Although modern medicine is able to save a person from many diseases and their terrible consequences, there are still problems that cannot be resolved to the end. The Epstein-Barr herpes virus in children, which has not manifested itself for a long time, is just one of these. For a child whose immunity is still not very strong, the risk of infection is higher than that of an adult. How to protect him?

Causes of the virus in oragnizm

The pathogen enters the body in several ways:

• airborne (if the patient coughs, and sputum penetrates through the skin / eyes);
• contact-household (when using some things with the patient);
• sexual (the child can become infected while in the womb of the mother or during conception);
• after transfusion of infected blood.

Most often, it is transmitted to the child from a pregnant mother - for example, through a kiss (which is why mononucleosis was called the "disease of kisses"). According to scientists, about 90% of the world's population are carriers of the virus, and everyone is able to infect a child with it. The main risk group is children under the age of 1 year.

The incubation of the disease takes from 4 weeks to several months. For a long time, it simply “nests” in blood cells, which at the same time do not collapse, and even multiplies inside them. The body develops immunity to the pathogen, but this does not mean that mononucleosis, as one of the consequences, will not develop.

Epstein-Barr virus in children can occur in a latent form for 3 years after infection. To start the inflammatory process, you do not need a large number of bacteria, and anything can serve as a trigger, starting with frostbite and ending with another vaccination. If at the time of intoxication or a sharp decrease in immunity there are enough viruses in the body, this can trigger a disease.

The consequences of pathogen infection

Despite the fact that modern medicine knows methods for treating the Epstein-Barr virus in children, it is almost impossible to completely get rid of the consequences of infection. A pathogen-provoked disease - infectious mononucleosis - has long been generally considered exclusively childish.

And, alas, it has certain, not the most pleasant consequences. For example, even after curing from infectious mononucleosis, the lymph nodes will increase (albeit slightly), and for about a year and a half the patient will be able to accidentally transmit the pathogen by airborne droplets. This is especially true in cases where the virus starts pathological processes in the body, but does not manifest itself in any way. This can affect, for example, the kidneys and liver. There are frequent cases in which mononucleosis causes cancer.

If the treatment is not started on time or it is obviously wrong to treat, the following complications may develop:

• anemia (anemia) associated with a change in the number of blood cells in the vessels;
• proliferative syndrome (may develop if the immune system is already impaired, and lead to numerous disorders in the internal functioning of the body);
• respiratory failure (lymph nodes grow in size and simply block the airways);
• damage to the central nervous system (encephalitis, meningitis);
• rupture of the spleen (in case of excessive physical exertion during the illness);
• cranial nerve disease (Martin-Bell syndrome, neuropathy, myelitis);
• hairy leukoplakia of the mouth (expressed in the occurrence of specific tubercles inside the cheeks and tongue and may indicate third-party infection with HIV infection);
• complete blockage of the nasal sinuses and ear canals - otitis media, sinusitis;
• rapid hepatitis.

It is much more difficult to cure diseases that have arisen a second time. Therefore, at the slightest suspicion of mononucleosis, it is necessary to show the child to the doctor in order to exclude the Epstein-barr virus.

Symptoms in children. How to recognize that a child is sick?

The degree of manifestation of infectious mononucleosis directly depends on the form of pathology. So, if there is a virus in the body, but without a pronounced disease, its presence can be detected through diagnosis. Another form, chronic, manifests itself periodically, imperceptibly progresses, and sometimes even extends the lesion focus. According to statistics, in a chronic form, mononucleosis occurs most often.

The first symptoms of the pathogen, alas, are weak or are perceived as a common cold. Already after, when the disease is at an advanced stage, parents note a variety of manifestations: from the usual increase in lymph nodes and ending with mental disorders. Other common symptom options:

• high temperature (above 37.5 °);
• weak migraine;
• frequent fungal infections;
• disturbances in the central nervous system, irritability, due to which the child begins to cry;
• slight hyperplasia of the lymph nodes in the neck and ears, occasionally throughout the body;
• skin rashes;
• muscle pain;
• impaired digestion, rare stools, impaired appetite;
• chronic fatigue;
• pneumonia.

The acute form of the disease is characterized by the following symptoms:

• severe fever;
• hyperplasia of the lymph nodes;
• enlarged liver / spleen;
• tonsillitis, respiratory failure;
• external hepatitis.

The older the child, the brighter the symptoms appear, and the easier it is to detect the disease. The more accurately the parent describes the clinical picture, the faster the doctor will tell you how to treat the child - and, therefore, the lower the risk of complications.

