I think if you read the subject line of this article you might think I’m being hyperbolic.
In a way, I am. And yet, in a way, I’m not.
Allow me to explain.
Every single day, people come to us looking for answers to health issues they’ve been dealing with for years. These chronic health issues have plagued them for years and they’re looking for answers.
In general the traditional medical establishment fails to address these issues because they’re not looking at the person’s life history.
That may be an overgeneralization, but the point is that more often than not the physicians aren’t looking at the cause of symptoms – they simply try and mask them with drug therapies.
So what does that have to do with kissing?
How Kissing Could Lead to a Lifetime of Misery
Well, one of the more devastating issues many of our patients deal with is called Epstein Barr Virus (EBV).
EBV is the virus that causes mono, also known as the kissing disease because it is spread through saliva.
Mono isn’t particularly harmful, although if you’ll remember back to high school, when someone got mono they were out of school for several weeks. The most common symptoms of mono include fatigue, sore throat, swollen lymph nodes, and abdominal pain. The abdominal pain is usually caused by a swollen spleen.
The vast majority of people who get mono don’t often deal with serious issues after they overcome the initial infection.
After an initial infection the virus remains inside most people’s body and remains inactive.
When the EBV virus is inactive for a lifetime it’s in a stage called latency.
There are times however, when the virus can “come back alive” and reactivate. Many times this happens and people are none the wiser as reactivation doesn’t produce any symptoms.
However, in an increasing number of specialized cases, people who get mono and contract EBV may see that the virus is able to re-attack them. This is especially true when the virus is reactivated during a period where the host has a weakened immune system. When this happens the host will experience symptoms similar to the initial EBV infection along with a host of potential other issues.
When EBV is reactivated it leads to something known as Chronic Active Epstein-Barr Virus infection (CAEBV).
The National Institute for Health lists CAEBV as a rare disease, and note that 95% of people who are initially infected with mono never need to worry about the virus reactivating.
While they say it’s rare, the truth is I’m shocked how many people come into my office who are still dealing with EBV. I would have never guessed when I was a kid that a “kissing cold” could have such deleterious effects on people’s health.
As I mentioned, upon the initial reactivation chronic EBV will display the same symptoms as mono. The difference here is people will deal with overpowering fatigue, sore throat, swollen lymph nodes, and abdominal pain for years, not weeks.
Additionally, a chronic EBV infection can produce a number of other life-altering health issues.
- A rupture of the spleen
- low platelet count (thrombocytopenia)
- conditions affecting the nervous system, including encephalitis, meningitis, and Guillain-Barre syndrome
The seriousness of these issues is why I am writing about CAEBV.
That combined with the fact that most people who have had mono don’t make the connection between how they feel and a possible ongoing infection from CAEBV.
For that reason I’m glad we’re starting to diagnose more people with this issue, but I do want to make a point and let you know that figuring out if you have CAEBV isn’t always as cut and dry as a single test.
Why CAEBV Is So Problematic
There Are Some Issues With Diagnosing EBV.
The truth of the matter is figuring out if you have CAEBV isn’t as simple as taking a test that comes back with positive or negative results.
A practitioner has to be trained to identify certain clues, and that usually takes clinical interpretation.
What do I mean by that?
Well, a temporary bout with mono and an ongoing battle with CAEBV will look the exact same when lab results are drawn up.
So, if an untrained practitioner is looking at the pattern of lab results they may dismiss CAEBV as a potential health concern because they’re going to assume the results they’re looking at are the remnants of mono.
This is why when we test for CAEBV in the office we’re looking at a few different things to help determine if CAEBV is the root cause of a person feeling lousy.
- We check for the presence of antibodies to EBV. Generally the higher the numbers of antibodies the more likely it is CAEBV is an ongoing problem.
- We test to see which antibodies are positive. While this might be technical, what we’re most concerned with is when the IgM antibodies (usually only positive with acute disease) or the IgG early antigen (usually only positive shortly after getting sick) remain positive.
- Lastly, we look to see the trend in antibody levels. If a person has CAEBV it generally means their IgM or IgG antibodies will trend downward. If they are getting worse, that is they’re continuing to remain elevated, then there is still antigen presentation which suggests an ongoing problem.
Even though it only takes a simple blood test to get all that information, the key to diagnosing CAEBV is making sure someone with a keen eye for tracking the right antibody levels is diagnosing you.
How to Know If You Should Get Tested
In the case of CAEBV, the most telling factor in considering testing is whether or not you had mono.
It should seem obvious, but just because you have all of the symptoms of CAEBV doesn’t mean you have it. You would have to have contracted mono at some point to develop CAEBV.
Of course, you may have contracted mono at some point in your life and not known it, in which case you may consider testing now.
I don’t think that’s likely as mono is particularly debilitating to those who get it, but there’s a chance you may have contracted EBV when you were younger and never developed full-blown mono.
If you know had mono at some point and feel awful today, then it may be the case you need to set up a test with a primary care provider who knows what to look for.
If you’re a patient of ours, and, if you’re interested in a test, please schedule an appointment with us in the patient portal (for existing patients) or call to set up an appointment (for new patients call 336-768-3335).