence of Lately frequent colds, fungal diseases, and the addition of other herpetic diseases. For example, simple herpes 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 (a decrease in the composition of almost all blood elements associated with inhibition of hematopoietic germs).

Patients may experience fever (wavy or intermittent, in which both sudden and gradual rises in temperature are possible with restoration to normal values), enlargement of the lymph nodes, liver and spleen, impaired 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 viral infection: most often it is a fever of unknown origin lasting for months, years, accompanied by enlarged lymph nodes, sometimes joint manifestations, muscle pain; another option is secondary immunodeficiency with frequent viral, bacterial, fungal infections (7)

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

In the presence of long-term increase temperature or enlarged and painful 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 “syndrome chronic fatigue"- 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 sleep poorly, and both the phase of falling asleep is disrupted and intermittent sleep is observed, insomnia and drowsiness are possible during the day. At the same time, autonomic disorders are characteristic: trembling or tremor of the fingers, sweating, periodically low temperature, poor appetite, joint pain.

The disease can develop at any age, and women predominate among patients. At risk are workaholics, people with increased physical and mental work, people in acute stressful situation, 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 that the patient’s complaints in this condition are not taken seriously enough and chronic fatigue syndrome is not recognized as a real problem caused by a biological process (7, 11).

To diagnose chronic forms of Epstein-Barr viral infection, in addition to the above serological tests, viral DNA determination is used PCR method in blood, saliva, oropharyngeal swabs and others biological materials, assessment of immune status (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.

Thus, with infectious mononucleosis, excessive enlargement of the palatine tonsils is possible, which can lead to obstruction of the upper respiratory tract, rupture of the spleen, and 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 older patients, liver damage from infectious mononucleosis can lead to cholestasis (10).

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

A rare complication of Epstein-Barr viral 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

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

It was discovered that the Epstein-Barr virus has a large set of genes that give it the ability to evade the human immune system to a certain extent. In particular, it produces proteins that are analogues of a number of human interleukins and their receptors that modify the immune response.

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

Another viral protein (BI3) can also suppress T-cell immunity and block killer cell activity (via suppression 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 (accumulated to the virus before its mutation) and host immune system cells for a certain time (7). Thus, the reproduction of the Epstein-Barr virus in the human body can cause the occurrence of infection, 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.

Classic 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 and gums, which gradually merge, forming white plaques with a heterogeneous surface, as if covered with grooves, cracks and erosive surfaces form. As a rule, there is no pain with this disease.
Lymphoid interstitial pneumonia, which is a polyetiological disease (there is also a connection with Epstein-Barr viral infection) and is characterized by shortness of breath, unproductive cough against the background of fever and symptoms of intoxication, as well as progressive weight loss of patients. The patient has enlarged liver and spleen, lymph nodes, enlarged salivary glands. X-ray examination showed bilateral lower lobe interstitial foci of inflammation of the lung tissue, the roots were expanded and 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 the occurrence of lymphoproliferative diseases in transplanted organs after transplantation and subsequent immunotherapy in individuals who have not been exposed to the Epstein-Barr virus before transplantation and do not have immunity to it at the time of intervention (12).

Epstein-Barr virus infection and pregnancy

In recent years, the transplacental mechanism of infection of the fetus has been proven and a congenital Epstein-Barr virus infection has been described, which occurs in the fetus when a pregnant woman is initially infected with the Epstein-Barr virus.

It has been established that its risk with primary EBVI during pregnancy is 67%, with reactivation - 22%.

Characterized by possible damage to the internal organs of the child in the form of interstitial pneumonia, encephalitis, myocarditis and others. Prematurity and premature birth are possible.

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

The influence of Epstein-Barr virus on the course of allergic diseases

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

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

The appearance of a rash to aminopenicillins is not an IgE-dependent reaction, therefore the use has neither preventive nor therapeutic effect. After recovery, repeated reactions to penicillin antibiotics may not be observed. It is possible to develop erythema multiforme exudate, in severe cases - Stevens-Johnson syndrome and. The latest cases are extremely different severe course and a high risk of death (2). Therefore, it is very dangerous to take penicillin antibiotics on your own for a sore throat without a preliminary medical examination and a general blood test.

In recent years, the possible influence of the Epstein-Barr virus on the occurrence of chronic relapsing disease has been studied (4). The possibility of the development of exudative erythema multiforme against the background of Epstein-Barr viral infection has been shown, regardless of the use of medications (16).

The Epstein-Barr virus was discovered relatively recently, in 1964, and belongs to the herpesvirus family, subfamily gamma. Interestingly, Epstein Barr virus can cause several diseases.

The source of infection is a person, and it does not matter whether he has this moment signs of illness or not.

Infectious mononucleosis or, as it is also called, the kissing disease. Infection is typical among children and young people (up to 40 years of age). The virus is transmitted in the following ways:

Through saliva (during kissing or oral sex);

When shaking hands;

When sharing toys and household items;

By blood transfusion.