Pathogen Diagnosis

Most often, according to statistics, the presence of a pathogen in the body is diagnosed at the age of 4 to 15 years. Prior to this, the Epstein-barr virus manifests itself slightly.

Symptoms and treatment of children must be carried out under the supervision of a doctor!

The following methods are used in diagnostics:

1. an immunogram indicates the number of immune cells that are responsible for fighting the infection - if there are any abnormalities, the disease is diagnosed. Different pathologies cause different deviations, therefore, in some cases, an immunogram is used as an additional study;
2. PCR (polydimensional chain reaction) studies DNA and gives a 100% error-free result. The technique allows you to determine whether the child has antibodies, at what stage the disease is, how much the internal organs are enlarged (and whether they are enlarged at all). It is mandatory after blood transfusion and organ transplantation.

If the Epstein-Barr virus is found in a child, there is no need to panic. With the timely suppression of the signs of the disease, timely prevention, hardening and a healthy lifestyle, it is quite possible to get rid of problems.

What tests will be needed?

A patient with suspected mononucleosis will have to pass the following tests:

• general blood analysis. Detects the number of blood cells (lymphocytes and platelets), as well as their condition and is used to determine the stage and form of the disease;
• donate blood - biochemical analysis. Investigates the level of certain chemical elements in the blood and reveals the possible development of hepatitis;
• epstein-Barr virus serology for children. It allows to detect the presence of a virus in the body, although even if it is “positive”, this does not mean that it is active. Appointed after actual contact with the carrier, pregnant women and with suspected acute form.

The problem of some diagnostic methods (in particular, blood tests and an immunogram) reveals only the presence of certain disorders in the body, but not a specific disease. Other diagnostic methods are suitable for secondary testing, and often targeted treatment of mononucleosis begins only with the results of these studies.

What does a doctor usually prescribe?

To begin treatment of the Epstein-Barr virus in children (even if it will be carried out at home), you must first consult a doctor to clarify exactly how the pathogen interacts with his body. If he does not manifest himself in any way, and the classical symptoms of mononucleosis do not appear, treatment will not be prescribed. If the disease has already begun to develop, the child may be put in an infectious diseases hospital. In the case of sick leave at home, the attending physician writes a certificate for 12 days. If a child goes to school or kindergarten, no quarantine is announced.

There are no funds that purposefully “exterminate” mononucleosis. The fight against infection is carried out by the immune system, and the goal of treatment is only to stimulate it. However, if complications are observed, the attending physician may prescribe antiviral drugs:

• for kids - “Cycloferon” in the form of injections;
• up to 2 years - “Acyclovir”, “Zovirax”, are accepted within 7-10 days;
• up to 7 years - "Viferon 1" rectally.

Against chronic mononucleosis appoint:

• Reaferon-EU;
• Intron A
• Roferon-A.

To relieve painful symptoms:

• antipyretic drugs - Panadol, Paracetamol;
• antihistamines - Tavegil, Fenistil;
• ascorbic acid and other vitamins;
• decoctions of herbs (chamomile, sage) or furatsilin for gargling;
• nasal drops to narrow the vessels - but not longer than 3 days, as they can be addictive.

Together with clinical recommendations (including individual ones prescribed by the attending physician), complex therapy quickly suppresses the Epstein-Barr virus in the body. Treatment in children should be carried out at the same time only after a physical examination: even the most harmless remedy can greatly affect the health of the baby.

What to do to accelerate recovery?

• bed rest;
• reduction of physical activity during treatment and a month after recovery;
• the child should drink a lot, since the liquid helps to avoid intoxication.

Infectious mononucleosis entails a metabolic disorder and weakens the immune system, and therefore the attending physician prescribes a special diet. It should be in abundance:

• fresh vegetables;
• cereals and cereals (buckwheat, oatmeal);
• low-fat fish (cod, pollock) - boiled or steamed;
• white lean meat (rabbit, beef);
• milk (cheese, cottage cheese);
• non-acidic berries;
• bakery products (dried).

If necessary, one egg can be introduced into the daily diet, but not more. Fatty foods should be discarded, and sweets should be limited. After curing the disease, the child should be observed by a specialist for several years in case of relapse. When visiting other doctors, you must always be reminded that the child suffered mononucleosis.

Here's what Komarovsky says about the Epstein-Barr virus in children:

What is dangerous Epstein-barr virus?

Symptoms in children are not pronounced at its initial stage, so it is necessary to monitor any condition of the child. However, even following all the rules does not guarantee that the treatment will end successfully and without further complications. There are several conditions under which a doctor can make a favorable prognosis for recovery:

• the child is not infected with immune diseases;
• mononucleosis is not started and is in the primary stage;
• treatment is targeted, all the rules are followed;
• necessary prevention was carried out from the first days of life;
• complications such as sinusitis, sinusitis, pneumonia, etc. do not develop.

