mono - epstein barr virus - glandular fever

Epstein Barr Virus Research
Infectious Mononucleosis - Glandular Fever

What diseases does the virus cause?

The Epstein-Barr virus is thought to be responsible for a number of diseases in addition to glandular fever (otherwise known as infectious mononucleosis) and Burkitt’s lymphoma. One of these is nasopharyngeal carcinoma: this is a tumour of the nasal passages and throat which affects up to 2 per cent of people in southern China and also occurs in Southeast Asia, northern Africa and among Arctic peoples. It has been proposed as a possible cause of Hodgkin’s disease (a type of cancer affecting cells of lymph nodes).

On this page: How was the virus discovered? - How is the virus spread?
How does the virus work? - The response of the body’s immune system

Diseases caused by the virus are particularly common among people with reduced immunity. For example, the virus is associated with ‘post-transplant lymphoproliferative disease’, a tumour often found in organ transplant patients. The immune systems of such patients are usually suppressed artificially by drug therapy to help prevent the body from rejecting the new organ.

A Holistic Protocol for the Immune System: HIV/ARC/AIDS/Candidiasis/Epstein-Barr/Herpes and other opportunistic infections
by Scott Gregory; Paperback

Epstein-Barr Virus and Human Cancer
(Current Topics in Microbiology and Immunology, 258)
by T. Osato, et al Hardcover (2001) Development of Epstein-Barr Virus Vaccines
(Medical Intelligence Unit)
by Andrew Morgan, Ph.D. Hardcover (1995)

AIDS sufferers, who also have reduced immunity, commonly suffer from ‘oral hairy leukoplakia’, a condition involving considerable replication of the Epstein-Barr virus in cells along the edge of the tongue. And researchers have suggested that the high incidence of malaria in countries where Burkitt’s lymphoma is prevalent may also play a role in the disease by suppressing the body’s immune system.

Scientists don’t know why the virus causes a relatively mild disease like glandular fever in some people and malignant tumours in others. Some evidence suggests that genetic factors may play a role. A more detailed article on the Epstein-Barr virus is here.

How was the virus discovered?

In 1961, a surgeon working in Uganda, Denis Burkitt, presented the results of his research to staff at the Middlesex Hospital Medical School in Britain. He reported that the incidence of a certain tumour in African children had a geographic distribution corresponding to rainfall and temperature patterns.

The disease, which affects about 8 in every 100,000 children in parts of Africa and Papua New Guinea, quickly became known as Burkitt’s lymphoma. The influence of climate on its incidence seemed to suggest that some biological factor was involved. Three researchers, M.A. Epstein, Y.M. Barr and B.G. Achong, immediately began looking for possible cancer-causing viruses in samples of the tumour sent from Uganda to Britain.

In 1964, they identified the culprit using an electron microscope: a previously unknown member of the herpes family of viruses. Epstein and Barr were awarded the dubious honour of having the pathogen named after them.

	Chronic Fatigue Syndrome by Jesse Stoff M.D., et al; Paperback
	Epstein-Barr Virus Protocols (Methods in Molecular Biology Vol 174) by Joanna Wilson, Gerhard May; Hardcover

How is the virus spread?

People infected with the Epstein-Barr virus will retain it for life, but it may not make them sick. In fact, the virus infects almost everyone in developing countries and more than 80 per cent of people in developed countries. It is spread mainly via the transfer of saliva between individuals, which is the reason that glandular fever has been dubbed the ‘kissing disease’.

Most people are infected with the virus during childhood, probably by their mothers, and are usually not noticeably affected. On the other hand, people infected for the first time during or after adolescence (10–20 per cent of people living in developed countries) have a 50 per cent chance of contracting glandular fever.

How does the virus work?

The Epstein-Barr virus appears capable of infecting only two major cell types: the outer (epithelial) cells of the salivary gland, and white blood cells known as B lymphocytes (B-cells). Infection with the Epstein-Barr virus develops first in the salivary gland. Large amounts of the virus are released in the saliva, enabling it to spread from one person to another.

Infection of B-cells with the virus causes them to proliferate. This proliferation is controlled by the immune system; if the correct immune response does not develop, individuals are at risk of developing a form of cancer.

The response of the body’s immune system

The Epstein-Barr virus produces about 100 different antigens (large protein molecules) during the active phase of the viral cycle. In contrast, only about 10 antigens are produced during the inactive phase: these include the Epstein-Barr virus nuclear antigens (EBNAs 1–6), and the latent membrane proteins (LMPs 1–3).

The heroes in the battle against the Epstein-Barr virus are white blood cells known as cytotoxic T lymphocytes (T-cells). These cells combine with certain antigens produced by the virus and kill cells that harbour it. Unfortunately, when the virus is associated with Burkitt’s lymphoma and nasopharyngeal carcinoma it appears to produce only one antigen – EBNA1. T-cells are unable to combine with this particular antigen and will not attack the infected cell. In such circumstances, the virus is able to ‘hide’ from the body’s immune system.

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	Mononucleosis and Other Infectious Diseases (21st Century Health & Wellness) by Laurel Shader, et al; Library Binding
Everything You Need to Know About Mononucleosis (Need to Know Library) by Paul Smart; Library Binding

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