The Epstein-Barr virus (EBV) is the cause of infectious mononucleosis, commonly known as glandular fever or the kissing disease. It is a herpesvirus. In most people, the infection occurs without symptoms. f there are symptoms, they usually include sore throat, fatigue, fever, and/or swollen lymph nodes. About half of children under the age of five have experienced an EBV infection. The majority of Dutch individuals come into contact with the virus before the age of twenty.

Symptoms

As mentioned, most people have no symptoms or only experience mild ones. Symptoms can be more severe in teenagers and young adults. These symptoms include extreme fatigue, fever, sore throat, and swollen lymph nodes. The fatigue is particularly present during the first two to three weeks, but can also persist for weeks to months. Sometimes, a rash (exanthema) can also develop.

Transmission

Transmission of EBV occurs through contact with infected saliva. The exact way the virus is transmitted is not fully understood. One mode of transmission can be through kissing, which is why the disease is often called the “kissing disease”. The period between infection and the onset of symptoms is 10 days to 6 weeks.

Treatment

There is no specific treatment for EBV; it involves resting and waiting for spontaneous recovery. Additionally, avoiding heavy physical activity and intense sports for two months is recommended. Paracetamol can be used to manage fever.

Antibodies

To determine whether someone has infectious mononucleosis or has experienced it in the past, IgG and IgM antibodies are tested. IgG and IgM antibodies are positive, while Ig EBNA is negative during an acute infection. After an infection has been experienced, IgM becomes negative and IgG and Ig EBNA become positive. In principle, IgG and Ig EBNA remain detectable for life. Because antibodies are produced, a person can become infected with the virus only once in their lifetime, after which they become immune.

Sources

• RIVM LCI. ziekte van Pfeiffer: Richtlijn. Available at https://lci.rivm.nl/richtlijnen/pfeiffer-ziekte-van
• Huidziekten: Epstein Barr virus infecties. Available at https://www.huidziekten.nl/zakboek/dermatosen/etxt/EpsteinBarrVirus.htm