Epstein-Barr Virus
CHAPTER 10 Epstein-Barr Virus Alfred S. Evans and James C. Niederman 1. Introduction 2. Historical Background Epstein-Barr virus (EBV), a member of the herpes In 1889, Emil Pfeiffer of Wiesbaden, Germany, group of viruses, is the cause of heterophile-positive described a condition called Driisenfieber (glandular infectious mononucleosis, of most heterophile-neg fever), characterized by fever, adenopathy, mild ative cases, and of occasional cases of tonsillitis and sore throat, and in severe cases enlargement of the pharyngitis in childhood. Rarely, it may involve the liver and spleen. (63, 126) Since Pfeiffer's original de liver or central nervous system as primary mani scription, as well as Filatov's, (53,54) a Russian, in festations. This virus is strongly implicated as hav 1892, antedated by some 30-50 years recognition of ing a causal relationship to African Burkitt lym the hematological changes and the heterophile an phoma and to nasopharyngeal cancer. High antibody tibody, it is uncertain whether these were true in titers are also present in 30-40% of cases of Hodg fectious mononucleosis. However, his description kin's disease, in some patients with sarcoidosis, and of this febrile syndrome in older children and young in systemic lupus erythematosus. adults seems best to fit this diagnosis. There is little This chapter will deal with the epidemiology of doubt about the classic description of the disease EBV infections and the epidemiology of infectious made by Sprunt and Evans, (139) from Johns Hop mononucleosis. Infectious mononucleosis can be kins, in 1920. They described the disorder in young defined as an acute febrile illness involving children adults as we now know it, named the disease "in and young adults characterized clinically by sore fectious mononucleosis," and reported in detail the throat and lymphadenopathy, hematologically by hematological changes.
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