Epstein Barr viral infection in children treatment. Test for Epstein-Barr virus in children - diagnosis and treatment of the disease. Epstein-Barr virus: prognosis depends on prevention

Epstein Barr virus (EBV) is one of the representatives of the family of herpes infections. Its symptoms, treatment and causes in adults and children are also similar to cytomegalovirus (herpes according to No. 6). EBV itself is called herpes number 4. In the human body, it can be stored for years in a dormant form, but when immunity decreases, it is activated, causes acute infectious mononucleosis and later - the formation of carcinomas (tumors). How else does the Epstein Barr virus manifest itself, how is it transmitted from a sick person to a healthy person, and how to treat the Epstein Barr virus?

What is the Epstein Barr virus?

The virus received its name in honor of the researchers - professor and virologist Michael Epstein and his graduate student Iwona Barr.

Einstein bar virus has two important differences from other herpes infections:

It does not cause the death of host cells, but on the contrary, it initiates their division and tissue proliferation. This is how tumors (neoplasms) form. In medicine, this process is called proliferation - pathological proliferation.
It is not stored in the ganglia of the spinal cord, but inside immune cells - in some types of lymphocytes (without their destruction).

The Epstein Barr virus is highly mutagenic. With the secondary manifestation of infection, it often does not respond to the antibodies produced earlier at the first meeting.

Manifestations of the virus: inflammation and tumors

Acute Epstein Barr disease manifests itself like flu, cold, inflammation. Long-term, low-grade inflammation initiates chronic fatigue syndrome and tumor growth. At the same time, different continents have their own characteristics of the course of inflammation and the localization of tumor processes.

In the Chinese population, the virus more often forms nasopharyngeal cancer. For the African continent - cancer of the upper jaw, ovaries and kidneys. For residents of Europe and America, acute manifestations of infection are more typical - high temperature (up to 40º for 2-3 or 4 weeks), enlarged liver and spleen.

Epstein Barr virus: how is it transmitted

Epstein bar virus is the least studied herpes infection. However, it is known that the routes of its transmission are varied and extensive:

airborne;
contact;
sexual;
placental.

People in the acute stage of the disease become a source of infection through the air(those who cough, sneeze, blow their nose - that is, they deliver the virus into the surrounding space along with saliva and mucus from the nasopharynx). During the period of acute illness, the predominant method of infection is airborne droplets.

After recovery(decrease in temperature and other symptoms of ARVI) the infection is transmitted by contact(with kisses, handshakes, shared dishes, during sex). EBV resides in the lymph and salivary glands for a long time. A person can easily transmit the virus through contact during the first 1.5 years after the disease. Over time, the likelihood of transmitting the virus decreases. However, research confirms that 30% of people have the virus in their salivary glands for the rest of their lives. In the other 70%, the body suppresses a foreign infection, while the virus is not detected in saliva or mucus, but is stored dormant in the beta lymphocytes of the blood.

If there is a virus in a person’s blood ( virus carriers) it can be transmitted from mother to child through the placenta. In the same way, the virus is spread through blood transfusions.

What happens when infected

The Epstein-Barr virus enters the body through the mucous membranes of the nasopharynx, mouth or respiratory organs. Through the mucous layer, it descends into the lymphoid tissue, penetrates beta lymphocytes, and enters the human blood.

Note: the effect of the virus in the body is twofold. Some of the infected cells die. The other part begins to divide. At the same time, different processes predominate in the acute and chronic stages (carriage).

During acute infection, the infected cells die. In case of chronic carriage, the process of cell division with the development of tumors is initiated (however, such a reaction is possible with weakened immunity, but if the protective cells are sufficiently active, tumor growth does not occur).

The initial penetration of the virus often occurs asymptomatically. Epstein Barr virus infection in children manifests itself with visible symptoms only in 8-10% of cases. Less commonly, signs of a general disease develop (5-15 days after infection). The presence of an acute reaction to infection indicates low immunity, as well as the presence of various factors that reduce the body's protective reactions.

