Divisions of 1Infectious Diseases and Hospital Epidemiology, 2Otolaryngology, and 3Anesthesia, University Children's Hospital of Zurich, Zurich, Switzerland.
J Infect Dis. 2010 Oct 15;202(8):1192-9. doi: 10.1086/656335.
Human-to-human transmission of the persistent infection establishing Epstein-Barr virus (EBV) occurs via saliva. Tonsils act as important portal of entry and exit of EBV. The contagiousness of pediatric EBV carriers and the role played by tonsillar enlargement (TE) are not known.
We compared EBV shedding in mouthwash samples from pediatric EBV carriers with or without TE to that in mouthwash samples from pediatric patients with infectious mononucleosis (IM), the symptomatic form of primary infection if delayed after the age of 5 years. EBV DNA was quantified by polymerase chain reaction, and contagiousness was assessed using the cord lymphocyte transformation assay.
EBV carriers with TE shed EBV DNA at an almost similar frequency (although in lower amounts) as pediatric patients with acute IM but more frequently (P <.001) and in higher amounts (P = .038) than EBV carriers without TE. EBV DNA levels in mouthwash samples from EBV carriers with TE mirrored levels in tonsils and gradually declined after tonsillectomy. Almost half of the mouthwash samples from pediatric EBV carriers contained infectious EBV.
Pediatric EBV carriers--in particular, those with TE-may considerably contribute to the spreading of EBV in industrialized countries.
人类持续性感染 EB 病毒（EBV）可通过唾液在人与人之间传播。扁桃体是 EBV 进入和离开人体的重要门户。儿科 EBV 携带者的传染性以及扁桃体肿大（TE）所起的作用尚不清楚。
我们比较了伴有和不伴有 TE 的儿科 EBV 携带者漱口液样本与传染性单核细胞增多症（IM）儿科患者漱口液样本中的 EBV 脱落情况，IM 是 5 岁以后发生的原发性感染的有症状形式。采用聚合酶链反应定量 EBV DNA，采用淋巴细胞转化试验评估传染性。
伴有 TE 的 EBV 携带者的 EBV DNA 脱落频率几乎与急性 IM 儿科患者相似（尽管脱落量较少），但比不伴有 TE 的 EBV 携带者更为频繁（P<.001）且脱落量更多（P=.038）。伴有 TE 的 EBV 携带者的漱口液样本中的 EBV DNA 水平与扁桃体中的水平相匹配，并且在扁桃体切除术后逐渐下降。儿科 EBV 携带者的近一半漱口液样本中含有传染性 EBV。
儿科 EBV 携带者，尤其是伴有 TE 的患者，可能会极大地促进 EBV 在工业化国家的传播。
