Epstein-Barr Virus (EBV)

What is the Epstein-Barr virus (EBV)?

The Epstein-Barr virus (EBV) is a member of the herpes virus family (human herpes virus 4). EBV is found worldwide and is a common cause of viral pharyngitis, especially in young adults. EBV is transmitted from person to person and then infects human B cells, which in turn spread the infection throughout the entire reticuloendothelial system (RES, or the liver, spleen, and peripheral lymph nodes). About 50% of the population has antibodies to the virus by age 5; about 12% of susceptible adults (college-age) develop antibodies to the virus, and one half of those adults develop the disease termed mononucleosis (also termed infectious mononucleosis, mono, glandular fever, and kissing disease), which produces symptoms of lymph node, spleen, and liver swelling, fever, inflamed throat, malaise, and rash.

About Epstein-Barr Virus (EBV)

  • Symptoms
  • Transmission
  • Diagnosis
  • Prevention & Treatment

Epstein-Barr virus (EBV), also known as human herpes virus 4, is a member of the herpes virus family. It is one of the most common human viruses. EBV is found all over the world. Most people get infected with EBV at some point in their lives. EBV spreads most commonly through bodily fluids, primarily saliva. EBV can cause infectious mononucleosis, also called mono, and other illnesses.


Symptoms of EBV infection can include

  • fatigue
  • fever
  • inflamed throat
  • swollen lymph nodes in the neck
  • enlarged spleen
  • swollen liver
  • rash

Many people become infected with EBV in childhood. EBV infections in children usually do not cause symptoms, or the symptoms are not distinguishable from other mild, brief childhood illnesses. People who get symptoms from EBV infection, usually teenagers or adults, get better in two to four weeks. However, some people may feel fatigued for several weeks or even months.

After you get an EBV infection, the virus becomes latent (inactive) in your body. In some cases, the virus may reactivate. This does not always cause symptoms, but people with weakened immune systems are more likely to develop symptoms if EBV reactivates. EBV Spreads Easily

EBV is spread by saliva through:

  • kissing
  • sharing drinks and food
  • using the same cups, eating utensils, or toothbrushes
  • having contact with toys that children have drooled on


EBV spreads most commonly through bodily fluids, especially saliva. However, EBV can also spread through blood and semen during sexual contact, blood transfusions, and organ transplantation.

EBV can be spread by using objects, such as a toothbrush or drinking glass, that an infected person recently used. The virus probably survives on an object at least as long as the object remains moist.

The first time you get infected with EBV (primary EBV infection) you can spread the virus for weeks and even before you have symptoms. Once the virus is in your body, it stays there in a latent (inactive) state. If the virus reactivates, you can potentially spread EBV to others no matter how much time has passed since the initial infection.


Diagnosing EBV infection can be challenging because the symptoms are similar to other illnesses. EBV infection can be confirmed with a blood test that detects antibodies. About nine out of ten of adults have antibodies that show that they have a current or past EBV infection.

Prevention & Treatment

There is no vaccine to protect against EBV infection. You can help protect yourself by not kissing or sharing drinks, food, or personal items, like toothbrushes, with people who have EBV infection.

There is no specific treatment for EBV. However, some things can be done to help relieve symptoms, including

  • drinking fluids to stay hydrated
  • getting plenty of rest
  • taking over-the-counter medications for pain and fever

Everything You Need to Know About Epstein-Barr Virus

What is it?

Epstein-Barr virus (EBV) is a member of the herpes virus family that can infect humans. EBV infections are very common — you’ve probably already contracted the virus without even knowing it.

The condition that you may associate EBV infection with is infectious mononucleosis, or mono. However, experts are researching potential links between EBV and other conditions, including cancer and autoimmune diseases.

Read on to learn more about EBV, including common symptoms of an infection and how the virus spreads.

What are the symptoms?

EBV infections don’t always cause symptoms. This is especially true for children.

Teens and adults are more likely to experience symptoms, which can include:

  • fever
  • feeling tired or fatigued
  • headache
  • sore throat
  • swollen lymph nodes in your neck or under your arms
  • swollen tonsils
  • enlarged spleen (splenomegaly)
  • skin rash

These symptoms can last for two to four weeks, though feelings of fatigue may linger for weeks or months.

What about symptoms of reactivation?

Once you’ve been infected with EBV, the virus remains inactive within your body for the rest of your life. This is called latency.

In some cases, the virus can reactivate. But this usually doesn’t cause any symptoms.

However, reactivated EBV may cause symptoms similar to those of an initial EBV infection in people who have a weakened immune system.

How does the virus spread?

EBV spreads from person to person through bodily fluids, particularly saliva. This is why mononucleosis, one of the most well-known EBV infections, is casually known as the “kissing disease.”

But you can also get the virus by sharing personal items, such as toothbrushes or eating utensils, with someone who has an active EBV infection. EBV can also be spread through blood and semen.

You can start spreading EBV to others as soon as you contract it. This means you can pass it on to others before you even start to have symptoms of an active infection.

You’ll be able to pass EBV on to others as long as the virus is active, which could mean weeks or even months. Once the virus becomes inactive, you can no longer spread it to others, unless it reactivates.

Is there a test for it?

Potential EBV infections are often diagnosed without any testing. However, blood tests can detect the presence of antibodies associated with EBV.

