When coming into contact with the outside world, the likelihood of picking up some kind of bacteria is very high, but this will not necessarily immediately cause the development of the disease. Some microorganisms are very rare, others enter the body of almost every person.
The virus is easy to catch in normal situations
The latter includes the Epstein-Barr virus; it is considered one of the most widespread on the planet. This virus belongs to the herpetic group, so it is often called herpes type four. This microorganism was discovered in 1964 by scientists from Great Britain, after whom it was named. Why is it necessary to know about this virus? The thing is that infection often occurs before the age of 15 years and can cause the development infectious mononucleosis, but if the virus is activated in adulthood, this leads to serious disruptions in the functioning of the body. It is important to recognize and deal with the problem in time - after suffering from the disease, the child develops immunity and is no longer afraid of the virus.
Symptoms and routes of entry of the virus
Another name for the disease is “kissing disease”, since the pathogen can be transmitted by parents to children through kissing
The Epstein-Barr virus is very specific: once it enters the body, it can remain there for many years without giving the slightest sign its presence – its containment occurs due to the body’s immune defense. As soon as the immune system weakens for one reason or another, the child becomes ill.
Typically, the infection spreads through carriers, or more precisely, through their saliva. That is why the disease is often called the “kissing disease” - the pathogen is transmitted to the child through frequent parental kisses.
The most common methods of penetration of a microorganism (besides kissing) are the use of common funds hygiene, the same dishes or toys (especially those that have been in the mouths of other children). There are known cases when infection occurred at the stage of intrauterine development.
High fever is a symptom of the virus
The incubation period can last from one to two months, and the first manifestations are general character characteristic of all viral infections:
- initially there appears weakness in the body, aches, appetite significantly worsens;
- after a few days there is a strong increase in temperature (up to 40 degrees), which is accompanied by an increase in the size of the cervical lymph nodes;
- often arise painful sensations in the liver area;
- V individual situations a rash appears all over the body (1 case out of 10).
Gradually, the presence of the virus in the body leads to the occurrence of other diseases. The most common manifestation of the Epstein-Barr virus in children is infectious mononucleosis, but other ailments may also appear (herpes sore throat, tonsillitis).
Provoked infectious mononucleosis has specific symptomatic manifestations. Thus, the temperature remains at a fairly high level for a long period of time (from 2 weeks to a month).
Symptoms of mononucleosis also include: general weakness, headache, dysfunction gastrointestinal tract, painful sensations in the joints. Without proper treatment, the risk of lung complications increases.
It is important to know that this disease develops extremely rarely in infants, since the baby is protected by the mother’s immunity, transmitted through milk. If symptoms of the disease are detected, you must immediately go to the hospital - timely treatment will not only improve the general condition, but will also significantly reduce the risk of dangerous complications. In some situations, outpatient treatment is required.
Dangerous consequences of virus activity
The type of complications is related to what kind of disease was provoked by the activity of the virus, while the incidence of complications is low, but the probability still exists. For example, to the number possible consequences advanced infectious mononucleosis include:
- damage to central organs nervous system(meningitis, encephalitis). Symptoms of this condition usually appear after the first two weeks of illness (headache, psychosis, even paralysis of the facial nerves is possible);
- splenic rupture (the probability of such a complication is 0.5%, with a higher risk in males). Characteristic manifestations: sharp pain in the abdomen, disturbance in hemodynamic processes;
- due to excess tissue growth in the tonsils, the disease may be complicated by obstruction respiratory tract;
- there is a low likelihood of developing myocarditis, vasculitis, hepatitis and pericarditis.
How to treat Epstein-Barr virus in a child?
First of all, it is necessary to carry out a diagnosis
When visiting a hospital, diagnostic procedures are initially carried out to identify the causative agent of the disease - a blood test is sufficient for this. As soon as accurate diagnosis It will be clarified whether active treatment is started depending on the stage of advanced disease. So, if the disease occurs in an acute form, then the first steps will be aimed at reducing the intensity of symptoms and transferring it to a more light form. Standard set of drugs: antivirals and means to strengthen the immune system. Additionally, symptomatic treatment is prescribed, namely drugs to lower the temperature, gargling to reduce pain when swallowing, etc.
When the disease has already become chronic, treatment becomes much more complicated - in addition to medications, it is no longer possible to do without a complex physical exercise and special diet. Nutritional correction in such a situation is aimed at reducing the load on the liver and increasing the level of immune protection through the consumption of healthy foods.
If the activity of the virus in the child’s body was mild or asymptomatic, then the reason for contacting doctors will be the disease that developed against this background. So, if a microorganism provokes infectious mononucleosis, then the main efforts will be aimed at eliminating this disease.
The prognosis for treating children is positive; symptoms usually subside completely within three weeks. Despite the treatment procedures, general weakness and poor health remain for some time (this period can last for several months).
Traditional methods of treatment
Since the opinions of experts about the right approach the diseases do not coincide with treatment, parents often have doubts about traditional treatment - this becomes the impetus for using traditional medicine. Regardless, before using any product, it is better to consult with your doctor and make sure that independent actions will not harm the child.
So, herbal medicine is widely used to treat Epstein-Barr virus. It is believed that the following recipes will help cope with the problem:
- chamomile, calendula flowers, coltsfoot, mint and dum root can be brewed and given to the child instead of tea no more than three times a day. These herbs contain a huge amount of useful substances that improve the functioning of the immune system, and also have a calming effect necessary during illness;
- Regular consumption of green tea with additives (honey and lemon) will be beneficial. When using such a product, you need to remember the likelihood of an allergic reaction;
- a decoction of chamomile, immortelle, yarrow and centaury;
- tincture of ginseng (for a child, the recommended dose is up to 10 drops);
- inhalations with eucalyptus or sage;
- a sore throat can be gently lubricated with essential oils (fir, juniper or sage).
Epstein–Barr virus (human herpesvirus type IV, Epstein–Barr virus, EBV, human herpesvirus type IV) is a member of the herpevirus family of the gammaherpesvirus subfamily. It can replicate in lymphocytes, immune cells and the central nervous system, the mucous membrane of the upper respiratory tract, internal organs. The Epstein-Barr virus, unlike other herpeviruses, does not lead to the death of infected cells, but, on the contrary, promotes their active reproduction (proliferation).