Epstein Barr virus: symptoms, treatment

Acute infection by a virus or its activation with decreased immunity is difficult to distinguish from a cold, acute respiratory infection or acute respiratory viral infection. The symptoms of Epstein bar are called infectious mononucleosis. This is a common group of symptoms that accompany a number of infections. Based on their presence, it is impossible to accurately diagnose the type of disease; one can only suspect the presence of an infection.

In addition to the signs of a common acute respiratory infection, Symptoms of hepatitis, sore throat, and rash may occur. The manifestations of the rash increase when the virus is treated with penicillin antibiotics (such erroneous treatment is often prescribed due to incorrect diagnosis, if instead of a diagnosis of EBV, a person is diagnosed with tonsillitis or acute respiratory infections). Epstein-Barr is a viral infection in children and adults, Treatment of viruses with antibiotics is ineffective and fraught with complications.

Epstein Barr infection symptoms

In the 19th century, this disease was called an unusual fever, in which the liver and lymph nodes become enlarged and the throat hurts. At the end of the 21st century, it received its own name - Epstein-Barr infectious mononucleosis or Epstein-Barr syndrome.

Signs of acute mononucleosis:

Symptoms of acute respiratory infections- feeling unwell, fever, runny nose, enlarged lymph nodes.
Symptoms of hepatitis: enlarged liver and spleen, pain in the left hypochondrium (due to an enlarged spleen), jaundice.
Symptoms of a sore throat: soreness and redness of the throat, enlarged cervical lymph nodes.
Signs of general intoxication: weakness, sweating, soreness in muscles and joints.
Symptoms of inflammation of the respiratory organs: difficulty breathing, cough.
Signs of damage to the central nervous system: headache and dizziness, depression, sleep disturbances, attention, memory.

Signs of chronic virus carriage:

Chronic fatigue syndrome, anemia.
Frequent recurrences of various infections- bacterial, viral, fungal. Frequent respiratory infections, digestive problems, boils, rashes.
Autoimmune diseases- rheumatoid arthritis (joint pain), lupus erythematosus (redness and rashes on the skin), Sjogren's syndrome (inflammation of the salivary and lacrimal glands).
Oncology(tumors).

Against the background of a sluggish infection with the Epstein Barr virus, a person often develops other types of herpes or bacterial infections. The disease becomes widespread and is difficult to diagnose and treat. Therefore, the Einstein virus often occurs under the guise of other infectious chronic diseases with wave-like manifestations - periodic exacerbations and stages of remission.

Virus carriage: chronic infection

All types of herpes viruses reside in the human body for life. Infection often occurs asymptomatically. After the initial infection, the virus remains in the body for the rest of life.(stored in beta lymphocytes). In this case, a person often does not realize that he is a carrier.

The activity of the virus is controlled by antibodies produced by the immune system. Without the opportunity to multiply and manifest itself actively, the Epstein-Barr infection sleeps as long as the immune system functions normally.

EBV activation occurs with a significant weakening of protective reactions. The reasons for this weakening may be chronic poisoning (alcoholism, industrial emissions, agricultural herbicides), vaccination, chemotherapy and radiation, tissue or organ transplantation, other operations, long-term stress. After activation, the virus spreads from lymphocytes to the mucous surfaces of hollow organs (nasopharynx, vagina, ureteral canals), from where it reaches other people and causes infection.

Medical fact: Herpes viruses are found in at least 80% of people examined. Bar infection is present in the body of the majority of the adult population of the planet.

Epstein Barr: diagnosis

Symptoms of Epstein Barr virus are similar to signs of infection cytomegalovirus(also herpetic infection No. 6, which manifests itself as a long-term acute respiratory infection). It is possible to distinguish the type of herpes and name the exact causative virus only after laboratory tests of blood, urine, and saliva.

