Although the Epstein-Barr virus (EBV) is less contagious than the common cold, it may still be passed on to others. It is transmitted through contact with an infected person's saliva. For instance, individuals can acquire the disease after kissing an infected person or sharing food or beverages with an infected person. The infection is rarely transmitted through airborne mucus droplets or contact with infected blood.
Individuals are typically contagious for several weeks after signs and symptoms develop. However, some people may carry and spread the virus intermittently throughout their lives. For this reason, it is almost impossible to prevent transmission of the virus.
Individuals who have already been infected with EBV rarely become infected again.
General: In many cases, infections with the Epstein-Barr virus (EBV) go undiagnosed. This is because some patients experience mild or no symptoms. Many cases are mistaken for the common cold.
Heterophile antibody test (monospot): A heterophile antibody test, also called a monospot, is considered the standard test to diagnose EBV infections. A sample of the patient's blood is taken and analyzed for the presence of EBV antibodies. When the EBV virus enters the body, the patient's immune system develops these antibodies to fight against the infection. If antibodies are present, a positive diagnosis is made.
Sometimes, early in the infection or in young children, the antibody test produces false negative results. This means the patient tests negative for the infection even though he/she is, in fact, infected. Therefore, if patients test negative, but EBV is strongly suspected, additional antibody tests may be performed.
signs and symptoms
General: Symptoms of the Epstein-Barr virus vary depending on the specific strain (type) of the virus. Children younger than five years old usually do not experience any symptoms of an infection. Adolescents and adults may or may not experience symptoms. If symptoms do develop, they usually appear 30-50 days after exposure to the virus. The duration of symptoms also varies. In general, symptoms start to lessen after about two weeks. However, fatigue may last for several more weeks or months.
Common symptoms: Often, the first signs of an infection is a general feeling of discomfort and tiredness that may last anywhere from several days to a week. The four main symptoms of EBV infections are: fatigue, sore throat, fever, and enlarged lymph nodes (especially in the neck). Fatigue is generally the worst two to three weeks after symptoms develop, and it may last six weeks or longer. Fatigue may be severe and interfere with a person's ability to perform normal daily activities. A pus-like substance may also be present in the back of the throat. Other common symptoms include swollen tonsils, headache, loss of appetite, and night sweats.
About half of patients with mononucleosis develop an enlarged spleen. This is because the immune cells in the spleen destroy the virus that is present in a person's blood. Most patients experience few, if any symptoms, indicating an enlarged spleen. This is typically identified during a physical examination.
Less common symptoms: The liver may become enlarged in some patients. In less common cases, the patient's skin and eyes may appear yellow in color (a condition called jaundice).
Ruptured spleen: Many patients with mononucleosis caused by the Epstein-Barr virus develop an enlarged spleen. In extreme cases, the spleen may rupture. This is most likely to happen if the person participates in rigorous physical activities while he/she is sick. Patients who rupture their spleens typically experience a sharp and sudden pain in the upper-left side of the abdomen. If this type of pain develops, patients should be taken to the nearest hospital immediately. A ruptured spleen generally requires surgery.
Nerve problems: Complications of the nervous system are rare, but may include nerve damage, seizures, behavioral changes, inflammation of the brain (called encephalitis), and inflammation of the tissues surrounding the brain and spinal cord (called meningitis).
Blocked airways: In rare cases, the lymph nodes in the neck may become extremely large and block the airways. This may make it difficult for the patient to breathe.