Epstein-Barr virus is widespread among the population. According to WHO, over 90% of people, including infants, are its carriers. However, it still remains insufficiently studied.
Infection with the Epstein–Barr virus leads to the development hidden infection, i.e., virus carriage, which can last throughout a person’s life without manifesting itself clinically. However, against the background general decline immunity, the virus is able to become more active and cause the development of a number of diseases.
Mechanism of infection and routes of infection
The source of infection is a person with an active form of the Epstein-Barr virus, contagious from the last days of the incubation period and for 6 months. According to medical statistics About 20% of people who have had an active form of infection remain spreaders of the infection for many years.
It is believed that the majority of adults are carriers of the Epstein-Barr virus, so measures aimed at strengthening the immune system are important to prevent exacerbations from occurring, i.e. secondary prevention.
Those at risk for infection with the Epstein–Barr virus include:
- pregnant women;
- children under 10 years of age;
- patients with immunodeficiencies of various origins;
Pregnant women are at risk of contracting the Epstein–Barr virus
Epstein-Barr virus can be transmitted from person to person in the following ways:
- contact and household (through kisses, personal hygiene items, shared towels, toys, dishes);
- airborne (from coughing, sneezing or talking);
- transmissible (during transfusion of blood and its components, organ transplantation and bone marrow);
- vertical (from mother to child during pregnancy, childbirth or breastfeeding);
- nutritional (through food and water).
When infected, the Epstein–Barr virus penetrates the cells of the mucous membrane oral cavity, upper respiratory tract, salivary glands or tonsils. Here it begins to actively multiply, and then the virions enter the cells of other organs and tissues through the bloodstream.
Infection of B-lymphocytes by the virus is accompanied by an increase in their population. This causes the activation of T lymphocytes, which begin to attack the affected immune cells. Clinically, this process is manifested by an increase in all groups lymph nodes.
With a normally functioning immune system, infection with the Epstein-Barr virus may not manifest any clinical symptoms, which is due to the presence of developed immunity to various types of herpes simplex viruses. But in some cases, infection leads to the development of acute infectious process, called infectious mononucleosis (Filatov's disease). It is accompanied by the active production of immunoglobulins that can retain the Epstein-Barr virus for many years in B-lymphocytes. Filatov's disease in many cases remains undiagnosed due to its latent course or is mistakenly regarded by doctors as a respiratory viral infection.
If a person has good immunity, the Epstein-Barr virus may not manifest itself for years
When the patient’s immunity is low, especially when there is an insufficient number of T-lymphocytes, a latent chronic infection forms that has no external signs.
Against the background of a significant deficiency of T-lymphocytes, patients may develop a generalized pathological process in which the virus affects the heart, spleen, liver, and central nervous system. Therefore, this infection poses a particular danger for people with HIV infection (especially at the AIDS stage), since they have a sharp decrease in the number of T-lymphocytes.
In the case of a chronic latent course of infection, any decrease in the functions of the immune response contributes to the activation of the Epstein-Barr virus and creates the preconditions for the occurrence of a number of diseases associated with it:
- toxic hepatitis;
- viral or bacterial (caused by the addition of a secondary infection) pneumonia;
- a decrease in the number of platelets in the blood, manifested by a tendency to hemorrhage;
- malignant neoplasms (cancer of the intestines, stomach, esophagus, tonsils, nasopharynx, as well as Burkitt's lymphoma, Hodgkin's disease);
- autoimmune diseases (rheumatoid arthritis, autoimmune hepatitis, systemic lupus erythematosus, type I diabetes mellitus, multiple sclerosis).
When studying biopsy material obtained from cancer patients, the Epstein-Barr virus is detected in approximately 50% of samples. By itself, it does not have the ability to cause the formation of tumor cells, but is capable of enhancing the effect of other carcinogenic factors.
The development of autoimmune diseases due to infection with the Epstein-Barr virus has the following explanation: the virus, together with other pathogenic microflora, distorts the immune response, which causes the immune system to recognize its own tissues as foreign and actively damage them.
Against the background of chronic infection, many patients develop common variable immune deficiency over time. Clinically, it manifests itself as frequently occurring infectious diseases that are characterized by a long and severe course. An insufficiently formed immune response leads to the fact that patients may experience repeated cases of rubella, chickenpox, measles and others infectious diseases, to which stable immunity should normally be formed. Bacterial infections are also more severe than usual and can be complicated by the development of septic conditions.
Functional impairment immune system Epstein-Barr virus can cause the development of severe, generalized allergic reactions (Stevens-Jones syndrome, Lyell's syndrome, erythema).
Symptoms of Epstein–Barr virus
Clinical symptoms of the Epstein-Barr virus are characterized by polymorphism, which is explained by the many diseases it causes.
Infectious mononucleosis
Infectious mononucleosis is one of the most common infections, the development of which is caused by the Epstein-Barr virus in children. The incubation period for this disease lasts 4–15 days. Upon completion, the patient’s body temperature rises sharply to 38-40 °C, which is accompanied by chills. At the same time, intoxication symptoms occur (sharp deterioration in general health, headache and muscle pain, feeling of weakness, lack of appetite). They join in a few hours flu-like symptoms: Patients begin to complain of sore throat and nasal congestion. In approximately 85% of patients, enlargement of lymph nodes occurs on days 5–7 of the disease. Manifestations of lymphadenitis persist until the end of the period at the height of infectious mononucleosis. Some patients may experience hepatosplenomegaly (enlarged spleen and liver).
Infectious mononucleosis is the most common infection caused by the Epstein-Barr virus.
Epstein-Barr virus in infants causes a blurred clinical picture of infectious mononucleosis. How older child, the more pronounced the symptoms of the disease appear.
Chronic fatigue syndrome
With the syndrome chronic fatigue(CFS) fatigue, malaise, a feeling of general weakness and decreased ability to work are constantly observed in the patient and do not go away even after proper rest.
CFS most often affects young and middle-aged people. Its main features:
- constant feeling of fatigue;
- body aches;
- headache;
- sleep disturbances (difficulty falling asleep, nightmares, frequent waking up at night);
- flu-like symptoms (nasal congestion, sore throat, low-grade fever);
- mental disorders (labile mood, disappointment in life, indifference to the environment, psychosis, depressive states);
- decreased concentration;
- forgetfulness.