Testing for Epstein Barr virus includes several laboratory tests:

Blood is tested for Epstein Barr virus. This method is called ELISA (enzyme-linked immunosorbent assay) determines the presence and amount of antibodies to infection. In this case, primary antibodies of type M and secondary antibodies of type G may be present in the blood. Immunoglobulins M are formed during the first interaction of the body with an infection or when it is activated from a dormant state. Immunoglobulins G are formed to control the virus during chronic carriage. The type and quantity of immunoglobulins allows us to judge the primacy of the infection and its duration (a high titer of G bodies is diagnosed with a recent infection).
Saliva or other biological fluid of the body (mucus from the nasopharynx, discharge from the genitals) is examined. This examination is called PCR, it is aimed at detecting viral DNA in liquid samples. The PCR method is used to detect various types of herpes viruses. However, when diagnosing the Epstein Barr virus, this method shows low sensitivity - only 70%, in contrast to the sensitivity of detecting herpes types 1, 2 and 3 - 90%. This is explained by the fact that the bara virus is not always present in biological fluids (even when infected). Since the PCR method does not provide reliable results for the presence or absence of infection, it is used as a confirmation test. Epstein-Barr in saliva - says that there is a virus. But it does not show when the infection occurred, and whether the inflammatory process is associated with the presence of the virus.

Epstein Barr virus in children: symptoms, features

Epstein-Barr virus in a child with normal (average) immunity may not cause painful symptoms. Therefore, infection of children of preschool and primary school age with the virus often occurs unnoticed, without inflammation, fever or other signs of illness.

Epstein-Barr virus often causes a painful infection in adolescent children- mononucleosis (fever, enlarged lymph nodes and spleen, sore throat). This is due to a lower protective reaction (the reason for the deterioration of immunity is hormonal changes).

Epstein-Barr disease in children has the following features:

The incubation period of the disease is reduced - from 40-50 days it is reduced to 10-20 days after the virus penetrates the mucous membranes of the mouth and nasopharynx.
The recovery time is determined by the state of immunity. A child’s defensive reactions often work better than an adult’s (as evidenced by bad habits and a sedentary lifestyle). Therefore, children recover faster.

How to treat Epstein-Barr in children? Does treatment depend on the person's age?

Epstein Barr virus in children: treatment of acute infection

Since EBV is the least studied virus, its treatment is also under research. For children, only those drugs are prescribed that have passed the stage of long-term testing with identification of all side effects. There are currently no antiviral drugs for EBV that are recommended for the treatment of children of any age. Therefore, pediatric treatment begins with general supportive therapy, and only in cases of urgent need (threat to the child’s life) are antiviral drugs used. How to treat Epstein bar virus in the stage of acute infection or when chronic carriage is detected?

In acute manifestations, the Epstein-Barr virus in a child is treated symptomatically. That is, when symptoms of sore throat appear, they gargle and treat the throat; when symptoms of hepatitis appear, medications are prescribed to support the liver. Vitamin and mineral support of the body is required, in case of long-term protracted course - immunostimulating drugs. Vaccination after suffering from mononucleosis is postponed for at least 6 months.

Chronic carriage cannot be treated unless it is accompanied by frequent manifestations of other infections and inflammations. For frequent colds, measures to strengthen the immune system are necessary.- hardening procedures, walks in the fresh air, physical education, vitamin and mineral complexes.

Epstein Barr virus: treatment with antiviral drugs

Specific treatment for the virus is prescribed when the body cannot cope with the infection on its own. How to treat Epstein bar virus? Several areas of treatment are used: counteracting the virus, supporting one’s own immunity, stimulating it and creating conditions for the full development of protective reactions. Thus, the treatment of Epstein-Barr virus uses the following groups of drugs:

Immunostimulants and modulators based on interferon (a specific protein that is produced in the human body when a virus intervenes). Interferon-alpha, IFN-alpha, reaferon.
Drugs containing substances that inhibit the proliferation of viruses inside cells. These are valacyclovir (Valtrex), famciclovir (Famvir), ganciclovir (Cymevene), and foscarnet. The course of treatment is 14 days, with intravenous administration of drugs recommended for the first 7 days.

Important to know: the effectiveness of acyclovir and valacyclovir against the Epstein Barr virus is under research and has not been scientifically proven. Other drugs - ganciclovir, famvir - are also relatively new and insufficiently studied; they have a wide list of side effects (anemia, disorders of the central nervous system, heart, digestion). Therefore, if Epstein-Barr virus is suspected, treatment with antiviral drugs is not always possible due to side effects and contraindications.