One of these is known as the mono spot test. However, the Centers for Disease Control doesn’t recommend Trusted Source it for general use because the results aren’t always accurate.

In addition to the mono spot test, there are other blood tests for more specific antibodies to EBV, including:

  • Viral caps-id antigen (VCA). Antibodies to VCA appear early in the infection. One type (anti-V CA IgM) disappears after several weeks while another (anti-V CA IgG) persists for life.
  • Early antigen (EA). Antibodies to EA appear during an active infection. They typically become undetectable after several months, although they may persist for longer in some people.
  • EBV nuclear antigen (EBNA). Antibodies to EBNA slowly appear in the months following infection and can be detected throughout a person’s life.

A healthcare provider will take these results and other factors into account, including a person’s overall health and any underlying health conditions, to make a diagnosis.

What is the Epstein-Barr virus test?

The Epstein-Barr virus (EBV) is a member of the herpes virus family. It’s one of the most common viruses to infect people around the world.

According to the Centers for Disease Control and Prevention Trusted Source, most people will contract EBV at some point in their lives.

The virus typically causes no symptoms in children. In adolescents and adults, it causes an illness called infectious mononucleosis, or mono, in about 35 to 50 percent of cases.

Also known as “the kissing disease,” EBV is usually spread through saliva. It’s very rare for the disease to be spread through blood or other bodily fluids.

The EBV test is also known as “EBV antibodies.” It’s a blood test used to identify an EBV infection. The test detects the presence of antibodies.

Antibodies are proteins that your body’s immune system releases in response to a harmful substance called an antigen. Specifically, the EBV test is used to detect antibodies to EBV antigens. The test can find both a current and past infection.

Epstein-Barr virus infection facts

  • The Epstein-Barr virus (EBV) is a herpes virus that is found worldwide and is a common cause of viral pharyngitis (infectious mononucleosis).
  • The cause of an Epstein-Barr infection (mononucleosis) is EBV; risk factors include intimate contacts with body secretions (especially saliva) and objects that may be exposed to body secretions of infected people.
  • The Epstein-Barr virus is contagious and is spread from person to person.
  • EBV is contagious during the incubation period and while symptoms are present; some individuals may be contagious for as long as 18 months.
  • EBV is transmitted from person to person mainly by saliva; however, other body fluids may transmit the disease. Items contaminated with bodily fluids like saliva (toys, utensils, cups, for example) may also transmit the disease.
  • The incubation period for an Epstein-Barr virus infection is about four to seven weeks.
  • The symptoms and signs of an EBV infection may include malaise, fever, muscle aches, headaches, sore throat, lymph node swelling, liver swelling, rash, and spleen swelling.
  • Preliminary diagnosis of EBV infection is based on the patient’s history and physical exam; physicians may also use immunological tests that vary in specificity.
  • Treatment of EBV infection is mainly supportive (see home remedies section); some health care providers use cortisone treatment.
  • Home remedies that may help reduce symptoms are rest, fluids, over-the-counter (OTC) pain medications, and avoiding trauma that can further injure organs like a swollen spleen.
  • The possible complications of EBV infection may include an enlarged spleen, jaundice, liver inflammation, anemia, splenic rupture, swollen tonsils, breathing difficulties, rash, irregular heartbeats, and a possible increased risk for cancer.
  • The majority of people with EBV have a good prognosis; a few have a more guarded prognosis.
  • There is no vaccine for EBV, and prevention is difficult. Risk can be reduced by not contacting body fluids from infected individuals and practicing good hand-washing techniques.

Epstein-Barr virus (EBV) or human herpes virus 4, is a B lymphotropic gamma-herpes virus that infects more than 90% of the world’s population. The most common manifestation of primary infection with this organism is acute infectious mononucleosis, a self-limiting clinical syndrome that most frequently affects adolescents and young adults. Classic symptoms include sore throat, fever and lymphadenopathy that may, or may not, be accompanied by a faint generalized maculopapular rash. Humans are the only known reservoir of EBV.

To better understand the psychophysiology of EBV infection that is occurring in our case, the following series of graphics explains both the normal activation pathway of B cells when stimulated by antigen and the mechanism by which EBV drives naïve infected B cells to recapitulate this pathway.

We also explain the immunological events that occur in X-linked lymphoproliferative disease (XLP), a rare primary immunodeficiency in which sufferers have a selective inability to control EBV infection and which we speculate is the likely cause of the patient’s condition in our case study.

After exposure, EBV establishes a persistent infection in the host and is intermittently shed in oropharyngeal secretions.  In uncomplicated EBV infections the main target cells are B lymphocytes that express CD21 which, along with HLA class II molecules, serve as the viral entry receptor and co-receptor, respectively. The virus can also infect epithelial cells and may initially replicate in the oropharynx before infecting B cells. Naive B cells become infected in local lymphoid tissue, most often Waldemar tonsillitis ring, and establish latent infected memory B cell pools that migrate to other lymphoid tissues. Periodic reactivation of latently infected memory B cells are thought to facilitate infection of epithelial cells in the oropharynx that permits shedding of virus into saliva for transmission to new hosts. Latently infected memory B cells are long-lived and due to low levels of expression of viral proteins they escape detection by CD8+ cytotoxic T cells. Therefore persistence of EBV in the body is life-long.

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