Epstein-Barr Virus (EBV)

Causative Agents

Epstein-Barr virus (EBV) (also called as human herpes virus 4 (HHV-4)) belongs to the family of Herpesviridae, genus Lymphocryptovirus which is the cancer-causing member of Herpesviridae family, also containing herpes simplex virus 1 and 2. There are two different types (EBV-1, EBV-2) based on their nuclear antigen genes. It is an enveloped virus containing double-stranded linear DNA genome with viral particles 120-150 nm in diameter and enclosed by capsid and lipid envelope. [1]


EBV is ubiquitous that infects 80-90% of adults worldwide without discrimination between sex and among racial groups. In developing countries, infection occurs early in life and usually without clinical symptoms while that may be symptomatic in non-developed countries. So, 90% of children over the age of 2 are seropositive. Also studies show that almost 50% of students were susceptible when they entered college at an average age of eighteen years old. BV is associated with several diseases such as acute infectious mononucleosis and several oncogenic states where it may act as the direct agent or as one of several cofactors where considered with various environmental, socioeconomic, and genetic factors as well. [2]

Modes of Transmission

Since virus shedding can be demonstrated in the oropharynx of most seropositive individuals, it is thought that transmission occurs mainly by the oral route (saliva) and thus also named “kissing disease”. More recently, virus replication has been detected in vivo in the uterine cervix, thus raising the possibility of sexual route for the transmission which been acquired by individuals receiving large amounts of blod as well. [3]


The diagnosis may be done by physical examinations and/or laboratory tests. Mono-spot test and platelet count are also used for the confirmation of the physical examination. Hovewer there are  false negatives  occured commonly in patients under the age of 5 years. Antibody tests (IgM, IgG, EA-DıgG) are available and have widepread use. Hovewer by using Real-Time-PCR technology it is possible to quantify the virus load fastly and with high analytical specifity and sensitivity when compared to serological methods. [4]


  1. Zuckerman AJ, et al. Principles and Practice of Clinical Virology Sixth Edition (2009)
  2. Evans AS, et al. Viral Infections of Humans Fourth Edition (1997)
  3. Material Safety Data Sheet (MSDS) for Epstein-Barr Virus
  4. Hiroshi Kimura,Makoto Morita, Quantitative Analysis of Epstein-Barr Virus Load by Using a Real-Time PCR Assay, J Clin Microbiol. 1999 January; 37(1): 132–136.

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