During treatment in hospitals, hormonal drugs are also prescribed:

Corticosteroids are hormones that suppress inflammation (they do not act on the causative agent of infection, they only block the inflammatory process). For example, prednisolone.
Immunoglobulins - to support immunity (administered intravenously).
Thymic hormones - to prevent infectious complications (thymalin, thymogen).

If low titers of the Epstein Barr virus are detected, treatment can be restorative - vitamin s (as antioxidants) and drugs to reduce intoxication ( sorbents). This is maintenance therapy. It is prescribed for any infections, diseases, diagnoses, including those with a positive test for the Epstein-Barr virus. Treatment with vitamins and sorbents is allowed for all categories of sick people.

How to cure Epstein Barr virus

Medical research asks: is the Epstein-Barr virus a dangerous infection or a quiet neighbor? Is it worth fighting the virus or focusing on maintaining immunity? And how to cure Epstein Barr virus? The answers from doctors are mixed. And until a sufficiently effective cure for the virus is invented, we must rely on the body's immune response.

A person has all the necessary defense reactions against infections. To protect against foreign microorganisms, it is necessary to have good nutrition, limit toxic substances, as well as positive emotions and the absence of stress. Failure in the immune system and infection with the virus occurs when it is weakened. This becomes possible with chronic poisoning, long-term drug therapy, and after vaccination.

The best treatment for the virus is create healthy conditions for the body, cleanse it of toxins, provide adequate nutrition, provide the opportunity to produce their own interferons against infection.

Epstein-Barr virus (EBV infection) is one of the newest terms in medicine. And although 90% of the population or 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 its presence, or you can find out about infection when a serious illness is detected.

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

Epstein-Barr virus - what is it?

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

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

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

Features of EBV infection:

Infection usually occurs in infancy (from the mother's kiss).
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 kissing disease.
Typical symptoms of the Epstein-Barr virus in children are frequent colds and inflammation of the upper respiratory tract (sinusitis, tonsillitis, rhinitis), which are difficult to treat with traditional treatment.
In adults, the presence of EBV infection can be suspected if there is constant fatigue and weakness in the morning. It is herpes 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 minimally and not show external symptoms for a long time (hidden course).

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

EBV infection can occur:

Acute and chronic;
With typical and hidden (asymptomatic form) manifestations, damage to various internal organs;
According to the mixed type - most often in combination with cytomegalovirus.

Diseases caused by the Epstein-Barr virus

EBV infection manifests itself in three scenarios: primary infection against the background of immunodeficiency, a sluggish ongoing infection, or activation of a 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 rashes 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, and their high bleeding is noted;
severe damage to the liver, heart and spleen;
autoimmune diseases - lupus erythematosus, rheumatoid arthritis,;
blood diseases - pernicious anemia, leukemia,.

Types of EBV infection

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

Capsid (VCA) - antigen to the internal protein content of the herpes virus;
Membrane (MA) - protein agents aimed at the envelope of the viral substance;
Nuclear (EBNA) is an antigen that controls the reproduction of the virus and prevents its death.

In response to antigen 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 quantity varies depending on the stage of the disease:

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

At an early stage of the disease- only antibodies to the capsid antigen of the Epstein-Barr virus are detected (anti-VCA IgM more than 40 U/ml). Maximum performance is achieved at 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 cases- antiproteins to VCA IgM and VCA IgG appear. Caspid antibodies of the IgG class for 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, decreasing during the recovery process (can be detected for several more years).

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

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

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

Symptoms of Epstein-Barr virus

The symptoms of infection with the Epstein-Barr virus and the duration of the disease depend on both the form of the disease and the direction of the viral “hit”.

Primary infection can pass into the carrier phase asymptomatically; signs of the viral presence are detected only by serological blood testing.

With an erased course, traditional treatment of ARVI in children with Epstein-Barr virus does not bring a quick recovery.