The prevalence of Epstein Barr virus carriers is very high, reaching 95% of people over 35 years of age in the United States. Children, as a rule, become infected from their mothers; in developing countries, half of children under 5 years of age are infected with this virus. If the infection occurred at an early age, then, as a rule, the picture of the disease is rather “blurred” and can be regarded as another disease. Due to its prevalence, let's talk about it on our website www.site in the article “Epstein Barr Virus: symptoms, diagnosis, consequences.”

Epstein-Barr virus is characterized by incubation period, lasting 30-60 days, then the pathogen is fully activated and begins to multiply in the cells of the surface layers of the mucous membranes of the nose, pharynx and lymph nodes.

Epstein Barr virus has the following symptoms:

An increase in temperature to 38-40C, accompanied by chills;

Headache;

Severe weakness, malaise, loss of appetite;

Sore throat, especially when swallowing;

Sweating;

Sometimes a pinpoint rash appears on the body

Gradually, the Epstein-Barr virus enters the blood and spreads throughout the body. This is accompanied by enlarged lymph nodes. Typically the virus is found in the spleen, salivary glands, lymph nodes of any group, cervix, and liver.

Infectious mononucleosis is characterized by enlargement of the submandibular, cervical, and postauricular lymph nodes. Sore throat lasts about a week.

In a sick person, under the influence of the virus, the number of leukocytes - “white blood cells” - decreases, which can be detected in a blood test of the sick person.

If a person has an immunodeficiency (for example, with AIDS), then an enlargement of the liver and spleen is likely, accompanied by jaundice.

Infectious mononucleosis goes away on its own within one to two months, sometimes even earlier.

Consequences of the Epstein Barr virus

Complications of infectious mononucleosis are quite rare, but you should always keep in mind the likelihood of their occurrence:

A rupture of the spleen is very dangerous, even leading to death;

Changes in blood composition (decrease in red blood cells, platelets, leukocytes);

Damage to the nervous system – encephalitis, convulsive syndrome, cerebellar disorders;

Inflammation of the heart muscle - myocarditis, the lining of the heart - pericarditis.

Diagnosis of Epstein Barr virus

The diagnosis is made based on characteristic symptoms and a study of the level of antibodies in the patient’s blood to the Epstein-Barr virus.

No connection has been identified between infectious mononucleosis and the development of tumor processes.

Another disease caused by a virus is Burkitt's lymphoma. This is a tumor process that affects the lymph nodes, upper or lower jaw, kidneys, and ovaries. This disease occurs only in Africa in children aged four to eight years.

The diagnosis is made based on the detection of the virus in lymphoblasts and lymph nodes.

Also, the Epstein-Barr virus can contribute to the development of lymphogranulomatosis and malignant tumors of the nasopharynx.

As a rule, tumor processes develop under the influence of a virus quite rarely, usually due to genetic predisposition or immunodeficiency.

The outcome of acute Epstein-Barr virus infection (EBVD) depends on the degree of impairment of the immune system and on hereditary predisposition to diseases associated with EBVD. So, acute VEBI can end in the following ways:

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

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

Development of cancer;

Development of systemic autoimmune diseases.

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

In addition to the listed consequences, the Epstein-Barr virus can lead to complications in various organs and systems. Currently identified the following consequences Epstein-Barr virus, classified as complications:

Dr. Komarovsky about Epstein Barr virus in children

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

What it is

According to medical statistics, traces of past 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 proceeds unnoticed, without symptoms.

At risk are children under one year of age who actively explore the world around them through their mouths, trying to taste absolutely every object and thing they can get their hands on. 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 children develop vivid symptoms characteristic of many viral infections.

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

Komarovsky about VEB

Now let's listen to Dr. Komarovsky about infectious monoculosis.

The symptoms that allow one to suspect EBV in a child are quite vague:

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

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 advisable to do an immunogram and conduct an ultrasound examination of the abdominal organs - the liver and spleen.

Treatment according to Komarovsky

Ordinary children who do not suffer from HIV and other severe disorders of the immune system, according to Evgeniy Komarovsky, do not need any antiviral treatment for mononucleosis caused by EBV, and even more so they do not urgently need to be given immunostimulants. The famous pediatrician is confident 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).

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 herpes origin, named after the two scientists - researchers who discovered it in 1964, namely Canadian professor and virologist Michael Epstein and Iwona Barr, who was his graduate student. Due to its nature, EBV is also called herpes type 4. Recently, its prevalence (especially in children) has increased significantly and amounts to 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 can be present in the body for several years and not manifest itself in any way. 25% of people who are carriers may have it throughout their lives. A weakened immune system can trigger its activation. After infection, a person subsequently develops permanent immunity to the disease. However, the virus continues to exist in the body, like its herpes counterparts.

