The Morning Journal (Lorain, OH)
Dealing with Epstein-Barr virus
DEAR DR. ROACH
» I am a 63-yearold female who has suffered with Epstein-Barr virus twice in the past two years. My understanding is that for many people, this virus lies dormant until a trigger, such as stress, causes it to emerge.
My symptoms consisted of fever, extreme exhaustion and weakness. After three weeks, I am slowly feeling better. I never want to feel like this again! Aside from maintaining a healthy diet, exercising and stressing less, do you have any suggestions as to how I can stay symptom-free in the future?
— R.K.
DEAR READER » Epstein-Barr virus is the classic cause of infectious mononucleosis, which is a common condition in children and adolescents. Its symptoms of early fever followed by days or weeks of fatigue are nonspecific. Other viruses and even a parasite can cause a similar symptoms. Blood testing can confirm the diagnosis.
EBV is in the herpes family, and like all herpesviruses, it does lay dormant in the body. Unlike herpes simplex or varicella-zoster, it is very unlikely to recur. It is very rare to get mononucleosis from EBV more than once, although it happens occasionally if the immune system is severely depleted, such as in advanced HIV. It is almost unheard-of to get it at age 63.
Blood test results for EBV can be misinterpreted. If you ever had EBV — say, in childhood — you will have a positive antibody test for the IgG antibodies. Active infection stimulates the IgM antibodies. I suspect you may have had the IgG antibodies that were misinterpreted as active infection. If you really had recurrent EBV with positive IgM antibodies (or other, more precise tests of viral activity), then a visit with an immunologist and an infectious disease specialist is wise.
Your own advice — healthy diet, regular exercise, decreasing stress — are all good, commonsense ways of improving your immune system. I would add regular sleep to the list, and unless you really have had active EBV, which would surprise me, you shouldn’t need more than that.
Contact Dr. Roach at ToYourGoodHealth@med. cornell.edu.