Department of Laboratory Medicine and Pathology, USA.
Department of Pediatrics, University of Minnesota Medical Center, Minneapolis, MN 55455, USA.
J Clin Virol. 2018 May;102:84-92. doi: 10.1016/j.jcv.2018.03.001. Epub 2018 Mar 5.
Epstein-Barr virus (EBV) infects about 90% of adults worldwide. It is the main cause of infectious mononucleosis, which is observed most frequently in adolescents. The disease can last several weeks and is characterized by lymphocytosis, sore throat, lymphadenopathy, and fatigue. Exposure to oral secretions during deep kissing has been identified as the major source for primary EBV infection in adolescents. Oral secretions are also thought to be the source for younger children through intimate intact or sharing food and eating utensils, although this has not been confirmed. Unlike most acute viral illnesses such as influenza, the incubation period of symptomatic primary EBV infection is unusually long, lasting about six weeks. Diagnosis is typically made by heterophile antibody tests and/or EBV-specific antibody tests. Long-term consequences may result from acquisition of the virus, including nasopharyngeal carcinoma and lymphomas. Nevertheless, there remains a surprising dearth of knowledge regarding the establishment of an immune response to persistent EBV infection, especially during the incubation period. This lack of knowledge has impaired our ability to develop an effective prophylactic EBV vaccine, despite various attempts. Our greatest challenges in EBV research are to develop a prophylactic vaccine and devise treatment strategies for persons already infected with EBV.
EB 病毒（EBV）感染了全球约 90%的成年人。它是传染性单核细胞增多症的主要病因，这种疾病在青少年中最为常见。该病可持续数周，其特征为淋巴细胞增多、咽痛、淋巴结病和疲劳。在深吻期间接触口腔分泌物已被确定为青少年原发性 EBV 感染的主要来源。口腔分泌物也被认为是幼儿感染的来源，通过亲密接触、共用食物和餐具传播，但这尚未得到证实。与大多数急性病毒性疾病（如流感）不同，有症状的原发性 EBV 感染的潜伏期异常长，约为 6 周。诊断通常通过异型嗜异性抗体检测和/或 EBV 特异性抗体检测进行。病毒的获得可能导致长期后果，包括鼻咽癌和淋巴瘤。然而，对于建立针对持续性 EBV 感染的免疫反应，尤其是在潜伏期内，我们的知识仍然非常有限。这种知识的缺乏阻碍了我们开发有效的预防性 EBV 疫苗的能力，尽管我们已经进行了各种尝试。我们在 EBV 研究中的最大挑战是开发预防性疫苗，并为已经感染 EBV 的人设计治疗策略。