In other cases, an acute disease occurs with pronounced symptoms or a sluggish current infection with chronic pathological abnormalities. 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 - loose tonsils and hyperemia of the palatine arches (symptoms of tonsillitis), clear or purulent nasal discharge, ulcerative stomatitis.
Intoxication - from the first days of the disease, significant hyperthermia (above 38C), chills, joint pain, weakness. This picture lasts for 1-4 weeks.
Enlarged lymph nodes - detected 7 days after the onset of the disease, painless and dense. Palpated in the neck area: occipital, submandibular, axillary, sub- and supraclavicular.
Enlargement of the liver - by 2 fingers (detected by tapping) a week after the appearance of the first signs of the disease. 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 occurs no earlier than 2-3 weeks. With gradual improvement in well-being, periods of exacerbation of the disease may occur. Periodic recurrence of symptoms indicates a weak immune system. Recovery may take 1.5 years.

Chronic fatigue syndrome

A striking example of the symptoms of a sluggish EBV infection. Patients constantly complain of weakness, even after a full night's sleep. Temperature up to 37.5ºC for no apparent reason, headache, muscle and joint pain are often perceived as a cold.

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

The performance of adults also suffers noticeably. Children experience severe memory loss, absent-mindedness and inability to concentrate.

Generalized EBV infection

Generalized infection by the virus occurs against the background of significant immune failure. After an acute course of infectious mononucleosis, the following may 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;
splenic rupture;
DIC syndrome (intravascular blood coagulation);
damage to lymph nodes throughout the body.

Often the generalization of EBV infection is accompanied by a bacterial attack, which can lead to death.

No specific drugs have been created to completely eliminate EBV. Treatment of Epstein-Barr virus involves reducing the infection, balancing the immune system, and preventing complications. Drug therapy depends on the type of immune response to the viral attack and includes:

Antiviral drugs - Granciclovir, Valaciclovir, Famciclovir, Acyclovir (least effective), course for at least 2 weeks;
Interferons and immunoglobulins - Reaferon is the most effective;
Thymus hormones (Timalin, Thymogen) and immunomodulators (Dekaris, Lykopid) - increasing the level of T-lymphocytes and decreasing B-cells);
Corticosteroids (Prednisolone, Dexamethasone) and cytostatics - for an autoimmune reaction.

At the same time, symptomatic treatment and antibiotic therapy or Cefazolin (as indicated) are carried out. Be sure to maintain a healthy sleep schedule, eat well, avoid alcohol and avoid stressful situations.

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

Forecast

For most patients diagnosed with Epstein-Barr virus, the prognosis is good. You just need to be attentive to your health and do not delay consulting a doctor if signs of illness appear.

The main criterion for success and prevention of severe consequences is maintaining immunity at a sufficient level.

Due to weakened immunity, children suffer from various diseases much more often than adults. One of the causative agents of illnesses is the Epstein-Barr virus; in most cases it provokes mononucleosis. The infection does not pose a particular danger to the baby’s life; specific treatment is required only in advanced cases complicated by HIV infection.

The virus was discovered relatively recently and is poorly studied, but doctors know several features of the diseases that are caused by the pathogen. Young parents need to know the characteristic symptoms of the pathology and what needs to be done in such a situation.

general information

Epstein-Barr virus was discovered in 1964. As a result of research, the virus was classified as a herperovirus; it is widespread among the world's population. According to statistics, about 50% of eighteen-year-old residents are carriers of the virus. A similar situation exists with children over five years old. Babies under one year old get sick very rarely; along with breast milk, the baby receives the mother's antibodies (passive immunity), which protect the child's body from infection.

The main risk group is children older than one year. They actively communicate with other children and gradually switch from breastfeeding to full nutrition. It is worth noting that in children under three years of age, infection with the virus is practically asymptomatic and resembles a common cold.

As a result of infection, the pathogen ensures the formation of stable immunity in the child; the virus itself is not destroyed, it continues to exist without causing any discomfort to its owner. However, this situation is typical for all types of herpes virus.

