Something You Should Know: EBV

With COVID altering the very fabric of our lives for over a year between 2020 and 2021, much has been made about the microscopic agents that cause many of the infectious diseases humans and animals suffer from: viruses. While not technically living organisms, these little molecular machines are one of the most biochemically-efficient replicators in all of the known scientific realm. Now, most attention recently has gone to coronaviruses (and for good reason) and their ability to skirt the immune defenses our bodies possess to cause all sorts of havoc from our lungs to our head to the muscles of our feet. Today, I want to bring your attention to a different virus that directly targets your immune response: the Epstein-Barr Virus.

The Epstein-Barr Virus (or EBV), is a herpesvirus that is spread via bodily fluids and has infected about 95% of all people at one time or another. The good news about this virus is that most people who get it are completely asymptomatic. The bad news lies in the fact that those who do show symptoms can have a plethora of issues all throughout their bodies.

How does it infect a person's body?

EBV is a DNA virus that primarily enters your body, as mentioned above, via exchange of bodily fluids. This happens primarily via droplets of saliva from an infected individual entering the mouth of another person. Once the virus has entered the skin layers of your mouth (also known as the "epithelium"), it is able to enter the cells of the epithelium and begin "hijacking" the DNA replication instruments in those cells. Once the virus has replicated itself enough times, it releases chemicals that cause the cell to "lyse" or break apart. This allows all the replicated particles of the virus to spread to other cells in the area and begin the process all over again.

The new viruses are able to spread and infect a number of different cells in the body, and the most important type is your "B cells". B cells are an incredibly important component of your adaptive immune response to infection, and EBV causes these cells to replicate rapidly when it infects them. Sounds great, right? Who wouldn't want more immune cells to help fight off that infection? The problem lies in the fact that too many B cells can cause your immune system to be overactive in places where infections might not even be happening. When this happens, inflammation and damage to that area can occur. This can lead to a number of diseases/symptoms that are hard to combat because the infection is infecting the immune system itself!

So, what are these symptoms/diseases?

The most common and well-known manifestation of EBV is mononucleosis or "mono". Now that you know how EBV is transmitted, it makes sense why mononucleosis is called "the kissing disease", as kissing is a great way to spread saliva droplets between people. Mono can present with a number of symptoms like fatigue and cough, but swollen lymph nodes and a swollen spleen are also characteristic of the disease. Swollen lymph nodes are common in most infections, but why the spleen? The reason the spleen is swollen is because the spleen is the site of B cell generation in the body. Since EBV causes a lot of B cells to be made, it then makes sense that the spleen would fill up with lots of B cells! You want to be very careful not to engage in any kind of contact sport or activity, as the spleen is liable to rupture if it gets bumped too hard.

Mono is the common manifestation of EBV infection, but I want you to note a number of other possibilities that are rarer, but much more severe. Because EBV causes proliferation of B cells, there is a chance that far too many are made and there is no way for the body to stop them from growing. This can lead to cancerous or pre-cancerous diseases. Common types of cancer associated with EBV are lymphomas (cancers of the lymphatic system/nodes) and even nasal carcinomas. These are serious cancers with the possibility to have life-threatening complications if they spread to other regions.

Additionally, autoimmune diseases are not unlikely for a person who is infected with EBV. These can include anemia, multiple sclerosis, rheumatoid arthritis, and several others. Essentially what happens with the development of these diseases is that too many immune cells (like B cells) are in the blood and begin to attack parts of the body that are completely healthy.

Can it be treated?

The unfortunate news is that there is no vaccine or definitive treatment for the Epstein-Barr virus. EBV is a complicated virus that is still being extensively studied in the medical community, but much work still needs to be done before we are able to treat/get rid of the virus itself. If you were to be diagnosed with EBV infection, the physicians/healthcare providers would only be able to make sure you were hydrated and resting well. The good news is that this is usually all that needs to be done. Despite the virus' ability to compromise your immune system, you are still much more likely than not to be able to fight it off in a few days. Also, if any of the other, more serious diseases associated with EBV were to arise, there are treatments that address those as well.

Conclusion

In short, EBV is not a virus to be taken lightly, but your outlook is very likely to be just fine with some rest and hydration if you happen to contract it. It is a virus that can affect a lot of important systems in your body in a pretty unique way, but most people have it and are completely fine! Stay in touch with your doctor if you are feeling sick in a new way and have a history of EBV infection, but know that options for treatment exist for whatever disease process might arise because of the virus. Stay safe and healthy, and feel free to share this information with a friend!