Epstein-Barr virus behavior in different populations and implications for control of Epstein-Barr virus-associated tumors.

The epidemiology of Epstein-Barr virus (EBV) infection in populations at different risk for EBV-associated diseases indicates significant differences between the populations. EBV infection takes place much earlier in Uganda, where all children are infected before the age of 2 to 3 years, than in Southeast Asia, where nasopharyngeal carcinoma is prevalent. It is proposed that such early infection in Equatorial Africa is related to the risk for Burkitt's lymphoma. Four possible interventions to control EBV-associated diseases are presented: (a) simple hygienic measures to delay natural primary infection by EBV; (b) EBV vaccine; (c) intervention against cofactors such as malaria in Burkitt's lymphoma; and (d) characterization of high-risk groups to allow early detection and successful treatment.