The development of CFS is explained by the effect of the Epstein-Barr virus on the brain, which leads to prolonged overexcitation of cortical neurons, and then to their depletion.
Doctors explain chronic fatigue syndrome as a result of the Epstein-Barr virus
Generalized Epstein–Barr infection
A generalized course of infection is usually observed in people with severely weakened immune systems, for example, in patients suffering from AIDS or who have undergone a red bone marrow transplant taken from a donor who is a carrier of the Epstein-Barr virus.
The disease begins with signs of infectious mononucleosis, but after a short time they are joined by symptoms indicating damage to almost all vital organs:
- central nervous system (cerebral edema, meningitis, encephalitis);
- cardiovascular systems s (endocarditis, myocarditis, cardiac arrest);
- lungs (respiratory failure, interstitial pneumonia);
- liver (toxic hepatitis with symptoms of liver failure);
- blood (DIC syndrome, coagulopathy);
- kidneys (acute renal failure due to severe nephritis);
- spleen (significant increase in its size, leading to a high risk of rupture);
- lymphatic system (acute proliferative syndrome).
Generalization of infection caused by the Epstein–Barr virus often leads to death.
Infection with the Epstein-Barr virus leads to the development of a latent infection, i.e., virus carriage, which can last throughout a person’s life without manifesting itself clinically.
Diagnostics
Diagnosis of the infectious process caused by the Epstein-Barr virus is carried out in the laboratory, using serological research methods, which are based on the detection of specific antibodies to viral proteins. In clinical practice, the Henle reaction (indirect immunofluorescence reaction) is most often used, which determines antibodies (IgM, IgG, IgA) to capsid, non-capsid early and nuclear antigens. Diagnostic titers of specific antibodies are usually detected 15–30 days from the onset of the disease.
To diagnose the Epstein-Barr virus, it is necessary to detect IgM, IgG, IgA antibodies in a blood test
IgM and IgG titers to capsid antigens reach their maximum at 3-4 weeks of illness. Then there is a sharp decrease in IgM titer, and after 3 months it becomes impossible to determine them. IgG titers also gradually decrease, but small amounts circulate in the patient’s blood throughout his life.
Persistence of IgG in high titers can be observed during a long course of the infectious process, against the background of chronic renal failure, Burkitt's lymphoma, nasopharyngeal carcinoma, Hodgkin's lymphoma, HIV infection, immunodeficiency conditions and rheumatoid arthritis.
In the first 2-3 months of the disease, antibodies to early antigens are detected in the blood of 80-90% of patients. In approximately 20% of cases they can also be detected in patients with chronic variant course of the infectious process. High titers of these antibodies are observed in pregnant women, as well as in patients suffering from cancer and HIV carriers.
Antibodies to nuclear antigens begin to be detected two months after infection with the Epstein-Barr virus. They persist in low titers, and their absence suggests a disorder immune status patient.
In the acute course of Epstein-Barr infection, characteristic changes in the blood picture are also noted:
- monocytosis;
- hypergammaglobulinemia;
- thrombocytopenia;
- increased bilirubin concentration;
- the appearance of cryoglobulins;
- the presence of at least 80% of atypical mononuclear cells (precursor cells of cytotoxic T-lymphocytes that destroy virus-infected B-lymphocytes).
Diseases caused by the Epstein–Barr virus require differential diagnosis with a number of other pathological conditions, primarily with the following diseases:
- viral hepatitis;
- streptococcal pharyngitis;
- rubella;
Treatment of Epstein–Barr virus
Currently, there is no consensus among specialists regarding the treatment regimen viral infection Epstein-Barr.
For infectious mononucleosis, patients are hospitalized in infectious diseases hospital. In the acute period, in addition to the main therapy, they are prescribed semi-bed rest, plenty of fluids and dietary nutrition. Sweet, salty, smoked and fatty foods are excluded from the diet. Food should be taken often, in small portions. Fermented milk products must be included in the menu, fresh vegetables and fruits.
Existing therapy for Epstein-Barr infection does not allow the patient to fully recover; the virus persists in the patient’s B-lymphocytes for life.
For chronic fatigue syndrome general recommendations are:
- taking a complex of multivitamins with minerals;
- nutritious nutrition;
- positive emotions;
- regular exercise;
- long walks on fresh air;
- normalization of sleep;
- compliance with the regime of alternating work and rest.
When treating the Epstein-Barr virus, the patient is prescribed immunoglobulins
If necessary, drug treatment for Epstein-Barr virus is carried out. It is aimed at eliminating the symptoms of the disease, increasing immunity, preventing or treating possible complications. For this they use medicines the following groups:
- Immunoglobulins are drugs that contain ready-made antibodies that can bind the Epstein-Barr virus and remove it from the body. They are most effective in the acute period of Epstein-Barr viral infection, as well as in exacerbations of a chronic infectious process. Administered intravenously in a hospital setting;
- drugs that suppress the activity of DNA polymerase are prescribed to patients with a generalized form of infection, as well as for malignant neoplasms associated with the Epstein-Barr virus. In acute infectious mononucleosis they do not have the necessary therapeutic effect;
- drugs that have an immunostimulating and/or nonspecific antiviral effect - for severe infectious mononucleosis and during exacerbations of a chronic infectious process;
- Antibiotics are indicated when a secondary bacterial infection occurs. Patients with infectious mononucleosis should not be prescribed penicillin drugs;
- non-steroidal anti-inflammatory drugs - indicated for the relief of fever, headache and muscle pain. The use of aspirin (acetylsalicylic acid) is not recommended due to high risk development of Reye's syndrome;
- glucocorticosteroids - indicated for generalized Epstein-Barr infection or severe infectious mononucleosis;
- hepatoprotectors – help restore liver cells and improve their functions. Prescribed when a patient develops toxic hepatitis;
- antihistamines – have an antiallergic effect, their administration during the height of infectious mononucleosis helps reduce the risk of complications;
- vitamins – shorten the period of convalescence of infectious mononucleosis, improve the general condition of patients with chronic fatigue syndrome. (acute autoimmune polyneuropathy);
- transverse myelitis;
- Reye's syndrome (one of the variants of acute hepatic encephalopathy);
- hemolytic uremic syndrome;
- splenic rupture.