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

The number of infected people after 35 years of age 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 herpes 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 due to its development:

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;
polyadentopathy;
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, divided into erased, asymptomatic or affecting internal organs.

easy;
average;
heavy.

spicy;
protracted;
chronic.

active;
inactive.

Routes of transmission of the virus and sources of infection

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

The largest accumulation of particles is in human saliva, which people exchange when 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 person or carrier, there are other ways to become infected:

in the process of blood transfusion - parenteral method;
during transplantation;
contact-household route, when people use the same dishes or household and personal hygiene items - this option is unlikely, because this type of herpes virus is unstable and lasts for a long time environment does not live;
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 by communicating with a child infected with the virus, by handling 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 spread of the Epstein-Barr virus is an infected person. Particularly dangerous are those people whose disease is asymptomatic or latent. The threat of becoming infected with EBV from a patient 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 corresponding manifestations, which include four main signs of this disease:

fatigue;
increased body temperature;
the appearance of a sore throat;
enlarged 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 gradual recovery begins. The course of the pathological process occurs in stages. At the initial stage, the infected person develops a feeling of malaise, which can last about a week, and a sore throat. At this stage, temperature indicators remain normal.

Symptoms of Epstein-Barr virus in children

At the next stage, there is a sharp increase in body temperature up to several 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. Usually the anterior and posterior ones increase cervical lymph nodes, 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, under the armpits, in the elbows, groin and on the thighs. When palpated, they become dough-like, and minor painful sensations appear.

In addition, the pathological process extends to the tonsils, which resembles the symptoms of a sore throat. The tonsils swell back wall the pharynx becomes covered with a purulent coating, nasal breathing is disrupted 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 enlargement and heaviness in the right hypochondrium. Sometimes the urine becomes dark in color and mild jaundice occurs. The spleen with EBV also increases in size.

Another symptom of Epstein-Barr virus that is often seen in children is a rash. Usually the rash lasts up to 10 days. The degree of their severity is determined by the use of antibiotics. They may look like:

Diagnostic methods

The 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 throat;
angina;
adenoviral infection;
blood diseases.

For this reason, it is important to carry out 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 laboratory tests.

Blood tests

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 antibodies to the infection, which makes it possible to find out whether the infection is primary and how long ago it occurred.

Two types of antibodies can be found in the blood:

Immunoglobulins or primary antibodies of type M. Their formation occurs when the virus first enters the body or due to the activation of an infection that is in a “dormant” state.
Immunoglobulins or secondary antibodies of type G. They are characteristic of the chronic form of the pathology.

A general blood test also determines the presence of mononuclear cells in the blood. This is an atypical form, which occurs in 20-40% of lymphocytes. Their presence indicates infectious mononucleosis. Mononuclear cells may continue to be present in the blood for several years after recovery.

PCR method

Epstein-Barr virus DNA detected through research biological fluid body: saliva, mucus from the nasopharynx and oral cavity, cerebrospinal fluid, prostate secretions or discharge from the genitals using the PCR (polymerase chain reaction) method.

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

Features of treatment of the disease in children

Epstein-Barr virus is a young and not yet fully understood disease, and treatment methods continue to improve. In the case of children, any medications are prescribed only after careful study and identification of all side effects.

Currently antiviral drugs that would effectively combat this type of pathology and would be suitable for any age category people remain at the development stage. Children may be prescribed a course of such medications in exceptional situations when the baby’s life is at risk.

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

cleanse the body of toxins using sorbents;
diversify the diet so that the baby receives adequate 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, you should alleviate the condition of the baby by reducing the severity of his symptoms - give antipyretic drugs when the body temperature rises or put drops in the nose if there are breathing problems. If you have signs of a sore throat, you need to gargle and treat your throat, and if you have hepatitis, you need to take medications that will support the liver.

Recovery prognosis and possible complications

In general, with proper and timely care, the acute form of 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 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 swelling of the tonsils and soft tissues of the oropharynx;
hepatitis;
splenic rupture;
hemolytic anemia;
thrombocytopenic purpura;
liver failure;
pancreatitis;
myocarditis.

Another possible consequence of infection with herpes type 4 is hemophagocytic syndrome. It is caused by an infection of T lymphocytes, which results in the destruction of blood cells, namely red blood cells, platelets and white blood cells. The known symptoms include anemia, hemorrhagic rash and problems with blood clotting, which, in turn, can be fatal.

The Epstein-Barr virus also negatively affects the functioning of the entire immune system. As a result of the body’s inability 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 that can be triggered by EBV are:

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

Prevention of EBV in a child

There are currently no specific preventive measures aimed at preventing Epstein-Barr virus pathogens from entering the body and their reproduction. First of all, this concerns vaccination. It is not being carried out because the vaccine has not yet been developed. Its absence is due to the fact that the proteins of the virus change greatly in their composition - this is influenced 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, the pathology is dangerous due to its complications. In view of this, it is still necessary to think about any possible preventive measures. The main method of prevention comes down to the general strengthening of immunity, because it is as a result of its decrease that activation of the disease can occur.

