Epstein-Barr Virus Diagnosis - Symptoms, Tests & Stages Explained

Epstein-Barr Virus Diagnosis: Tests and Symptoms

The Epstein-Barr Virus (EBV) is an infectious disease that spreads through bodily fluids. Symptoms include fever and rash, among others. There are three stages of this infection. The Early Antigen (EA) Test and the Monospot Test are two of the many tests doctors conduct to diagnose this.

Introduction

Epstein-Barr virus (EBV) is a common infection which spreads primarily through bodily fluids (especially saliva). It is also known as human herpesvirus and is a member of the herpes virus family. Most people, especially children, get afflicted with this virus but may not show any symptoms.

In this blog, we will explore EBV, its symptoms, diagnosis, treatment options, and how to manage it effectively at home.

What are the Symptoms of Epstein-Barr Virus?

Recognising the symptoms of EBV infection is the first step towards effectively caring for and preventing further complications. While it is often asymptomatic in children, teenagers and adults may experience some symptoms.

Symptoms of EBV include the following:

• Fever
• Inflammation of the throat
• Fatigue
• Swelling of the lymph nodes
• Enlarged spleen
• Rash
• Swollen liver
   

Most people who start showing symptoms after infection recover in two to four weeks. However, fatigue may last for up to months for certain people.

What are the Stages of Epstein-Barr Virus (EBV) Infection?

When a person contracts EBV, they go through certain stages. Understanding these stages is crucial for effective EBV diagnosis. The stages of the EBV infection are as follows:

• Incubation Period/Initial Infection: Most primary EBV infections occur among children. These are often asymptomatic, meaning they do not show any symptoms. However, later, this infection develops into infectious mononucleosis. The virus multiplies by copying itself in your body.
• Latency: After the initial infection, the virus goes dormant inside the body. It primarily hides in a type of immune cell called the memory B cells. Most people afflicted with the virus in this stage show no symptoms or health concerns.
• Lytic Reactivation: When a person's immune system weakens, many EBV viruses can reactivate. It is known as the lytic reactivation phase and may lead to the onset of some diseases. EBV mainly causes four types of illnesses, including infectious mononucleosis, chronic active EBV infection, EBV-related cancer, and EBV-related autoimmune disease.

These diseases can be severe and life-threatening in some cases. However, proper research is underway on how this virus behaves and stays in your body.

Tests for EBV

Doctors can perform several tests to determine this infection. They are:

• Early Antigen (EA) Test: This type of test detects the EA-D and EA-R antigens, which are present during an ongoing Epstein-Barr virus (EBV) infection. Generally, doctors recommend this test to people who do not have infectious mononucleosis. A positive result indicates a recent viral infection or reactivation.
• EBV Nuclear Antigen Test (EBNA): Specifically known as the EBNA-1 IgG test, this helps determine whether or not a person has previously contracted the virus. It is a form of blood test that measures the presence of VCA IgM antibodies. This indicates the previous infection in a patient.

Antibodies to EBNA develop primarily between six and eight weeks after the virus has entered the body (primary infection). However, a small percentage of adults may fail to develop antibodies to the EBNA.

• Mono spot Test: It is also known as the heterophile antibody test. A mono diagnosis can determine whether you are infected within 5-10 minutes with a blood test. However, it may display false negatives in children, as they may not be able to produce the antibody.

It might also show a false positive, as there are other conditions with similar symptoms.  

• Viral Capsid Antigen (VCA) Test: Also known as the EBV-Viral Capsid Antigen (VCA) IgM Panel, doctors perform this by taking a blood sample from the patient. After that, they send it to the laboratory for testing. This test helps determine whether a person has had an EBV infection.

Complications of Epstein-Barr Virus (EBV) Infection

There are many complications of this viral infection. They are as follows:

• Splenic Rupture: It is one of the most dangerous complications of the EBV virus. It can happen anytime after you are infected. In one case, a patient was affected by this 6 years after infection. Doctors can treat it through surgery or pain management.
• Acute Acalculous Cholecystitis: It is a rare complication and is often seen in the paediatric population. In this, the patient's gallbladder is inflamed without any gallstones. Doctors manage it conservatively using medicines and close monitoring.
• Airway Obstruction: Typically seen in children, this causes breathing problems. Although it is a rare complication, doctors treat the infection keeping this in mind. Intubation, tracheotomy and steroids are used to treat this.
   

Differential Diagnosis of EBV

The Epstein-Barr Virus (EBV) infection shares symptoms with several other diseases. Therefore, it is necessary to know about differential diagnosis to accurately diagnose this infection. Other diseases sharing similar symptoms are:

• Bacterial Pharyngitis: It shares one of the most similar symptoms with EBV. They include pus-filled tonsils, swelling of the back of the throat and sore throat.
• Cytomegalovirus: It is also part of the herpesvirus family and causes symptoms such as fever, chills and fatigue.
• Viral Pharyngitis: Symptoms include conjunctivitis, fatigue and fever.
• Acute HIV Infection: Fever, joint pain and sore muscles are common symptoms of this infection and are often confused with EBV infection.
   

Homecare Treatments for EBV Infection

As there is no specific antiviral treatment to treat the virus directly, treatment primarily includes managing the symptoms of the infection. Homecare treatments for EBV infection focus on symptom management and adequate hydration. Some of the effective home care treatments are as follows:

• Get Rest: Most people afflicted with the illness are already tired. Hence, it is essential to take adequate rest to allow the body to heal.
• Drink Plenty of Water: During the primary infection phase, it is essential to stay hydrated to help fight off the virus. Hence, you should drink lots of water and fluids to facilitate hydration.
• Avoid Strenuous Activities: Avoid any form of strenuous activity for four to six weeks after you have been diagnosed. EBV and mono can affect your spleen, and participating in strenuous activity may rupture it.
• Get Relief for your Sore Throat: You can relieve your sore throat by gargling with salt water or taking lozenges.
• Over-the-Counter Medicines: You could also try taking over-the-counter medications like ibuprofen to help with the fever. However, they will not help in curing the disease.
   

Final Thoughts

 The Epstein-Barr Virus (EBV) infection is self-limiting. This means it resolves after some time. However, in some cases, it may cause serious complications. Therefore, it is important to know prevention techniques. It includes limiting contact with bodily fluids such as saliva and practising good hand hygiene. Always remember, prevention is better than a cure! Contact a doctor if you show any symptoms.