Forecast
Existing therapy for Epstein-Barr infection does not allow the patient to fully recover; the virus persists in the patient’s B-lymphocytes for life. When the immune system is weakened, the virus can become more active, which leads to an exacerbation of the infectious process, and in some cases, the development of cancer.
Prevention
There are no primary preventive measures to prevent infection with the Epstein–Barr virus. It is believed that the majority of adults are virus carriers, so measures aimed at strengthening the immune system are important to prevent exacerbations from occurring, i.e. secondary prevention. Such measures include:
- refusal bad habits(smoking, alcohol abuse);
- regular but moderate physical activity;
- maintaining a daily routine (a good night's rest is especially important);
- avoiding stress, mental and physical overload;
- timely diagnosis and active treatment of any somatic and infectious diseases.
Video from YouTube on the topic of the article:
Children often suffer from viral diseases, and some of them pose a serious threat to children's health. Currently, pediatricians around the world are addressing Special attention on the pathology that causes the Epstein-Barr virus.
When a child is initially infected, the symptoms of this infection may go unnoticed. The consequences of infection after a few months negatively affect all organs and systems of the body. What do parents need to know about the signs of this disease?
The Epstein-Barr virus is the causative agent of a number of human diseases and belongs to the group of herpes viruses (another name is the infectious agent of herpes type 4). Discovered in 1964 in Great Britain by scientists Michael Epstein and Yvonne Barr. It multiplies in the cells of the child’s immune system (lymphocytes) and causes their uncontrolled growth (cytomegalovirus causes an increase in the size of infected cells).
Associated with the following diseases::
- Infectious mononullosis;
- Burkitt's lymphoma;
- Nasopharyngeal carcinoma;
- Other oncological pathologies(chemotherapeutic and surgical treatment).
The virus contains the following elements against which B-lymphocytes produce antibodies of the IgM and IgG classes (immunoglobulin M, G) in the bodies of children:
- VCA – capsid antigen;
- ENBA – nuclear antigen;
- EA – early antigen.
When IgM and IgG (immunoglobulin M, G) against the above antigens (VCA, EA, ENBA) are detected in the child’s blood, if a serological analysis is performed, then an acute or chronic form of the disease caused by the Epstein-Barr virus can be diagnosed.
How the virus is transmitted
The virus has several modes of transmission. Released into the environment with biological fluids body. Its highest concentration accumulates in the saliva of children, so a common pathology caused by it is infectious mononucleosis, otherwise called the “kissing disease.”
The pathogen spreads when:
- Kisses on the lips;
- Intimate contacts;
- Blood transfusion;
- Using common objects (dishes, toys) with which a sick baby or a virus carrier has come into contact (the pathogen is in his saliva and through it enters the outside world);
- Using non-sterile medical equipment for injections, surgical interventions, cosmetic procedures;
- From mother to child through the placenta and during breastfeeding.
Cytomegalovirus (CMV) has similar transmission routes, and is especially dangerous for the unborn child if the baby becomes infected from a sick mother. Couples planning children must donate blood for EBV and CMV testing. If the test result is positive, treatment is recommended.
Risk group
Epidemiologists identify two risk groups among children:
- One-year-old babies who actively contact others;
- Preschoolers aged 2.5-5 years who regularly attend kindergarten.
Viral infection (EBV, not cytomegalovirus) spreads most quickly in small closed children's groups, which include groups in kindergartens.
Signs and symptoms
Let's look at the symptoms of infectious mononucleosis, which is a manifestation of a child's primary contact with the Epstein-Barr virus. Sometimes mononucleosis in children is caused by cytomegalovirus (differential serological analysis is always necessary).
The disease begins acutely and lasts from 3 to 4 weeks.
With mononucleosis (if it is caused by EBV and not cytomegalovirus), the following symptoms appear. It is discovered during direct examination of the child:
- Increase in body temperature to 39-40 degrees with severe intoxication syndrome - nausea, vomiting, weakness, headache, tachycardia;
- Enlarged lymph nodes throughout the body (especially in the neck - anterior and posterior cervical nodes);
- Nasopharyngitis and tonsillitis with white-gray or yellowish plaques (due to damage to the tonsils and adenoids);
- Difficulty nasal breathing in the absence of discharge from the nasal passages, puffiness of the face, nasal voice;
- Enlarged liver and spleen (hepatosplenomegaly in children), pain in abdominal cavity, icterus of sclera and skin;
- Exanthema (rash of viral origin) in the form of spots, papules, vesicles with widespread localization.
On microscopic examination ( general analysis blood) during acute infection among ordinary blood cells, large atypical lymphocytes are found that are affected by the virus - mononuclear cells (cytomegalovirus sometimes gives this picture of blood). They remain in the bloodstream for a month from the moment of infection.
The immune system of a sick child tries to cope with infected lymphocytes. There is an activation of T-helpers and T-suppressors, NK cells, which destroy mononuclear cells. Surviving B-lymphocytes produce antibodies of the IgG and IgM classes (immunoglobulin M, G) against each of the viral antigens (VCA, EBNA, EA), making the work of the cellular part of the immune system possible.
Infectious Mononucleosis (Virus Epstein Barr A). Symptoms and Treatment Methods
For serological diagnostics mononucleosis using enzyme-linked immunosorbent assay (ELISA) or polymerase chain reaction (PCR), which detects the Epstein-Barr virus.
What antibodies (AT) of the IgG and IgM types (immunoglobulin M, G) are diagnostic when performing an IF analysis?
| Type of antibodies | Characteristic |
| Anti-VCA antibodies IgM class(immunoglobulin M to capsid antigen) | Produced during acute EBV infection, they circulate in the blood for 2-3 months. They are resynthesized in case of virus reactivation. A high concentration of anti-VCA IgM, which persists for a long time, is evidence of a chronic form of EBV. |
| Anti-EA IgG antibodies (immunoglobulin G to early antigen) | They appear in the blood 3-4 weeks after the onset of acute EBV infection and persist for 2-6 months. Anti-EA IgG reappears when the pathogen is reactivated. |
| Anti-EBNA IgG antibodies (immunoglobulin G to nuclear antigen) | They begin to circulate in the bloodstream 1-6 months after the primary EBV disease. Gradually their concentration decreases. Anti-EBNA IgG can be detected until the end of a person's life (they are always detected by IF analysis). |
If an IF analysis was performed, positive result, which revealed:
- IgG antibodies (immunoglobulin G) against nuclear and early antigens;
- antibodies of the IgM type (immunoglobulin M) to the capsid (VCA) antigen of the virus
Confirms the diagnosis of “acute infectious mononucleosis” and indicates EBV infection. Additionally, a blood test is performed for antibodies against antigens that cytomegalovirus has.