You can support the normal functioning of the immune system in an adult or child in the simplest and most reliable way by following healthy image life, including:

Complete nutrition. The diet should be varied, providing a person with vitamins and beneficial minerals.
Hardening. Reasonable hardening procedures are an effective way to strengthen health and immunity.
Physical activity. Movement is life, and for the body to function fully, it needs to be regularly kept in good shape by playing sports or exercising regularly. hiking in the fresh air. It is important not to sit at home all the time at the computer or in front of the TV.
Taking immunomodulators of plant origin. Examples of such medicines Immunal and Immunorm serve. According to the instructions, they are taken 20 drops three times a day. They stimulate immune reactions and activate the regeneration of mucous membranes of various organs and cavities in the human body. You can turn to folk remedies, namely herbal remedies.

Prevention of the Epstein-Barr virus in childhood consists not only of strengthening the immune system, but also of minimizing the possibility of becoming infected through contact and household contact when communicating with other children. To do this, it is necessary to teach the child to observe from an early age basic rules 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 treatment methods

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

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

general information

Epstein-Barr virus was discovered in 1964. As a result of research, the virus was classified as a herperovirus; it is widespread among the world's population. According to statistics, about 50% of eighteen-year-old residents are carriers of the virus. A similar situation exists with children over five years old. Babies under one year old get sick very rarely; along with breast milk, the baby receives the mother's antibodies (passive immunity), which protect the child's body from infection.

The main risk group is children older than one year. They actively communicate with other children and gradually switch from breastfeeding to full nutrition. It is worth noting that in children under three years of age, infection with the virus is practically asymptomatic and resembles a 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, disinfectants, or drying out. When the pathogen enters a child’s body, it thrives in the patient’s blood, brain cells, and in case of cancer, in the lymph. The virus has a special tendency to infect its favorite cells ( lymphatic system, immune system, upper respiratory tract, digestive system).

The pathogen can provoke allergic reaction, 25% of sick children experience the appearance of Quincke's edema and rashes on the baby's body. Particular attention should be paid to the special property of the virus – lifelong presence in the body. Infection of the immune system gives cells an unlimited ability for active life and constant synthesis.

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Routes 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 the pathogen is released in small quantities at the beginning of the disease, the period of its course is even six months after recovery. About 20% of all patients become carriers of the virus, which is dangerous to others.

Routes of transmission of the Epstein-Barr virus:

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

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

How dangerous is the disease?

First of all, the virus is dangerous because it has a number of different manifestations. Because of this, parents, even experienced doctors, do not always immediately understand what they are dealing with and confuse it with other diseases. Only by carrying out the necessary studies (blood test, PCR diagnostics, DNA, biochemistry, serological manipulations) will it be revealed that the baby is infected with herpes virus 4.

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 body. children's body. Pediatricians identify several 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 experience infection in the form of a mild cold or are completely asymptomatic. The clinical picture of a child with a weak immune system 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 upon palpation;
elevated body temperature, it lasts for quite a long period of time. Antipyretics have little or no effect;
the child is constantly bothered by headaches, chronic fatigue and weakness;
wave-like pain in the throat is noted, attacks are felt;
the baby’s body becomes covered with red rashes of unknown etiology;
the liver and spleen are significantly enlarged;
there are digestive problems (diarrhea, constipation, abdominal pain);
the baby loses appetite, weight decreases uncontrollably;
there are herpetic rashes on the oral cavity;
against the background of chills, muscle pain and discomfort appear throughout the body;
sleep is disturbed, the child has increased anxiety.

Over time, without proper treatment, each symptom provokes the occurrence of various ailments(pneumonia, tonsillitis, infectious mononucleosis, lymphoma, multiple sclerosis, hepatitis and others). Doctors often mistake the disease for other pathologies, the course becomes more complicated, and the child gets 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 diagnosis, in which the antibody titer is determined, especially when characteristic picture infectious mononucleosis;
identification of certain titers of antibodies to the pathogen. This method is relevant for children who do not yet have heterophilic 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 prescribe the required range of studies; it is strictly forbidden to deal with the problem independently; making a diagnosis is strictly prohibited.

A selection of treatment methods

To date specific treatment Epstein-Barr virus does not exist. Strong immunity copes with the pathogen, the disease is asymptomatic, without consequences. Complicated acute form of the disease requires complex therapy, hospitalization of a small patient. The following medications are used to treat pathology:

Zovirax, Acyclovir. Children under two years old are prescribed 200 mg, children from two to six – 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 rectal suppositories(children under 7 years old), tablets (children over seven years old);
use interferon inducers (Cycloferon, Arbidol);
Human immunoglobulin is actively used. Drugs in this group increase the body’s resistance to the virus, promote the elimination of toxins, and have an antibacterial effect;
In addition, the baby is prescribed multivitamins.

