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Infectious mononucleosis. Epstein-Barr-virus shedding in saliva and the oropharynx
Abstract:
In an examination of excretion patterns of Epstein-Barr virus in 104 throat washings from 20 patients with infectious mononucleosis we found that three persons regularly shed virus from the second week through the third month after onset; 15 demonstrated intermittent excretion over three months, and in two cases, no virus was detected. In oral secretions, the virus appeared to be located extracellularly. Transforming activity was demonstrated in aliquots after centrifugation and filtration, in a sample in which cells were disrupted before filtration, and in specimens after two years' storage. Multiple oropharyngeal sites were examined for presence of the virus. In one patient, virus was regularly demonstrated in throat washings and saliva; swabs from Stensen's duct orifices yielded virus in three of four cases. Demonstration of virus in these oropharyngeal specimens explains increased transmissibility in age groups in which salivary exchange is high.
Insights
Epstein-Barr virus (EBV) shedding is common in infectious mononucleosis patients, with intermittent excretion lasting months. This EBV shedding in oral secretions contributes to its high transmissibility, especially in younger individuals.
Area of Science:
- Virology
- Immunology
- Infectious Diseases
Background:
- Epstein-Barr virus (EBV) is a common human herpesvirus.
- Infectious mononucleosis (IM) is a primary EBV infection.
- Understanding EBV excretion patterns is crucial for disease control.
Purpose of the Study:
- To investigate Epstein-Barr virus excretion patterns in patients with infectious mononucleosis.
- To identify oropharyngeal sites of EBV shedding.
- To assess the transforming activity of EBV in oral secretions.
Main Methods:
- Analysis of 104 throat washings from 20 IM patients.
- Detection of EBV in oral secretions (throat washings, saliva, Stensen's duct swabs).
- Assessing EBV transforming activity after centrifugation, filtration, and cell disruption.
Main Results:
- 18 out of 20 patients showed EBV excretion, with 15 exhibiting intermittent shedding over three months.
- EBV was detected extracellularly in oral secretions.
- Transforming activity was confirmed in processed samples, even after two years of storage.
- EBV was found in saliva and Stensen's duct orifices.
Conclusions:
- Epstein-Barr virus is intermittently shed in oral secretions for extended periods post-infection.
- Oropharyngeal sites, including salivary ducts, are reservoirs for EBV.
- The presence of EBV in saliva explains its high transmissibility through salivary exchange, particularly in young populations.