Unfortunately, “ridding the body” of a pathogen is completely impossible, but you can make it inactive. Therefore, doctors suggest conducting routine vaccinations to maintain immunity, and avoiding them is not always the best solution, because the consequences of the pathogen are very serious.

Prevention What to do in order not to get sick?

The pathogen is quite common in everyday life, and therefore it is quite difficult to avoid. However, this is not a reason to panic: with a proper lifestyle, the body is able to develop immunity, so the carrier of the virus does not encounter pronounced forms of the disease. Strengthen immunity as follows:

1. regularly walk with the baby in the fresh air;
2. move more, stimulating the child to play sports from the very first years;
3. take vitamins recommended by the pediatrician;
4. eat right, regularly eating vegetables and fruits;
5. in the presence of somatic diseases, do not rely on your own knowledge, but go to the doctor to avoid accidental error;
6. beware of stressful situations;
7. less likely to be in public places where there is a risk of contracting mononucleosis.

Useful video

   Doctors are of the opinion that zealous with prevention is not necessary. The sooner the child is ill, the easier he will suffer this disease. However, this does not mean that you need to let the baby’s health drift, and therefore following the preventive requirements is extremely important.

Epstein-Barr virus (VEB for short), or Epstein-Barr virus, or type 4 human herpes virus - a type of herpes virus family virus. Originally discovered in tumors and described in 1964 by the English professor Michael Epstein and graduate student Yvonne Barr. Why is it important for parents to know about him?

VEB's “place of residence” is lymphocytes, so it fights the child’s immune defenses. EBV causes Burkitt's lymphoma, lymphogranulomatosis, cytomegalovirus, hepatitis, infectious mononucleosis, herpes, and other unpleasant diagnoses.

It is more likely to catch the virus in adolescence, especially often at a younger age (5-6 years). After the child is ill, antibodies are developed, this is a protection for life from VEB. It is not yet possible to develop a vaccine capable of combating VEB, because the virus completely changes its protein composition at different stages.

Epstein-Barr virus is very specific and very dangerous: once it enters the body, it can remain in a “sleeping" state for a long time - the immune defense holds it back. As soon as immunity fails, the child becomes ill.

The English call this misfortune “kissing disease”, because the pathogen is transmitted from parents to children through kisses, with saliva.

Other ways of infection: general things and toys, transfusion of blood and its components, through the placenta to the baby during pregnancy, by airborne droplets, and also from the donor during bone marrow transplantation. In a special risk zone, children under one year old, pulling in the mouth everything that turns up at hand, and preschool children attending kindergartens.

Symptoms and diagnosis

The incubation period is from several days to two months, the first symptoms are similar to all viral infections. Signs in children are very ambiguous:

• Regular fatigue for no reason, tearfulness, irritability, excessive moods;
• Noticeable or insignificant (submandibular, behind the ear or throughout the body);
• Difficulties with digesting food, decreased appetite;
•   (infrequently);
•   - up to 40 degrees;
• Profuse sweating;
• Sore throat (as with and);
• Oversized liver and spleen. In children, they are manifested by aching pains in the abdomen;
• Rarely, the skin may acquire a yellow tint.

That is why, if there are even several symptoms or complaints only, it is impossible to diagnose EBV. Here, diagnostics of urine and blood tests are necessary (biochemistry is mandatory), serological examination, PCR, ultrasound of the spleen and liver.

Course of the disease

Traditionally, VEB proceeds in several stages. The latent period is from several days to two months. Active period - takes from 1 to 2 weeks, then a phased recovery occurs.

At an early stage in a child, a malaise appears, it lasts about a week.   And while the temperature remains normal. The next step is a sharp jump in temperature to 38–40 degrees. Toxication and polyadenopathy are added to this - a change in the lymph nodes up to 2 cm. Traditionally, the posterior and anterior cervical lymph nodes increase, but it is also possible to change the lymph nodes on the back of the head, submandibular, above and below the clavicle, under the armpits, in the inguinal region. On palpation, slight pain is felt.

In addition, the disease spreads to the tonsils, the picture resembles a sore throat. The back wall of the pharynx is covered with plaque, nasal breathing is difficult, tonsils increase. In the later stages, the Epstein-Barr virus affects the liver and spleen.   Damage to the liver suggests its increase, there is a heaviness in the right hypochondrium. Sometimes urine turns dark, mild jaundice occurs. The spleen with VEB also increases in size.