What are the complications of infectious mononucleosis (caused by EBV, not cytomegalovirus)?
- Hepatitis;
- Splenic rupture;
- Development of hematological and oncological pathologies;
- Development of immunodeficiency, anemia, thrombocytopenia;
- Autoimmune pathologies;
- Meningitis and meningoencephalitis;
- Pancreatitis;
- Pneumonia;
- Lesions of the myocardium and valvular apparatus of the heart.
In acute EBV infection, complications arise if the virus is accompanied by a secondary bacterial infection during the height of the disease or recovery.
Children aged 3-4 to 15-16 years are most vulnerable to infection. Infants get sick less often, and symptoms of the disease often go undetected. Expanded clinical picture and a severe course and negative consequences in a child can only occur if he was infected in utero or suffers from an immunodeficiency of any nature (for example, the immune response does not work due to the lack of antibodies to VCA, EA, ENBA antigen).
Doctor Komarovsky's opinion
Dr. Komarovsky believes that most children have already encountered the Epstein-Barr virus, and the symptoms of the disease were minimal.
Komarovsky warns against the use of amoxicillin and ampicillin for mononucleosis (antibiotics penicillin group), which are prescribed to a child in case of incorrect diagnosis as a treatment for sore throat. This can provoke the appearance of exanthema.
Pediatrician Komarovsky points out that for mononucleosis, only symptomatic treatment is indicated for ordinary children without immunodeficiency conditions (when anti-VCA, anti-ENBA antibodies are not produced). They do not need to be treated with antiviral or immunostimulating drugs.
Infectious mononucleosis – School of Dr. Komarovsky
Prevention
- To avoid infection with the Epstein-Barr virus early years teach your child personal hygiene.
- In autumn and winter, avoid large crowds of people, as sneezing and coughing also have a chance of transmitting the Epstein-Barr pathogen.
- Lead healthy image life, since the Epstein-Barr virus, after entering the body, can remain in it for a long time in a latent form (symptoms appear when the immune system is weakened, physical exhaustion, if treatment for another disease is interrupted).
Treatment
Specific treatment for Epstein-Barr virus has not been developed. In the case of a severe course of the disease (severe symptoms), drugs that are effective against other viruses of the herpes group are used in a hospital setting. The doctor may prescribe immunomodulatory drugs according to individual indications, taking into account the following indicators:
- titer of antibodies to VCA, ENBA and EA antigens (capsid, nuclear, early) in the patient (IF analysis is done) and
- the presence or absence of antibodies to antigens such as cytomegalovirus.
As a symptomatic treatment of sore throat caused by the Epstein-Barr pathogen, antiseptic lozenges, gargles with disinfectant solutions or herbal infusions are used.
To reduce the child's temperature, paracetamol is offered.
The rash can be treated with panthenol to speed up healing.
A sick baby needs to drink a lot, all food should be ground or semi-liquid.
Folk recipes
Traditional treatment is powerless against the cause of the disease – the Epstein-Barr virus.
To relieve sore throat, like effective treatment It is recommended to prepare infusions of chamomile, mint and sage and rinse the mouth with them.
Give your child plenty of rosehip infusion and offer your baby hot tea made from raspberry or currant jam (drinks with vitamin C stimulate the immune system to fight the Epstein-Barr virus).
Epstein-Barr virus is the causative agent of many dangerous infections, but proper care for the child, the first meeting with EBV will be without complications for the baby. Parents should know typical signs Epstein-Barr infection in order to see a doctor on time, donate blood for a serological test and preserve children's health.
How can you become infected with mononucleosis? – Doctor Komarovsky
Data May 14 ● Comments 0 ● Views
Doctor Dmitry Sedykh
Epstein-Barr virus is one of 8 types of herpes viruses diagnosed in humans. Other name - . According to various sources, the pathogen is present in the body of 60-90% of people. Most often, infection occurs at an early age, so great importance It has correct diagnosis and treatment of Epstein-Barr virus in children.
This type of herpes was first identified by the English virologist M.E. Epstein in 1964. The pathogen got its name (Epstein-Barr virus, or EBV) after the names of the scientist and his graduate student, Yvonne M. Barr. Further studies showed that the infection is widespread: among people over 35 years of age, the percentage of carriers is more than 90%, among children aged 5 years - about 50%. The virus is dangerous because, under certain conditions, it contributes to the development of cancer, autoimmune and inflammatory diseases.
Young children and children are most often exposed to infection. adolescence, which is due to three main factors:
- the prevalence of the pathogen (more than half of people are carriers);
- the child’s fragile immune system;
- highly contagious virus (easily transmitted from person to person).
Some children tolerate the infection easily, almost asymptomatically, while in others it can cause serious deterioration in health and the development of complications.
Epstein-Barr virus (EBV): causes and risk group
How does the virus enter a child's body?
The source of infection is a person with an acute EBV infection or who has had this disease in the foreseeable past. Even with complete recovery and absence external manifestations disease, it remains contagious for a long time– from 2 to 18 months. Epstein-Barr virus is transmitted:
- By airborne droplets. This is the most common method. A large number of pathogens are contained in saliva, the mucous secretion of the upper respiratory tract. Therefore, there is a high probability of transmitting the virus when talking, coughing, or sneezing.
- Contact - the risk of infection is high with close interaction - kissing, touching.
- Vertical - from mother to child. In this case, they talk about congenital Epstein-Barr viral infection. Infection can occur during fetal development or during labor. This is a rare method of transmission.
- Contact and household- through towels, toys, linen, dishes and other items. The pathogen is not persistent in the external environment, but can spread in this way.