The Epstein-Barr virus is quite resistant to the environment, but it quickly dies when exposed to high temperatures, disinfectants, or drying out. When the pathogen enters a child’s body, it thrives in the patient’s blood, brain cells, and in case of cancer, in the lymph. The virus has a special tendency to infect its favorite cells (lymphatic system, immune system, upper respiratory tract, digestive system).

The pathogen can provoke an allergic reaction; 25% of sick children experience the appearance of Quincke's edema and rashes on the baby's body. Particular attention should be paid to the special property of the virus – lifelong presence in the body. Infection of the immune system gives cells an unlimited ability for active life and constant synthesis.

Routes of transmission and infection

The source of the virus is an infected person. The patient becomes dangerous to others in the last days of the incubation period. Although the pathogen is released in small quantities at the beginning of the disease, the period of its course is even six months after recovery. About 20% of all patients become carriers of the virus, which is dangerous to others.

Routes of transmission of the Epstein-Barr virus:

airborne. Mucus and saliva released from the nasopharynx pose a danger to others (through coughing, kissing, talking);
contact-household. Infected saliva can remain on toys, towels, clothing, and household items. An unstable virus will not survive in the environment for long; this route of transmission of the pathogen is unlikely;
during blood transfusion, its preparations;
recent studies have proven that transmission from mother to fetus is possible, in which case the child is diagnosed with congenital Epstein-Barr viral infection.

Despite the variety of routes of transmission of the pathogen, there is a large group of people among the population who are immune to the virus (about 50% of children, 85% of adults). Most people become infected without developing a clinical picture, but antibodies are produced and the immune system becomes resistant to the pathogen. That is why the disease is considered low contagious, because many have already developed immunity to the Epstein-Barr virus.

How dangerous is the disease?

First of all, the virus is dangerous because it has a number of different manifestations. Because of this, parents, even experienced doctors, do not always immediately understand what they are dealing with and confuse it with other diseases. Only by carrying out the necessary studies (blood test, PCR diagnostics, DNA, biochemistry, serological manipulations) will it be revealed that the baby is infected with herpes virus 4.

The disease is dangerous because the virus spreads through the blood, multiplies in the bone marrow, and over time can affect any organ in the child’s body. Pediatricians identify several of the most dangerous consequences of infection with the Epstein-Barr virus infection:

oncological diseases of various organs;
pneumonia;
immunodeficiency;
serious damage to the nervous system that cannot be treated;
heart failure;
gradual enlargement of the spleen, its further rupture.

Note! The outcome of the disease can be: recovery, asymptomatic carriage, chronic Epstein-Barr viral infection, autoimmune diseases (Schinger syndrome, systemic lupus erythematosus, rheumatoid arthritis, cancer). Some diseases can be fatal.

Characteristic signs and symptoms

Children with strong immunity experience infection in the form of a mild cold or are completely asymptomatic. The clinical picture of a child with a weak immune system is significantly different from a child with strong body defenses. The incubation period is about two months, after this period the following clinical picture is observed:

swelling of the lymph nodes (in the neck), discomfort is felt upon palpation;
elevated body temperature, it lasts for quite a long period of time. Antipyretics have little or no effect;
the child is constantly bothered by headaches, chronic fatigue and weakness;
wave-like pain in the throat is noted, attacks are felt;
the baby’s body becomes covered with red rashes of unknown etiology;
the liver and spleen are significantly enlarged;
there are digestive problems (diarrhea, constipation, abdominal pain);
the baby loses appetite, weight decreases uncontrollably;
there are herpetic rashes on the oral cavity;
against the background of chills, muscle pain and discomfort appear throughout the body;
sleep is disturbed, the child has increased anxiety.

Over time, and without proper treatment, each symptom provokes the emergence of various ailments (lymphoma, multiple sclerosis, hepatitis and others). Doctors often mistake the disease for other pathologies, the course becomes more complicated, and the child gets worse. If the problem is not identified in time, a sharply negative outcome is possible.

Diagnostics

To differentiate mononucleosis from other pathologies, a number of clinical studies are carried out:

serological diagnosis, in which the antibody titer is determined, especially with the characteristic picture of infectious mononucleosis;
identification of certain titers of antibodies to the pathogen. This method is relevant for children who do not yet have heterophilic antibodies;
cultural method;
general blood analysis;
polymerase chain reaction.