Infectious mononucleosis

The most common disease caused by EBV - has special symptoms. Quite a long time (from two weeks to a month) the high temperature does not subside. The picture of mononucleosis also includes: weakness, migraine, impaired gastrointestinal tract function, joint pain. Without proper treatment, there is a risk of complications from the pulmonary system.

In infants, this infection occurs very rarely, since the baby is protected by her mother's immunity, transmitted with milk. If signs of such a disease are identified, immediately consult a doctor - timely treatment will reduce the risk of consequences and normalize the condition of the crumbs. Staying in a hospital is not necessary in all situations, but in some cases it is possible.

Treatment

When contacting a doctor, they first try to identify the pathogen by examining the tests. With a ready diagnosis, depending on the degree of the disease, treatment is started. So, if the disease is in acute form, then initially the reduction of symptoms and the treatment of the disease in a less intense phase is provided. Usually treated with immunostimulants and antiviral drugs.   Be sure to symptomatic treatment: the doctor will prescribe a gargle, means to lower the temperature and so on.

When the disease has a chronic appearance, therapy is more complicated - physical exercises and a special diet are added to the medications. In this case, changes to the menu are needed to reduce the load on the liver.

If the virus causes infectious mononucleosis, then therapy will be aimed at eliminating it. It is important to remember that the appointment of penicillin antibiotics for mononucleosis can cause serious complications. For example, development is a rash that occurs with viral diseases.

The prognosis for children with the Epstein-Barr virus is favorable; the disease can be cured within three weeks. But, despite the treatment, poor health and weakness still remain, possibly for several months.

ethnoscience

Due to the fact that the approaches to the treatment of the disease among specialists differ, parents begin to doubt the fidelity of conservative appointments - this encourages treatment with alternative methods. But, before trying any remedy, you need to consult a doctor and make sure that your efforts will not harm the child.

The first thing that comes to mind is herbal medicine:

• Inhalations with sage and eucalyptus;
• Ginseng root tincture (for a child, the dose is up to ten drops);
• Chamomile, calendula flowers, coltsfoot, mint and root can be brewed and given to the child instead of tea no more than three times a day. These herbs contain many useful substances that improve the immune response, they also have a sedative effect;
• An inflamed throat can be lubricated with fir oil, juniper or sage;
• It will be useful to give the patient green tea, adding lemon and honey to it. It is important to remember the possible.

Prevention

And finally, we recall a common truth: any disease is easier to prevent than to treat. The tips below will help you avoid infection:

• An excellent habit of washing hands more often is a good prevention of EBV in children.
• During epidemics, make sure that the child is minimally in crowded places, where, apart from, it is likely to catch the Epstein-Barr virus.
• A balanced menu can also help a child resist infection. After all, if the virus is weak, it will begin to develop.

The child caught an infection - you need to provide him with plenty of warm drink and bed rest. It is not worth feeding it and it is better if the dishes are loose texture.

Infection with a viral infection most often occurs in early childhood. That is why almost the entire adult population has antibodies to EBV.

The source of infection is patients with an acute or chronic form of the disease. Little ones are most often infected with this so-called “kissing disease” from their parents.

Symptoms of the disease caused by the Epstein-Barr virus in children

In children with normal immunity, the disease proceeds in the form of a mild cold or without any pronounced symptoms.

However, with a weakened immune system, mononucleosis can develop in the event of a virus infection. The incubation period of the disease lasts from four days to two weeks. Then there are sore throats, and the temperature rises to 38 - 40 degrees, which needs to be knocked down, by the way, many do not know. The lymph nodes also increase greatly, especially in the neck. The disease proceeds with all the signs of a sore throat, skin rashes also occur. Diagnosis of mononucleosis is performed by a clinical blood test if atypical cells - mononuclear cells are in the leukocyte formula. In infectious mononucleosis, the infection penetrates through the mucous membranes of the upper respiratory tract. In this case, swelling of the pharynx and shortness of breath are noted. After the penetration of the Epstein-Barr virus into the blood, it spreads to all organs and tissues of the body.

With the penetration of EBV into B-lymphocytes, proliferation of these cells occurs. This is what provokes an increase in palatine tonsils and the occurrence of systemic lymphopathy.

Tonsils are affected in the early days of the disease. In this case, a picture of catarrhal tonsillitis or lacunar tonsillitis is observed. Plaques appear on the tonsils, which after removal do not cause bleeding. Sometimes sick children have an unpleasant putrefactive breath.

Very often, infectious mononucleosis in children is characterized by hepatolienal syndrome. In this case, a densification and enlargement of the liver and spleen occurs.