Treatment tactics depend on the complexity of the situation and the child’s condition. During the period of rising temperature, the following actions are recommended:

drinking plenty of water ( mineral water, natural juices, fruit drinks, fresh fruit compotes);
bed rest;
nasal drops that have vasoconstrictor effect(Naphthyzin, Sanorin, Sofradex);
gargling, mouthwash antiseptics: decoction of chamomile, calendula, Furacilin, Iodinol;
taking antipyretic drugs (Paracetamol, Nurofen, Panadol);
If necessary, the baby is given antihistamines.

Hospitalization of a small patient is necessary only in isolated cases with severe fever or high temperature. If necessary, medications are prescribed to support normal liver function.

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Preventive measures

You can avoid infection or protect your baby from the acute course of the disease by strengthening the immune system from an early age:

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

Epstein-Barr virus in children: symptoms and consequences

The most common virus among people is the Epstein-Barr virus, or EBV for short. This herpes virus infection can affect young children, starting from one 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 occurs after 2-3 years of age against the background of reduced immunity, the child develops a rich clinical picture. Epstein-Barr virus in adolescent children occurs in the form of infectious mononucleosis. More than 90% of people on the planet are infected with this group of herpesvirus and are carriers of the disease. The danger of infection with this virus in children is manifested by disorders of the brain, lymphatic system, liver and spleen. Let's consider the main causes, symptoms and consequences of the development of the Epstein-Barr virus.

Introduction to Epstein-Barr Virus

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

Epstein-Barr virus in children is transmitted through airborne droplets, saliva, personal hygiene products, dishes, blood transfusion or transplantation. After infection and recovery, a person usually develops lasting immunity to this group of viruses.

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

Symptoms of virus development

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

Possible consequences and diagnosis of Epstein-Barr virus

If the infection in the child’s body is acute and rapid, there will most likely be disturbances in the functioning 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, and oral mucosa. In addition, the development of EBV in children can cause not only enlarged lymph nodes, the development of lymphadenopathy or lymphadenitis, but also persistent tonsillitis.

If the Epstein-Barr virus in children occurs in the form of infectious mononucleosis, characteristic symptoms may be: vomiting, pain in the abdomen, rare stools, pneumonia, enlarged 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 a year and a half, and 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 a child has any of the above symptoms and manifestations, we kindly ask that the child be tested for the presence of the Epstein-Barr virus!

How to diagnose a virus

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

Treatment of Epstein-Barr virus

There are currently no effective methods for curing sick children infected with the Epstein-Barr virus. Doctors can only eliminate clinical manifestations and transfer the active infection to a latent phase, which is not harmful to the child’s health.

Infectious mononucleosis and organs affected by the virus in the child’s body are treated in a hospital. In addition, if there is still a chance that the virus could further affect the brain and vital important organs, doctors prescribe antibiotics, antihistamines, and means for relieving acute manifestations: relieving swelling in the nose, normal lymph outflow.

If there are slight enlargements of the lymph nodes and 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.

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

Epstein-Barr virus

If we add to all this its amazing potential for imitating 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 common. Wider than its “brother” cytomegalovirus. Among the adult population of the planet, up to 98% of adults and at least 50% of children under five years of age are its carriers.
He defends well. The virus has structures related to receptors on lymphocytes, so it is not recognized by the immune system. Instead, he is able to penetrate even these immune cells and multiply in them, which allows him to very successfully oppress immune protection 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 alarming to us. It is curious that the set of symptoms of the Epstein-Barr virus in a child depends most on his age. So, the younger he is, the easier the acute stage will be, and vice versa: in children over three years old, 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 appears as a mild illness, say, due to a cold. In this case, they may experience:

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

Complications of infection

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

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

loss of strength;
bronchitis;
headache;
aches in joints and muscles;
temperature about 37 C;
sore throat;
the appearance of a herpetic sore somewhere in the lip area.

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

Inflammation of the lymph nodes. It is limited at first, but can appear anywhere on the body. Without specialized treatment, such a lesion 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.
Increased 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 lymphoma. Another serious complication is lymphogranulomatosis.

Brackett's lymphoma

Burkitt's lymphoma is a type of non-Hodgkin's (not containing 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 by lymph throughout the body (this is not a local tumor that can be removed). In the case of Burkitt's lymphoma, B-lymphocytes undergo degeneration - one of the types of immune lymph bodies that are successfully attacked by the Epstein-Barr virus.

Lymphogranulomatosis

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

However, the course of lymphogranulomatosis is not characterized by such malignancy. And modern oncology has already managed to achieve a 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.

Routes 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.

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

Diagnosis and treatment of EBV

To diagnose this disease, a blood test for herpes virus type 4 is used. More precisely, when testing blood for the Epstein-Barr virus in children, the laboratory technician 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 of more and more new cells by the pathogen 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. We are talking about IgM class antibodies. A positive result indicates that no more than a month has passed since the child was infected.

