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Kissing linked to primary EBV infection in college students
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Among university students, kissing was a significant risk factor for primary Epstein-Barr virus infection, according to researchers from the University of Minnesota.
“Epstein-Barr virus was discovered in 1964 and conclusively linked to infectious mononucleosis in 1968,” the researchers wrote. “More than four decades later, however, the incidence and risk factors for acquisition and correlates of severity of primary Epstein-Barr virus infection are incompletely understood.”
The researchers conducted a study among 546 university freshmen who completed a history form and donated blood for testing. Those who were antibody-negative for Epstein-Barr virus (EBV) were then invited to participate in a surveillance phase. The 143 students who enrolled in the surveillance phase visited the research clinic throughout their university career, at least every 8 weeks. At each visit, the student provided a medical history, blood samples and oral wash and completed a health questionnaire. The students were informed if their blood tested positive for EBV, and the researchers tracked symptoms.
During the surveillance phase, the overall EBV infection incidence was 14.4 cases per 100 person-years. The incidence of infection among freshmen was more than double the mean incidence during the following 3 years. Sexual behavior, especially kissing, was significantly associated with infection acquisition.
The most common clinical manifestation of EBV was infectious mononucleosis in 51 students. Eight patients had symptoms, but not mononucleosis, and seven were asymptomatic. The most common clinical findings were sore throat, cervical lymphadenopathy, fatigue, upper respiratory symptoms, headache, decreased appetite, fever, body aches and abdominal pain. Among symptomatic patients, the median duration of illness was 10 days.
“Disease severity was related to high numbers of [natural killer] and CD8 T cells and elevated blood viral loads,” the researchers wrote. “Our data suggest that preventing or reducing viremia by immunization or antiviral therapy could lessen the morbidity of primary Epstein-Barr infection.”
Disclosure: The researchers report no relevant financial disclosures.
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