The above methods help to find viral particles or its DNA in individual tissues, blood. Only a qualified specialist can prescribe the required range of studies. It is strictly forbidden to deal with the problem on your own or make a diagnosis.

A selection of treatment methods

To date, there is no specific treatment for Epstein-Barr virus. Strong immunity copes with the pathogen, the disease is asymptomatic, without consequences. A complicated acute form of the disease requires complex therapy and hospitalization of a small patient. The following medications are used to treat pathology:

Zovirax, Acyclovir. Children under two years old are prescribed 200 mg, children from two to six – 400 mg, over six years old – 800 mg four times a day. The duration of treatment is no more than 10 days, the individual course is determined by the doctor;
Viferon is used in the form of rectal suppositories (for children under 7 years old), tablets (for children over seven years old);
use interferon inducers (Cycloferon, Arbidol);
Human immunoglobulin is actively used. Drugs in this group increase the body’s resistance to the virus, promote the elimination of toxins, and have an antibacterial effect;
In addition, the baby is prescribed multivitamins.

Treatment tactics depend on the complexity of the situation and the child’s condition. During the period of rising temperature, the following actions are recommended:

drink plenty of fluids (mineral waters, natural juices, fruit drinks, fresh fruit compotes);
bed rest;
nasal drops with a vasoconstrictor effect (Naphthyzin, Sanorin, Sofradex);
gargling, mouthwash with antiseptic agents: decoction of chamomile, calendula, Furacilin, Iodinol;
taking antipyretic drugs (Paracetamol, Nurofen, Panadol);
If necessary, the baby is given antihistamines.

Hospitalization of a small patient is necessary only in isolated cases with severe fever or high temperature. If necessary, medications are prescribed to support normal liver function.

Preventive measures

You can avoid infection or protect your baby from the acute course of the disease by strengthening the immune system from an early age:

accustom your baby to being in the water and performing water procedures;
balance your diet (exclude spicy, salty foods, limit your consumption of sweets);
avoid stress;
From childhood, accustom your child to regular physical activity.

The Epstein-Barr virus is a serious problem; it can only be dealt with if the baby has a strong immune system. From an early age, take care of the child’s body’s defenses and visit the doctor in a timely manner.

Described by Michael Epstein and Yvonne Barr in 1964. Often the disease occurs hidden. The characteristic symptoms of the virus are very similar to regular flu, so the disease is quite difficult to diagnose.

EBV affects leukocytes, but does not kill them and changes their structure. Penetrates into all organs. Can disrupt the activity of the central nervous system.

General information

The virus was recently discovered. There is no complete description. Doctors believe it is possible that it is present in the body of 90% of the population. Children become infected between the ages of 2 and 5 years. The source of infection is a sick or recovered person.

The effect of the virus on the child’s body and classification

After the Epstein Barr virus enters the child’s body, it invades B lymphocytes. Its DNA is integrated into the DNA of cells. The death of the latter does not occur. When infected B lymphocytes divide, they produce similar ones.

Conventionally, VEB can be classified:

by type of infection: acquired (infection from outside) or congenital (infection of the fetus during pregnancy);
asymptomatic or typical (ARVI, rhinitis, sinusitis) form;
mild, moderate, severe disease;
inactive or active form of the disease.

After recovery, the virus remains in the body for life. If the immune system is weakened, it can cause serious illnesses.

How dangerous it is for children

Primary infection occurs unnoticed. It is not always possible to make a diagnosis right away. For infectious mononucleosis caused by EBV, there are 2 ways:

cure with lifelong presence of the virus in the body;
transition of the disease to a chronic form.

If a child has an immunodeficiency, EBV provokes the development of:

nasopharyngeal cancer;
hepatitis A;
Hodgkin's disease;
Alice in Wonderland syndrome;
infectious mononucleosis;
Burkitt's lymphoma.

Diseases caused by the virus are complicated by otitis media, liver failure, and splenic rupture.

Little has been written about this virus, and the unknown scares parents. What is dangerous for a child is not the presence of EBV in the body, but the consequences.

