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You may have heard about the link between Epstein-Barr virus and Burkitt’s lymphoma. Did you know that it is associated with a lot of other malignancies as well? In today’s blog we look at the history of EBV, its link with cancer, and a hopeful new treatment that may curb the spread of the virus.

At some point in our lives, we have all had a friend, classmate, coworker or family member that has had to stay home for a few weeks due to the “kissing disease” mononucleosis, or, if you don’t want to say that mouthful (pun intended), just “mono”. Mono is the combined symptoms (fatigue, fever, an inflamed throat, swollen lymph nodes, rash and an enlarged spleen) caused by Epstein-Barr virus (EBV) infection. 

Like other viruses found under the Herpesviridae family, for example Chicken Pox (VZV), EBV (also known as human herpesvirus 4) is a very common virus. Like its VZV cousin, EBV infection most frequently occurs in childhood, with the virus remaining latent or asymptomatic in the body for the rest of the person’s life. When either of these cousins infects a person, the results don’t generally lead to death; they seem benign and, in a way, unimportant. However, that is where this tricky little kissing virus (EBV) has had us all fooled.

As early as the 1960’s the link between EBV and malignant tumors of B-cells began appearing in the scientific literature. “While EBV lives unnoticed in as many as 95 percent of all humans,” said an article in Science Daily, “it also produces cancers that kill nearly 100,000 people around the world each year.”(1)

Is mono sounding a little more serious now? Clearly, EBV is more than just the “kissing disease”.

EBV has been linked with several different kinds of human cancers. Among those are Burkitt’s lymphoma (a malignancy typically found in African children); nasopharyngeal carcinoma (a cancer of the nose and back of the throat); and last but not least, post-transplant lymphoproliferative disorder (PTLD-a cancerous condition which affects transplant patients). EBV has also been found in lymphomas in AIDS patients and in one half of all Hodgkin’s disease cases. This list can go on and on as the scientific and medical communities are still studying and finding out how EBV can lead to or cause different types of cancers.

If you think this “kissing disease” is only linked to cancer, think again. EBV has also been associated with numerous autoimmune disorders, including systemic lupus erythematosus (SLE), multiple sclerosis (MS), rheumatoid arthritis (RA), juvenile idiopathic arthritis (JIA), inflammatory bowel disease (IBD), celiac disease, and type 1 diabetes. In all there are roughly eight million people in the United States alone who are impacted by these ailments.

The majority of people infected with the virus, which is most of us, don’t get cancer of course. “Individuals who carry the virus in most cases do not go on to have Burkitt’s Lymphoma because the immune system can recognize the transformed cells and destroy them before they cause malignancies. The immune system in the immunocompromised patients, however, is not typically able to perform such a task, making the individual at risk for malignancies that lead to Burkitt’s lymphoma.” (2)

That being said, with about 200,000 people each year afflicted with cancers (not to mention the other diseases) related to EBV, it’s definitely a problem that needs continued research and, we hope, an eventual vaccine.

The good news is that there is a silver lining. In early 2018, researchers found a human antibody that in laboratory tests blocks infection by the virus. This could be a hopeful step toward a vaccine preventing the spread of EBV. (3)

For now, you can still share a friend’s drink without too much worry of developing cancer.  And when a vaccine for EBV finally comes to fruition, we can all celebrate with a kiss.