In 5 - 7% of children, a rash develops on the body during the disease, but most often it is a consequence of taking antibiotic drugs of the aminopenicillin group. The rash is presented in the form of large and small papules, sometimes with a hemorrhagic component. Itching is absent. After the rash, pigmentation on the skin remains.

Complications caused by infectious mononucleosis in children are very rare. In this case, there are cases of rupture of the spleen, bleeding and severe stomach pain. In this case, the child requires urgent surgery.

  Treatment for Epstein-Bara virus disease in children.

Most often, the disease subsides within two to three months, without needing specific treatment.

The treatment of the disease is prescribed in a complex manner, and it depends on the severity of the symptoms. First of all, symptomatic therapy is prescribed, which includes the use of interferon or viferon (suppository).

With etiotropic therapy, acyclovir is used that disrupts the synthesis of viral DNA.

In severe cases of infectious mononucleosis, glucocorticosteroids are prescribed. Antibiotics in the treatment of this disease are contraindicated. They are prescribed to children only in case of bacterial infection.

Immunocorrective therapy, as a poorly understood tactic in the treatment of children suffering from infectious mononucleosis, is advisory in nature, since it has not yet been fully studied. It is recommended that routine monitoring of the immunological parameters of the child every three months during the year.

Many of us have not heard about the Epstein-Barr virus (EBV), but meanwhile it is considered one of the most common human viruses. More than 90% of adults in the world and about 50% of children under 5 years old have not only experienced this infection, but they are carriers and potential sources, because once it enters the body, the virus remains in it for life.

After infection, EBV is in no hurry to detect itself and often lives in the body in an inactive form. However, under certain circumstances, it can cause various diseases, including cancer.

Historical reference

Epstein-Barr virus was first described in 1964 by English scientists - virologist Michael Epstein and his assistant Yvonne Barr.

Epstein discovered an unknown virus in tumor cells, a sample of which was sent to him by a colleague - surgeon Denise Burkitt.

While working in equatorial Africa, Burkitt became interested in a specific local cancer, which occurred mainly in children under 7 years old   (later this disease became known as Burkitt’s lymphoma). The new virus was named after the discoverers.

Epstein-Barr virus is a type 4 herpes virus. Outwardly, it is a spherical capsid, inside of which there is double-stranded DNA.

The surface of the capsid is equipped with many glycoproteins, due to which the virus easily attaches to the cell. The target cells for him are B-lymphocytes. Then viral DNA is introduced into a healthy cell   and further propagation of the virus in it.

Cell death does not occur   (as when exposed to other herpes viruses), and their proliferation is triggered, i.e., the multiplication of infected cells. This mechanism of infection provides high virulence of EBV.

Causes of infection than dangerous

Epstein-Barr virus infection most often occurs in early childhood or adolescence. The main risk group is children from 1 year, because in the first year of life, the baby is well protected by maternal antibodies, later maternal immunity weakens, and the child becomes vulnerable, plus children after a year begin to communicate more with others.

After infection, the virus exists in the human body throughout life as a latent (latent) infection.

The source of infection is a sick personnot only with active, but also with asymptomatic and erased forms of the disease.

The main transmission routes:

• contact: with kisses - the most common way of infection;
• airborne: when coughing and sneezing;
• contact household: Infection of young children through toys exposed to saliva is possible.

Also possible:

• transfusion (with blood transfusion);
• transplant (with bone marrow transplant).

For Epstein-Barr virus infection close contact is needed, because the greatest amount of it is excreted with saliva. Therefore, the most common disease caused by the virus is infectious mononucleosis, or “kissing disease”.

When examining the material of patients, it was found that EBV can be released into the external environment for at least 3 months after the disease, and sometimes up to 1.5 years.

The danger of the Epstein-Barr virus is that it after infection, stored in the body for life   and under certain conditions (for example, with immunodeficiency) can cause many far from harmless diseases, some of which are oncological:

Classification

A generally accepted classification of EBV infection has not been developed. Conditionally divided by the following characteristics:

• By the period of occurrence:   congenital or acquired.

  It was found that Epstein-Barr is able to be transmitted from mother to child (subject to primary infection during pregnancy).

• According to the form of the disease:typical (manifestation of infection in the form of infectious mononucleosis), atypical - erased, asymptomatic or visceral.
• According to the severity of the process:mild, moderate, severe.
• By phase:   active, inactive.

Symptomatology

Primary infection often asymptomatic, especially in young children (up to 5 years). During the period of infection in children, nonspecific symptoms of the Epstein-Barr virus may occur, characteristic of other diseases:

It is very difficult to suspect an EBV infection in the body., especially in childhood, so often the primary infection goes unnoticed.