Treatment

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

"Acyclovir". It gives good results in the treatment of herpes zoster.
"Ganciclovir." Mainly due to its ability to suppress the activity of cytomegalovirus - a very close “relative” of the Epstein-Barr virus.
Recombinant α-interferon. Interferons are universal cell defense proteins, 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, serve as part of the immune system not of cells, but of blood. 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 complete absence of effective treatment and prevention from official medicine, we are completely free to choose tactics to protect ourselves from the virus.

The only thing we must understand is that treatment of the Epstein-Barr virus in children at home and using traditional methods is 100% likely to be as “effective” as in the hospital. The world only recently learned about the existence of this pathogen. And even the “people” could not create a method of treating something that no one suspects. The same applies to his treatment with homeopathy. Therefore, at the moment, the only means of treatment and prevention of its complications is, perhaps, systematic work to strengthen the child’s immunity. But if we are sure that it can be strengthened with medicinal herbs or “memory” of water, they can also be included in the therapeutic program.

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

Considering the high infection rate 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 nasopharyngeal tumors, as well as lymphoma high degree malignancy.

Epstein-Barr virus (EBV) is a member of the herpes virus. In 1964, Canadian scientists discovered this pathogen, after whom it was named. According to its structure, this virus contains a DNA molecule that has a spherical shape. This virus was initially discovered 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 can be caused by the Epstein-Barr virus:

Infectious mononucleosis.
Damage to 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:

Airborne (is the most common).
Contact (the virus is transmitted through saliva, infection is possible through kissing, passing toys from children, using the same dishes, towels).
Reproductive tract (the pathogen is found on the mucous membrane of the genital organs).
Infection of a child during childbirth when passing through the birth canal.
Transmission of the virus through blood (through transfusion of blood components).
Penetration of the virus through the placenta in utero.

EBV or human herpes virus 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 is also very important when the infection spreads. This means that the transmission of viral particles from a person suffering from an acute stage of the disease 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 shed 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 the virus in human lymphoid tissue.

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

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

It is extremely rare (in 0.1% of cases) that patients experience rupture of the spleen as a result of a significant enlargement of this organ. The spleen capsule cannot withstand tension and ruptures. A clinical picture of intra-abdominal bleeding develops (sharp drop in pressure, tachycardia, fainting, 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, emergency surgery is necessary to stop the bleeding.

Besides typical shape diseases with a clear clinical picture, infectious mononucleosis can occur atypically:

Erased form. It is characterized by the presence of symptoms, but mild ones. The patient has virtually no complaints. Also, the erased form can manifest itself as an acute respiratory disease.
The asymptomatic form occurs completely without any signs of disease. In this case, the person is only a carrier of the virus.
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:

The appearance of inflammatory changes in the blood (moderate increase in leukocytes, increase in erythrocyte sedimentation rate (ESR), decrease in segmented and increase in band neutrophils).
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.
Decreased platelet count. This process is associated with the production of antiplatelet antibodies in the body, as well as additional destruction of platelets in the enlarged spleen.

What diseases need differential diagnosis?

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

Treatment of infectious mononucleosis

In mild forms 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 cases 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. Today, 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. For example, despite the fact that EBV belongs to the family of herpes viruses, the drug Acyclovir (Zovirax) has practically no effect on it. The drug “Isoprinosine” (“Inosine pranobex”), which stimulates a person’s own immunity, has shown good effectiveness against EBV-associated infections. It is important that this medicine can be used in children over 3 years of age. In addition, the drug is well tolerated and practically does not cause adverse reactions. The combined use of Isoprinosine with recombinant alpha-interferons has shown decent results. These drugs include: “Roferon-A”, “Intron-A”, “Viferon”
Local treatment in the form of gargling with antiseptic solutions (for severe sore throat, a 2% solution of Lidocaine, which has a local anesthetic effect, can be added to the solution).
Hepatoprotectors (“Essentiale”) for the appearance of icteric syndrome.
Given the prolonged fever, the prescription of antipyretic drugs is justified. For children, Nurofen drops, as well as Tsefekon rectal suppositories, are effective. For adult patients with prolonged high, debilitating fever, the use of the drug “Perfalgan”, which is administered intravenously, is effective.
In immunodeficiency states, the use of the drug “Polyoxidonium”, as well as B vitamins, is justified.
In rare cases, infectious mononucleosis occurs with an exacerbation of a fungal infection (especially in people with immunodeficiency). In such cases, it is necessary to add to the treatment regimen antifungal drugs(“Fluconazole”, “Nystatin”). If fungal infection is resistant to these drugs, you can use the drug “Cancidas”.
Prescribing antibiotics for mononucleosis is not always justified. Many doctors are inclined to believe that the prescription 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: Cephalosporins (Cefotaxime), Macrolides (Macropen).