More than half of 5-year-old children show traces of the disease. Mothers are often unaware of the illness they have had; it is asymptomatic.

Children's immunity is young. It is not always possible to quickly cope with the infection. The consequences cannot be foreseen. In some children, infection causes complications, in other cases it proceeds without consequences.

“Most adults were infected with EBV during childhood. They don't suspect it and feel great. The panic around a virus with a fancy name is unfounded.”

Risk group and routes of transmission

People who are most susceptible to infection are:

with reduced immunity;
children aged 0 to 1 year;
children from 3 to 6 years old attending kindergarten;
not maintaining social hygiene.

The disease occurs with or without pronounced symptoms. But a person is at risk of infection in any case.

When kissing through saliva. The second name is the kissing disease.
Through shared toys, dishes (with saliva on objects).
By airborne droplets (coughing, sneezing).
During blood transfusion. Rare route of infection.
For organ (bone marrow) transplantation.
Vertical. During pregnancy from mother to fetus. Dangerous due to early complications.

You can only become infected through close contact! The virus does not live outside the body.

Characteristic symptoms

The presence of a virus may be indicated by frequent:

acute respiratory viral infections, acute respiratory infections;
colds;
tonsillitis;
inflammation of the respiratory tract (rhinitis, sinusitis, tonsillitis).

Symptoms of Epstein-Barr virus in children:

the child complains of fatigue after kindergarten or school;
has difficulty waking up in the morning;
eats poorly and eats little.

If you have a combination of complaints, you should consult a doctor. The examination will confirm or refute the diagnosis.

At first, the virus does not appear. During the latent period (1 - 2 months), an infected person is dangerous to others.

In 25% of cases, primary infection is asymptomatic. In the rest, it has the following characteristics:

ARVI disease (40% of cases);
infectious mononucleosis (18% of cases).

Diseases are treated using traditional methods. Subsequently, the virus does not manifest itself.

Recovered children remain a source of infection for up to 18 months!

Diagnostic methods

If you suspect an EBV infection, you should visit your local pediatrician. The doctor will order laboratory tests. Based on the results, he will conduct treatment.

Rules for preparing and donating blood:

the material is taken on an empty stomach;
72 hours in advance, eliminate fatty foods, sweets, and alcohol;
stop drinking tea, coffee, carbonated drinks 24 hours before;
Replace dinner the night before with a light meal.

Parents should explain simple preventative techniques to their children:

adherence to daily routine;
maintaining a healthy lifestyle;
alternating mental and physical activity;
ability to overcome stress;
strengthening the immune system (walking, exercise, diet);
maintaining personal and social hygiene;
hygiene of intimate life (for teenagers).

Compliance with such simple preventive measures will strengthen the child’s immunity. After all, only a strong immune system will prevent the virus from becoming acute and keep it suppressed.

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. It is almost impossible to recognize diseases that arise as a result of the development of viruses of various types without special tests. 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 a child’s body sometimes proceeds unnoticed. But it can also be a source of very dangerous diseases.

Content:

Characteristics of the virus

The discoverers of this infectious pathogen are the 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 fed 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, and with HIV.

At normal temperature and humidity, this type of virus is quite stable, but in dry conditions, under the influence of high temperatures, sunlight, and disinfectants, it 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 is 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 from a sick person into the body of a small child, who 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, various factors are taken into account, indicating the degree of activity of the pathogen and the severity of the 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.

In primary schoolchildren and 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.

With the atypical form of Epstein-Barr virus infection, only isolated symptoms appear, and the disease is not as acute as the typical one. 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

Laboratory blood testing methods are used to detect viruses, determine the degree of damage to lymphocytes, and other characteristic changes.

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 that 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 earliest stages of the disease.

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, especially those with specific effects, 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 alleviate the general condition of 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 with antiseptic solutions of furatsilin or soda helps with sore throat. 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, and a normal daily routine.

If symptoms of a viral infection occur, you should immediately contact your pediatrician. In the acute form of Epstein-Barr infection, timely treatment leads to rapid 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.