In children of school and adolescence, and sometimes in young children, Epstein-Barr during primary infection can cause a specific disease - infectious mononucleosis. Its other names are glandular fever, disease of kisses, Filatov’s disease.

Symptoms of Epstein-Barr virus infection in children:

• Fever: often the disease begins with a sharp increase in temperature, which reaches its maximum in 2-4 days (reaches 38-40 ° C) and lasts about 4-7 days. Further, a low temperature (up to 37.5 ° C) may remain for 3-4 weeks.
• Intoxication: as with other diseases - weakness, loss of appetite, pain in muscles and joints, etc.
• Lymph node inflammation: mainly posterior cervical lymph nodes are affected, they increase, become painful to the touch.
• : nasal congestion without a runny nose, shortness of breath, nasal congestion, snoring during sleep.
• Characteristic feature- lack of effect when applying vasoconstrictive drops for the nose.
• Enlarged liver (hepatomegaly) and spleen (splenomegaly).
• Rash on the background of taking some antibacterial drugs.
• Exist atypical form of the diseasein which only some of the main symptoms are expressed.

Outcome of infectious mononucleosis:

• recovery with the formation of lifelong carriage of the virus without clinical manifestations;
• the formation of a chronic form of the disease.

How to recognize a disease

Infants: The most difficult thing to recognize is the presence of EBV infection in children under 2 years of age who cannot yet tell what is bothering them. Manifestations of the disease easily confused with acute viral infection. In this case, parents should alert:

• prolonged course of viral infection, poorly treatable;
• snoring (or grunting) in a dream;
• an increase in posterior cervical lymph nodes (if it can be determined by touch).

In preschool children, in addition to these symptoms, frequent tonsillitis can serve as a reason for examination, constant fatigue, poor appetite.

Pupils can already explain quite well what is bothering them, but their complaints will also be associated with the listed manifestations.

If signs of EBVI are detected in children of any age, one should not self-medicate, since only a doctor can make a diagnosis on the basis of laboratory data.

You can contact your local pediatrician, who after examination and analysis of symptoms or prescribe treatment or refer to hospitalization   to the infectious diseases hospital.

A specific first aid is also not required for the child, except for the treatment of existing symptoms.

What are the causes of conjunctivitis in a child, is it possible to treat it at home? .

Diagnostics

Epstein-Barr virus is used to establish infection. laboratory research methods:

• :   lymphomonocytosis or monocytosis on the background of lymphopenia, thrombocytosis, anemia (), the detection of atypical mononuclear cells from 10% and higher is characteristic.

  Atypical mononuclear cells (virocytes) are mutated lymphocytes resembling monocytes.

  Appear in the blood to fight a viral infection. For additional diagnosis of atypical mononuclear cells, the method of concentration of leukocytes is used.

• : increased ALT, AST, bilirubin and alkaline phosphatase.

Specific laboratory diagnostics:

• Heterophilic test:   determination of heterophilic antibodies in the patient's blood serum. It is characteristic of most patients with EBVI. Heterophilic antibodies are autoantibodies that are synthesized by virus infected B cells.

  They are IgM antibodies, appear in the blood at the beginning of the disease, their number rises the first 3-4 weeks after infection, and then begins to gradually decrease. False positive results are possible with hepatitis, lymphomas, leukemia, etc.

• Enzyme-linked immunosorbent assay (ELISA):determination of specific antibodies IgM and IgG to virus antigens.
• Polymerase chain reaction (PCR):   detection of virus DNA to determine the stage of the infectious process and its activity. Material for research - saliva, oral or nasopharyngeal mucus, blood, cerebrospinal fluid,.

  Especially informative is the study to determine the virus in children under 3 years of age, because they may still have not formed antibodies, serodiagnosis is difficult. PCR is a highly accurate method, practically does not give false positive results.

• Immunogram:   study of the immune status. The presence of the virus in the patient’s body can cause both activation of the immune system and its inhibition, which will be confirmed by appropriate indicators.

Methods and treatment regimens

Patients with acute EBV   infections are subject to hospitalization in an infectious diseases hospital. First of all, this applies to young children. With the course of the disease in a mild form, treatment can be carried out on an outpatient basis.

otitis, peritonsillitis, respiratory or liver failure, hepatitis, spleen rupture is possible in 1% of cases.

Some cancers (lymphogranulomatosis or Burkitt’s lymphoma) associated with the Epstein-Barr virus are also today successfully treatable.

In this video, Dr. Komarovsky will answer your questions about the Epstein-Barr virus in children:

Specific prevention of EBV, i.e. vaccination, does not exist. Therefore, all preventive measures are aimed at increasing immunity.