Important! Administration is contraindicated penicillin group antibiotics for infectious mononucleosis 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 occurs 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 reside in the body in the lymphoid tissue. However, its reproduction (virus replication) stops. It is for this reason that antibodies remain in the body of those who have recovered from mononucleosis for the rest of their lives.

Rehabilitation after infectious mononucleosis

1 month after the symptoms of the disease disappear, you must take a general blood test. After 6 months, you need to check the viral load in the body. To do this, an ELISA test is performed to determine antibody titers. If the virus remains active 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 and mineral complexes to maintain immunity.

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

Chronic fatigue syndrome

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

Symptoms of the disease

Feeling of “soreness” in the throat.
Slight enlargement of lymph nodes, especially cervical and occipital.
Constant temperature, often low.
Severe muscle weakness.
A significant decrease in overall performance by more than 50% of the original level.
Constant feeling of fatigue, weakness.
Violation of the daily routine, insomnia.
Memory disorder.
Pain and dryness in the eyes.
Irritability.

Features of treatment

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

However, the following methods are effective:

General restorative therapy (immunomodulatory drugs, physiotherapeutic treatments, vitamin therapy).
In cases of depression associated with this disease, consultation with a psychiatrist is necessary.

Disease prognosis

In most cases, patients notice an improvement in their condition after treatment after 1-2 years. But, unfortunately, complete restoration of performance practically does not occur.

Oncological diseases caused by EBV infection

Nasopharyngeal carcinoma

Nasopharyngeal carcinoma is a malignant disease of the nasopharynx.

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

Difficulty in nasal breathing.
One-sided hearing loss is possible (when a malignant oncological process moves to the Eustachian tube).
Patients often experience nosebleeds.
Unpleasant odor from the mouth and when breathing.
Pain in the nasopharynx.
Non-healing ulcers in the throat.
Pain when swallowing.

Treatment methods

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

Among the treatment methods, the fight against malignancy comes to the fore:

Surgery. The use of Cyber Knife in the early stages of the disease showed good results.
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.
Antiviral treatment is prescribed after surgery for a long period in order to minimize the activity of oncogenic viruses.

Burkitt's lymphoma

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

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

Most often, the disease begins with damage to the lymph nodes of the nasopharynx and oropharynx, mandibular, postauricular, supraclavicular lymph nodes. It is for this reason that the first symptoms are impaired nasal breathing and pain when swallowing.
The disease progresses quite quickly, involving new groups of lymph nodes in the pathological process.
In advanced stages of the cancer process, the organs of the chest and abdominal cavity are affected.

Treatment

Given the high malignancy of the disease, they are used simultaneously surgical method, as well as radiation and chemotherapy. This disease has a high risk of recurrence. When symptoms of the disease reappear 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 unfavorable, given the high malignancy of Burkitt's lymphoma. In the early stage of the disease when started in a timely manner complex treatment the prognosis is improving.

Diagnosis of diseases, antibodies to Epstein-Barr virus

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

If symptoms suspicious for EBV infection appear, it is necessary to use additional laboratory methods that identify this pathogen.

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

The body's immune system 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 initially enters the body, class M immunoglobulins are formed within 3 months, and when the infection becomes chronic and the pathogen remains in the body’s 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 (enzyme-linked immunosorbent assay):

Antibodies to early antigen indicate an early stage of the disease and primary lesion (class M immunoglobulins - IgM)
Antibodies to capsid and nuclear antigen are an indicator of 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 can cross the placenta to the baby, the presence of positive antibodies is not always dangerous.

When should you not worry?

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

When is antiviral therapy needed during pregnancy?

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

Availability IgM antibodies dangerous for the baby and also create a risk for the course of the pregnancy. It has been proven that the presence of EBV infection in the body of a pregnant woman leads to gestosis, the threat of miscarriage, pathology of the placenta, premature birth, impaired blood flow, and fetal hypoxia.

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

Such a widespread distribution of the Epstein-Barr virus, as well as the significant variety of “masks” that this infection takes on, contribute to increased attention to this microorganism. Unfortunately, at the moment, there is no single and clear treatment regimen for this infection. Moreover, 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 advanced EBV infection can cause malignant oncological processes that are very difficult to treat.

Professor Michael Epstein and his graduate student Yvonne Barr described a virus relatively recently - in 1964 - which was given a double name after their last names - Epstein-Barr. Despite the fact that this is one of the most common microorganisms of the herpes species, it is still “overlooked” by attention.

Danger of Epstein-Barr virus

This microorganism was isolated from biopsies of lymphoma tumors taken from children from African countries.

The difference between this virus and its “brothers” is that it encodes 85 proteins. For comparison: a virus herpes simplex encodes only 20. The virus attaches to the cell using a special structure - on its surface there is a large number of glycoproteins that ensure reliable penetration into the mucosa.