- During blood transfusion or organ transplantation.
Susceptibility to the Epstein-Barr virus in humans is very high, and the severity of the reaction to infection largely depends on the state of the immune system. It is the individual characteristics of the body’s defenses that explain the fact that some children tolerate infection practically asymptomatically, while others suffer severely and for a long time.
The peak incidence occurs between the ages of 3 and 10 years. This is facilitated by the close interaction of children in groups - kindergarten or school.
Epstein-Barr virus (EBV): transmission routes, infection, prognosis
How does the virus manifest itself in children and what diseases does it cause?
The incubation period after infection lasts from several days to 1-2 months. The first noticeable symptoms in children appear after its completion, mainly from the respiratory system. The uncomplicated course of the disease resembles a mild cold (ARVI).
Having penetrated the body, the Epstein-Barr virus primarily affects the upper respiratory tract - the mucous membrane of the nasopharynx, salivary glands. There it multiplies and accumulates, then spreads throughout the body through the bloodstream, penetrating the internal organs. The infectious agent invades B lymphocytes, special cells responsible for the functioning of the immune system.
Symptoms of the Epstein-Barr virus in children can vary significantly depending on age, immune status, and individual characteristics of the body. With mild external manifestations, the infection often remains unrecognized, and the malaise is explained as a common cold. This course of the disease is most typical for children younger age(up to three years).
Teenagers and school-age children are more susceptible to infection. If in total characteristic features Based on the test results, the causative agent was identified as the Epstein-Barr virus, and the disease was classified as infectious mononucleosis. It is characterized by the following symptoms:
- A noticeable increase in the size of the lymph nodes in the neck and abdomen.
- Increase in temperature (reaches 39-40 degrees).
- Inflammatory processes in the nasopharynx are signs of tonsillitis, tonsillitis, rhinitis. Inflammation and swelling of the tonsils cause difficulty breathing. Increased mucus secretion in the upper respiratory tract can cause coughing.
- Enlarged spleen and liver. When palpated, they are hard and painful.
- Increased fatigue.
- In some cases acute course The disease is accompanied by a reddish rash on the skin (as a reaction to the use of antibiotics).
If the immune system cannot cope with the pathogen, a chronic EBV infection may develop, which will bother the child for a long time. It can be active, erased or atypical. The most severe form is generalized, in which severe damage to the nervous and cardiovascular systems is observed. serious inflammation internal organs (hepatitis, pneumonia, meningitis).
In 90% of cases, Epstein-Barr infection is accompanied by a sore throat, which cannot be treated with antibiotics. In severe cases, inflammation in the throat can develop into a follicular or necrotic form.
Epstein-Barr virus (EBV) in children: symptoms (temperature), consequences, prevention, vaccination
Diagnostics
External symptoms for precise definition an infectious agent is usually not enough. Therefore, to detect the Epstein-Barr virus, various methods laboratory diagnostics:
- Serological tests (antibody tests) - show the intensity and adequacy of the immune response. Depending on the class of detected antibodies (immunoglobulins), the stage of the disease is classified (acute phase, incubation period, recovery).
- Polymerase chain reaction (PCR) - allows you to determine the DNA of the causative virus. This modern way diagnostics is characterized by high accuracy and can be used to analyze blood, sputum, biopsy samples and other biomaterials. The PCR method is not used in all cases due to the high cost of the analysis.
- General and clinical tests blood. With Epstein-Barr infection, the main indicators of the blood condition change in a certain way - the ESR increases, hemoglobin decreases, and the number of leukocytes increases. A manual analysis reveals atypical monocytes in the blood - the so-called mononuclear cells.
- Since the infection negatively affects liver function, they may be prescribed liver tests to monitor the condition of this organ.
The doctor determines what tests will be required in a particular case of the disease. Also, these laboratory tests can be prescribed in cases where the causes of the disease are unknown, but there is a suspicion of their association with the Epstein-Barr virus.
The most informative is comprehensive examination, including laboratory diagnostics, careful study of all external manifestations of the disease, ultrasound of internal organs.
Diagnosis of Epstein-Barr virus (EBV): blood test, DNA, PCR, liver tests
Treatment methods
The pathogen belongs to the group of herpes viral infections, from which no one can completely get rid of modern drug. Therefore, in both adults and children, treatment of the Epstein-Barr virus is aimed at stopping clinical symptoms and reduction of the acute phase of the disease. In young children, infection often goes unnoticed and does not require treatment.
The main goals of therapy for acute EBV infection are to support the patient’s immunity, alleviate his condition, and prevent damage to internal organs. Treatment is symptomatic, prescribed by a doctor on an individual basis. The scheme usually includes the following points (according to indications):
- Bed rest– allows you to mobilize the body’s own defenses and reduce the likelihood of complications.
- Special diet. Epstein-Barr infection negatively affects the condition of internal organs; gentle nutrition makes their work easier.
- Vitamin therapy. Increases the body's resistance.
- Immune stimulation using special drugs (“Interferon”, “Viferon”).
- Antibiotics (except penicillins, which are not used for EBV) are used in case of complications of the disease with a secondary bacterial infection. Pick up effective drug A special analysis will help - bacterial culture, which allows you to determine the sensitivity of microorganisms to groups of antibiotics.
- Anti-inflammatory drugs based on paracetamol or ibuprofen. Prescribed for high temperatures and severe inflammatory processes.
- Antihistamines to alleviate the condition. Glucocorticosteroids (“Prednisolone”) are used only in cases of severe disease.
- Antiseptics for treating the oral cavity and pharynx - help prevent the development of secondary bacterial infections.
- Sorbents (activated carbon, Polyphepan, Enterosgel) - reduce intoxication of the body and alleviate the patient’s condition.
- Hepatoprotectors and choleretic drugs (“Karsil”, “Hofitol”) - improve the functioning of internal organs and prevent their damage.
The acute phase of the disease lasts from 2-3 weeks to 2 months (in severe cases). Then comes a long period of rehabilitation, the work of all organs and systems gradually returns to normal. A person who has recovered from the disease develops a strong immunity to the Epstein-Barr virus. In this case, the pathogen is present in the body in a “dormant” state and does not manifest itself in any way.
When sharp decline immunity, the infection can become more active and lead to recurrent illness.