Epstein-Barr virus (EBV infection) is one of the newest terms in medicine. Although 90% of the population and more are infected with EBV infection, there is still no complete information about the effect of the virus on the body.

You can live your whole life without even knowing about his presence, or you can find out about infection when a serious illness is detected.

So, the Epstein-Barr virus: a fashionable diagnosis that draws money for expensive drugs, or is it really a serious problem that requires increased attention?

Epstein-Barr virus - what is it?

Epstein-Barr virus is a microorganism from the herpes virus family, called the 4 type of herpes. The virus invades B cells, but does not destroy them, but transforms them.

Herpes virus type 4 is distributed exclusively among people (including patients with asymptomatic forms of infection) in the following ways:

1. Airborne - in case of saliva or mucus from the patient’s nasopharynx;
2. Sexual and blood transfusion - during sexual contact or blood transfusion / bone marrow transplantation from an infected person;
3. Intrauterine - a woman's EBV disease during pregnancy leads to the formation of fetal malformations (earlier contact with the infection does not pose such a serious threat to the fetus).

Features of EBV infection:

• Infection usually occurs in infancy (with a kiss from the mother).
• Although EBV is contagious, infection occurs only through close contact between an infected person and a healthy person. That is why the disease is called the disease of kisses.
• Typical symptoms of Epstein-Barr virus in children are frequent colds and inflammation of the upper respiratory tract (sinusitis, tonsillitis, rhinitis), which are difficult to treat traditionally.
• In adults, the presence of EBV infection can be suspected with constant fatigue, weakness in the morning. It is herpetic infection that most often provokes chronic fatigue syndrome.

Recent medical studies have shown that the Epstein-Barr virus can trigger processes in the body that lead to severe, and sometimes incurable, diseases:,.

The virus, initially affecting lymphoid tissue (B-lymphocytes) and epithelial cells of the salivary glands and nasopharyngeal region, can multiply to a minimum and do not manifest itself for a long time with external symptoms (hidden course).

The impetus for active reproduction is any condition that causes immune weakness and inadequate immune response (autoimmune reaction). An imbalance in the links of the immune system - a decrease in the level of T-lymphocytes and an increase in B-lymphocytes - further provokes serious disorders in the division and maturation of cells of various organs and often leads to oncology.

EBV infection can occur:

• Acutely and chronically;
• With typical and latent (asymptomatic form) manifestations, damage to various internal organs;
• According to the mixed type - most often in combination with cytomegalovirus.

Epstein-Barr Diseases

  EBV infection manifests itself in three scenarios: primary infection against the background of immunodeficiency, sluggish current infection or activation of latent EBV infection with a sharp decrease in immune defense (surgery, colds, stress, etc.). As a result, the virus can provoke:

• hodgkin’s lymphoma () and its non-Hodgkin’s forms;
• nasopharyngeal carcinoma;
• herpes of the skin and mucous membranes - herpetic eruptions on the lips, herpes zoster,;
• chronic fatigue syndrome;
• burkitt's lymphoma - a cancerous tumor that affects the jaw, kidneys, retroperitoneal lymph nodes and ovaries;
• oncology of the digestive tract;
• leukoplakia - the appearance of white spots on the skin and mucous membranes, while their high bleeding is noted;
• severe damage to the liver, heart and spleen;
• autoimmune diseases - lupus erythematosus, rheumatoid arthritis,;
• blood diseases - malignant anemia, leukemia,.

Types of EBV infection

Epstein-Barr virus produces several specific proteins (antigens):

1. Capsid (VCA) - antigen to the internal protein content of the herpes virus;
2. Membrane (MA) - protein agents aimed at the shell of a viral substance;
3. Nuclear (EBNA) - an antigen that controls the multiplication of the virus and prevents its death.

In response to antigenic synthesis, the immune system produces antibodies to the Epstein-Barr virus, which serve as an indicator of the stage of the disease. Their presence in the blood and the amount varies depending on the stage of the disease:

In the absence of infection   - antibodies to herpes type 4 IgM - less than 20 units / ml, IgG - less than 20 units / ml.

In the early stages of the disease   - only antibodies to the capsid antigen of the Epstein-Barr virus are detected (anti-VCA IgM more than 40 Units / ml). The maximum performance is achieved for 1-6 weeks. from the onset of the disease, and their normalization takes 1-6 months. The presence of IgM in the blood indicates an active infection.

In acute course   - there are anti-proteins to VCA IgM and VCA IgG. Caspid antibodies of the IgG class in the Epstein-Barr virus in the acute phase are positive and show more than 20 U / ml and reach a maximum value by 2 months from the onset of the disease, decrease in the process of recovery (several more years can be detected).