Once the virus enters the body, it remains for life and infects 90% of the human population. It is transmitted through contacts, during operations - through blood and bone marrow - and by airborne droplets.

But in most cases, the Epstein-Barr virus is transmitted to children through kisses from infected adults. The danger of this pathogenic flora lies not in its penetration into the body, but in the fact that it provokes malignant processes and causes diseases that, in people with reduced immune status can cause serious complications. One of the diseases that occurs when the Epstein-Barr virus is introduced is infectious mononucleosis or Filatov's disease.

An increase in its activity causes the following diseases:

chronic fatigue syndrome;
systemic hepatitis;
lymphogranulomatosis;
lymphomas;
multiple sclerosis;
hairy leukoplakia of the oral cavity and some others.

Epstein-Barr symptoms

The characteristic symptoms of the Epstein-Barr virus depend on the disease that it provoked, but general signs indicate its introduction.

For example, infectious mononucleosis causes the following symptoms:

increased fatigue;
signs of pharyngitis;
temperature rise above febrile – more than 39º;
by days 5-7, the lymph nodes enlarge, starting with the cervical ones;
the spleen increases in size, sometimes the liver;
urine darkens;
the rash is heterogeneous in nature - urticaria, papules with liquid, roseola appear simultaneously.

Similar symptoms occur with chronic infection of the Epstein-Barr virus, the only thing is that during it the function of nasal breathing is impaired and mental abilities are reduced.

Against the background of the disease caused by this virus, the introduction of pathogenic flora of a different type begins and secondary infection occurs, candidiasis, stomatitis, inflammatory diseases upper and lower respiratory tract and digestive organs.

Consequences of the EPSTEIN-BARR VIRUS

Infectious mononucleosis can be mild or severe; in some cases, it goes away without treatment after 4 months.

But the introduction of the virus sometimes causes severe complications that appear after the disease:

encephalitis and meningitis;
obstruction of the bronchopulmonary tree;
general damage to the nervous system
hepatitis;
damage to the cranial nerves;
pericarditis;
myocarditis.

These diseases occur more often in children, since adults suffered from mononucleosis in childhood. In whatever form the diseases caused by the introduction of the virus occur.

Epstein-Barr - acute or chronic - they need to be treated. This is the only way to avoid complications.

Diagnosis of EPSTEIN-BARR VIRUS

To detect the Epstein-Barr virus in the body, the following laboratory diagnostic tests are used.

In a general blood test, the number of leukocytes, monocytes and lymphocytes is calculated - if infected, their number exceeds the norm;
Biochemical analysis - enzyme indicators AST, LDH and ALT are increased;
The state of the immune system is assessed: the production of interferon, immunoglobulins, etc. is specified;
Serological diagnostics are carried out - in time, antibodies to the Epstein-Barr virus are detected. IgM titers are determined. They are elevated during the clinical picture caused by mononucleosis, but also remain high after recovery - immunity against this virus lasts for life;
During DNA diagnostics, it is determined whether there are antibodies in physiological fluids: saliva, smears from the upper respiratory tract, spinal cord;
With the culture method, the spread of the virus is established - it is grown on brain cells, cells of patients with leukemia, etc.

Research allows not only to find viral particles in the blood, but also to determine the degree of damage to the body and predict the risk of complications.

Treatment of Epstein-Barr virus

There is no specific scheme according to which treatment is carried out. Each case requires its own therapeutic approach.

All patients suspected of infectious mononucleosis must be hospitalized.

bed rest;
increasing the amount of fluid you drink - drinks should be warm;
respiratory manifestations are relieved with vasoconstrictor drops and rinses - solutions with antiseptics and folk remedies;
decrease in temperature;
vitamin therapy;
antihistamines.

Therapy begins with the use antiviral agents different groups: Arbidol, Valtrex, Acyclovir, interferons.

Antibiotics are included in therapeutic measures more often when a secondary infection occurs or respiratory conditions of acute severity.

Immunoglobulins used against the Epstein-Barr virus are one of the main drugs that help avoid complications after diseases caused by the introduction of this pathogenic flora. Immunoglobulin is administered by injection intravenously. The therapy is supplemented with drugs that increase the immune status of the body - immunomodulators and biological stimulants: Derinat, Likopid, cytokines, Actovegin...

If additional symptoms occur, they are eliminated according to individual schemes. The temperature is reduced with conventional antipyretics, mucolytics and antitussives are prescribed for coughs, otitis media is treated with special drops, and a runny nose is treated with local vasoconstrictor medications.

The duration of the disease varies from 2-3 weeks to 3-4 months, it all depends on the severity of the symptoms.

Preventative measures for EPSTEIN-BARR VIRUS

It is impossible to prevent the introduction of the Epstein-Barr virus; it is necessary to try to create conditions so that the child’s body can endure the “meeting” with it as easily as possible and subsequently develop immunity for life. Children with normal immune status tolerate mononucleosis normally - it can even be asymptomatic.