Infectious mononucleosis – School of Dr. Komarovsky
Possible complications
In rare cases, EBV in children leads to the development of complications varying degrees gravity. These can be autoimmune diseases, secondary bacterial infections, and even oncological changes.
Among the autoimmune diseases associated with the presence of the Epstein-Barr pathogen are:
- peripheral neuropathy;
- thrombocytopenic purpura;
- optic neuritis;
- hemolytic anemia;
- hemophagocytic syndrome;
- immunodeficiency;
- Guyen-Barre syndrome
- chronic fatigue syndrome.
Secondary bacterial infection due to Epstein-Barr disease can lead to the development of streptococcal sore throat, sinusitis, pneumonia or otitis in a child. In this case inflammatory processes are often chronic.
The following complications are possible in children from internal organs:
- heart failure, myocarditis;
- splenic rupture;
- liver failure;
- pancreatitis;
- meningitis, encephalitis;
- hepatitis.
Most often, the liver and spleen are affected by viral infections in children.
A connection has been established between infection with the Epstein-Barr virus and cancer:
- Burkitt's lymphoma;
- leukemia;
- malignant tumors of various organs.
Complications of this type are rare, a significant part of them are associated not only with the pathogen, but also with gender (a number of diseases develop only in boys), territorial and racial characteristics.
Infection with the Epstein-Barr virus is not a death sentence. According to research, up to 97% of people are its carriers. Only in rare cases, when improper treatment, the presence of a genetic predisposition or immune deficiency, the pathogen can give impetus to the development of more dangerous diseases. Therefore, if a child is diagnosed with this infection, you should not panic - you must carefully monitor the baby and follow all medical recommendations. In most children, the disease can be cured without consequences or complications.
Also read with this
Infection of children with viral infections is facilitated by the fact that their immune system is weakened, and at the same time they are more likely than adults to have close contact with virus carriers. Recognize diseases that arise as a result of the development of viruses various types, without special analyzes almost impossible. Even the same virus can manifest itself as symptoms of several diseases with different consequences and manifestations. For example, the development of the Epstein-Barr virus in children's body sometimes it goes unnoticed. But it can also be a source of very dangerous diseases.
Content:
Characteristics of the virus
The discoverers of this infectious pathogen are English microbiologist Michael Epstein and his assistant Yvonne Barr. This type of microorganism is one of the representatives of the herpetic group of viruses. Human infection usually occurs during childhood. Most often, children aged 1-6 years are infected as a result of the physiological imperfection of their immunity. A contributing factor is that at this age most children are still little familiar with the rules of hygiene. Their close contact with each other during play inevitably leads to the spread of the Epstein-Barr virus (EBV) from one baby to another.
Fortunately, in most cases, infection does not lead to serious consequences, and if the baby does get sick, he develops a strong immunity. In this case, the pathogen remains in the blood for life. Such microorganisms are found in approximately half of children undergoing virological examination and in most adults.
In infants feeding breast milk, EBV infection occurs extremely rarely, since their body is protected from the effects of viruses by the mother’s immunity. At risk are small children born prematurely, with poor development or congenital pathologies, patients with HIV.
At normal temperature and air humidity, a virus of this type is quite stable, but in dry conditions, under the influence high temperatures, sunlight, disinfectants he quickly dies.
What is the danger of contracting Epstein-Barr infection?
Until 5-6 years of age, infection most often does not pose a serious threat to health. Symptoms are typical for ARVI, sore throat. However, children may become allergic to EBV. In this case, the body’s reaction can be unpredictable, up to Quincke’s edema.
The danger is that once the virus enters the body, it remains there forever. Under certain conditions (decreased immunity, the occurrence of injuries and various stresses), it is activated, which becomes the cause of the development of serious diseases.
The consequences may appear many years after the infection occurs. The development of the Epstein-Barr virus is associated with the occurrence of the following diseases in children:
- mononucleosis – destruction of lymphocytes by viruses, the consequences of which are meningitis and encephalitis;
- pneumonia, increasing airway obstruction (obstruction);
- immunodeficiency state (IDS);
- multiple sclerosis- a disease caused by the destruction of nerve fibers in the brain and spinal cord;
- heart failure;
- rupture of the spleen due to its strong enlargement (this causes acute abdominal pain), which requires immediate hospitalization;
- lymphogranulomatosis - damage to the lymph nodes (cervical, axillary, inguinal and others);
- malignant lesion of the lymph nodes (Burkitt's lymphoma);
- nasopharyngeal cancer.
Most often, an infected baby, after promptly started treatment, fully recovers, but is a virus carrier. As the disease becomes chronic, symptoms periodically worsen.
If timely examination is not carried out, doctors may not recognize the true nature of the symptoms. The patient's condition worsens. A severe option is the development of deadly diseases.
Causes and risk factors
The main cause of infection is the entry of the Epstein-Barr virus directly into the body from a sick person. small child, which is especially contagious at the end of the incubation period, which lasts up to 1-2 months. During this period, these microorganisms multiply rapidly in the lymph nodes and mucous membranes of the nose and throat, from where they then enter the blood and spread to other organs.
The following routes of transmission of infection exist:
- Contact. Many viruses are found in saliva. A child can become infected if a sick person kisses him.
- Airborne. Infection occurs when particles of the patient's sputum are scattered around when coughing and sneezing.
- Contact and household. Infected saliva ends up on the child's toys or objects he touches.
- Transfusion. Transmission of the virus occurs through blood during a transfusion procedure.
- Transplantation. The virus is introduced into the body during a bone marrow transplant.
The patient's symptoms may be hidden, so he, as a rule, is unaware of his illness, continuing to be in contact with the small child.
Video: How EBV infection occurs, what are its manifestations and consequences
Classification of Epstein-Barr infections
When prescribing a course of treatment, take into account various factors, indicating the degree of activity of the pathogen and the severity of manifestations. There are several forms of Epstein-Barr virus disease.
Congenital and acquired. Congenital infection occurs during the period of intrauterine development of the fetus when viruses are activated in a pregnant woman. A child can also become infected during passage through the birth canal, since viruses also accumulate in the mucous membranes of the genital organs.