The more acute the infection during the initial infection, the higher the titer of anti-VCA IgG.

In persistent stage   - all types of antibodies are synthesized (VCA IgM, VCA IgG and EBNA IgG). The appearance of IgG class antibodies to the EBNA nuclear protein antigen indicates the onset of disease regression and an early recovery. Their titer increases by 3-12 months. disease and continues to be held at high numbers for several years.

In the absence of painful symptoms of anti-EBNA IgG in the blood, the fact of a previous disease is ascertained, possibly in an asymptomatic form.

Symptoms of Epsten-Barr virus

Symptoms of Epstein-Barr virus infection, the duration of the course of the disease - both the form of the disease and the direction of the viral “stroke” depend.

Primary infection can asymptomatically go into the phase of carriage, signs of viral presence are detected only with a serological blood test.

When the course is erased, the traditional treatment of acute respiratory viral infections in children with the Epstein-Barr virus does not bring a quick recovery.

In other cases, there is an acute disease with severe symptoms or a sluggish current infection with a chronic pathological deviation. Sometimes a generalized form develops with severe damage to organs and systems.

Infectious mononucleosis

From infection to the appearance of the first signs of the disease, 5 to 45 days pass. The main symptoms of mononucleosis:

• Catarrhal phenomena - friability of tonsils and hyperemia of palatine arches (tonsillitis symptoms), transparent or purulent discharge from the nose, ulcerative stomatitis.
• Intoxications - from the first days of the disease significant hyperthermia (above 38C), chills, joint pain, weakness. A similar picture lasts 1-4 weeks.
• Enlarged lymph nodes - detected after 7 days from the onset of the disease, painless and dense. Palpated in the neck: occipital, submandibular, axillary, sub- and supraclavicular.
• An increase in the liver - by 2 fingers (detected by tapping) a week later from the appearance of the first signs of the disease. It is accompanied by abdominal pain, lack of appetite, nausea, jaundice (yellowish skin and sclera, discolored stool, dark urine).
• Enlarged spleen - significant splenomegaly is accompanied by pain in the left side.

Recovery does not occur earlier than 2-3 weeks. With a gradual improvement in well-being, periods of exacerbation of the disease can be observed. Periodic symptoms return indicates weak immunity. Recovery can drag on for 1.5 years.

Chronic fatigue syndrome

A striking example of symptoms is a sluggish current EBV infection. Patients constantly complain of weakness, even after a full sleep. Temperatures up to 37.5 ° C for no apparent reason, headache, muscle and joint pain are often perceived as a cold.

Moreover, this condition lasts a long time, and against the background of poor sleep and mood swings, the exhausted body reacts with depression or psychosis.

Notably, adult performance also suffers. In children, there is a pronounced decrease in memory, distraction and inability to concentrate.

Generalized EBV infection

Generalized defeat of the virus occurs against a background of significant failure of the immune system. After the acute course of infectious mononucleosis, the following can develop:

• severe pneumonia, accompanied by respiratory failure;
• inflammation of the membranes of the heart (fraught with cardiac arrest);
•   encephalitis (threat of cerebral edema);
• toxic hepatitis and liver failure;
• rupture of the spleen;
• DIC-syndrome (intravascular coagulation);
• damage to the lymph nodes throughout the body.

Often, the generalization of VEB infection is accompanied by a bacterial attack, which leads to and is fatal.

To completely eliminate VEB, no specific drugs have been created. Epsthen-Barr virus treatment reduces infection, balancing the immune system and preventing complications. Drug therapy depends on the type of immune response to a viral attack and includes:

1. Antiviral drugs - Granciclovir, Valaciclovir, Famciclovir, Acyclovir (least effective), the course is not less than 2 weeks;
2. Interferons and immunoglobulins - the most effective Reaferon;
3. Thymus hormones (Timalin, Timogen) and immunomodulators (Dekaris, Likopid) - an increase in the level of T-lymphocytes and a decrease in B-cells);
4. Corticosteroids (Prednisolone, Dexamethasone) and cytostatics - with an autoimmune reaction.

At the same time, symptomatic treatment and antibiotic therapy or Cefazolinum (according to indications) are carried out. Be sure to follow a healthy sleep regimen, good nutrition, refusal of alcohol and the exclusion of stressful situations.

The effectiveness of treatment is confirmed by the normalization of blood serology.

Forecast

For most patients in whom the Epstein-Barr virus is detected, the prognosis is favorable. You should only be careful about your health and not delay with the advice of a doctor when signs of malaise appear.

• The main criterion for success and the prevention of serious consequences is the maintenance of immunity at a sufficient level.