Typical and atypical. In the typical form, symptoms of mononucleosis usually appear. With an atypical course, the symptoms are smoothed out or similar to manifestations of respiratory tract diseases.
Mild, moderate and severe forms. Accordingly, in a mild form, the infection manifests itself as a short-term deterioration in well-being and ends with complete recovery. A severe form leads to brain damage, progressing to meningitis, pneumonia, and cancer.
Active and inactive form, that is, the appearance of symptoms of rapid reproduction of viruses or a temporary lull in the development of infection.
Symptoms of EBV infection
At the end of the incubation period, when infected with the EB virus, symptoms appear that are characteristic of the development of other viral diseases. It is especially difficult to understand what a child is sick with if he is less than 2 years old and is unable to explain what exactly is bothering him. The first symptoms, as with ARVI, are fever, cough, runny nose, drowsiness, and headache.
U junior schoolchildren and in adolescent children, the Epstein-Barr virus is usually the causative agent of mononucleosis (glandular fever). In this case, the virus affects not only the nasopharynx and lymph nodes, but also the liver and spleen. The first sign of such a disease is swelling of the cervical and other lymph nodes, as well as an enlargement of the liver and spleen.
Typical symptoms of such an infection are:
- Increased body temperature. By 2-4 days it can rise to 39°-40°. In children, it remains high for up to 7 days, then drops to 37.3°-37.5° and remains at this level for 1 month.
- Intoxication of the body, symptoms of which are nausea, vomiting, dizziness, diarrhea, bloating, aching bones and muscles.
- Enlargement of lymph nodes (mainly cervical) due to their inflammation. They become painful.
- Pain in the liver area.
- Inflammation of the adenoids. It is difficult for the patient to breathe through his nose due to its congestion; he has a nasal sound and snores in his sleep.
- The appearance of a rash all over the body (this sign is a manifestation of an allergy to toxins). This symptom occurs in approximately 1 in 10 children.
Warning: When visiting a doctor, parents of preschool children should insist on examining their child for the presence of EBV if he often suffers from colds and sore throats, eats poorly, and often complains of fatigue. Treatment with specific antiviral drugs may be required.
At atypical form Epstein-Barr virus lesions appear only individual symptoms, and the disease is not as acute as typical. Mild discomfort can last much longer than with the usual acute form.
Video: Symptoms of infectious mononucleosis. Can the disease be treated with antibiotics?
Diagnostics
Methods used laboratory research blood, with the help of which viruses are detected, the degree of damage to lymphocytes and other characteristic changes are determined.
General analysis allows you to determine the level of hemoglobin and the presence of an atypical structure of lymphocyte cells. These indicators are used to judge the activity of the virus.
Biochemical analysis. Based on its results, the condition of the liver is judged. The content of enzymes, bilirubin and other substances produced in this organ in the blood is determined.
ELISA (enzyme-linked immunosorbent assay). It allows you to detect the presence of specific antibodies in the blood - immune cells, which are produced in the body to destroy the EB virus.
Immunogram. The number of cells of various blood elements in a sample taken from a vein (platelets, leukocytes, immunoglobulins) is counted. Their ratio determines the state of immunity.
PCR (polymerase chain reaction). The DNA of microorganisms found in a blood sample is examined. This allows the presence of Epstein-Barr viruses to be confirmed, even if they are present in small quantities and are in an inactive form. That is, the diagnosis can be confirmed at the very early stages diseases.
Ultrasound of the liver and spleen. The degree of their increase and the presence of changes in tissue structure are determined.
Video: How EBV is diagnosed. What diseases is it differentiated from?
Epstein-Barr treatment method
If the disease occurs in a complicated form, shortness of breath appears or signs of heart failure or acute abdominal pain occur, the child is hospitalized. An urgent examination is carried out. If the presence of a viral infection is confirmed, specific antiviral and auxiliary treatment is prescribed.
For mild forms of the disease, treatment is carried out at home. Antibiotics are not prescribed, since they are powerless in the fight against viruses. Moreover, their prescription for mononucleosis can only worsen the patient’s condition, since antibiotics have a lot of side effects that are not harmless for children.
Specific therapy for Epstein-Barr infection
Drugs to strengthen the immune system and antiviral drugs are prescribed only in severe cases of the disease, when signs of severe intoxication and immunodeficiency occur. Children of any age can take Acyclovir, Isoprinosine. From the age of 2, Arbidol and Valtrex are prescribed. After 12 years you can use Famvir.
Antiviral and immunomodulatory agents include interferon derivatives: Viferon, Kipferon (prescribed at any age), Reaferon (from 2 years). Interferon inducer drugs (stimulating its own production in the body) are used. Among them are Neovir (prescribed from infancy), Anaferon (children over 1 year old), Kagocel (from the age of 3 years), Cycloferon (after 4 years), Amiksin (after 7 years).
Based on the results of the immunogram, the patient may be prescribed immunomodulatory drugs of other groups, such as Polyoxidonium, Derinat, Lykopid.
Note: Any medications, and even more so a specific action, should only be prescribed to children by a doctor. It is necessary to strictly adhere to the instructions without violating the dosage and treatment regimen.
Additional (symptomatic) therapy
It is carried out to facilitate general condition sick children.
Paracetamol or ibuprofen are usually given as antipyretics in forms suitable for children: syrups, capsules, suppositories. To facilitate nasal breathing, vasoconstrictors Sanorin or Nazivin (in the form of drops or spray) are prescribed. Gargling helps with sore throat antiseptic solutions furatsilin or soda. A decoction of chamomile or sage is used for the same purpose.
Anti-allergenic drugs are prescribed (Zyrtec, Claritin, Erius), as well as drugs that improve liver function (hepatoprotectors Essentiale, Karsil and others). Vitamins C, group B and others are prescribed as general tonics.
Prevention
There is no specific vaccine for the Epstein-Barr virus. You can protect your baby from infection only by instilling hygiene skills in him from birth, as well as strengthening his immunity. The development of the immune system is promoted by hardening, long walks in the fresh air, good nutrition, normal daily routine.
If symptoms of a viral infection occur, you should immediately contact your pediatrician. In acute form Epstein-Barr infection timely treatment leads to a quick recovery. If the symptoms are smoothed out, this does not mean that you should not pay attention to them. The disease can become chronic and cause serious complications.
