When you look at statistics on Lyme disease, it becomes clear that this illness is a rapidly growing threat to public health. Results of studies conducted by the Centers for Disease Control (CDC) suggest that around 300,000 people are diagnosed with Lyme disease in the United States every year. Since these studies rely on surveillance systems that don’t account for every illness, and because only a fraction of Lyme disease cases are reported, these numbers only begin to scratch the surface of the impact this illness is having across the country.
Given the rapid rise of Lyme disease incidence, it makes sense that researchers are devoting more and more resources to its examination. As science reveals more information about transmission, symptoms, diagnosis, and treatment of Lyme disease, clinicians gain a deeper understanding of how to help Lyme patients.
One of the areas that hasn’t yet been fully explored is that of Lyme co-infections. While it’s generally known that Lyme disease itself is caused by the bacterium Borrelia burgdorferi, which is transmitted through the bite of a black-legged tick (also known as an Ixodes tick or deer tick), many people don’t realize that disease vectors like ticks may carry many different strains of bacteria along with viruses, protozoans, and fungi. All of these organisms can be transmitted in a single tick bite, potentially leading not just to the development of Lyme disease, but to Lyme co-infections as well.
The word “co-infection” is often used as an umbrella term that includes not only co-infections transmitted along with Lyme, but also opportunistic infections that prey on the weakened immunity of Lyme patients. A subset of opportunistic infections called “re-activated opportunistic infections” consists of latent infections already present in the host, which wait for a chance to re-activate. One of these, the Epstein-Barr virus (EBV), can have a significant impact on the health of people with Lyme disease.
What is the Epstein-Barr virus?
Also known as human herpesvirus 4, the Epstein-Barr virus (EBV) is a member of the herpes family of viruses. EBV is incredibly common, and most people around the world will be infected with it at some point during their lives.
Infection with EBV frequently happens during childhood. Because the symptoms of childhood EBV are usually mild and/or easily confused with those of the common cold or flu, many parents don’t realize their kids have been infected with EBV.
EBV is sometimes referred to as mononucleosis (mono), also known as “kissing disease.” It likely earned this name because it is spread through bodily fluids, the main one being saliva. This means EBV is frequently transmitted through kissing, especially among teenagers and young adults. Other ways EBV is spread through saliva include:
- Sharing drinks and food with an infected person
- Using the same eating utensils or toothbrush as an infected person
- Touching toys that have been drooled on by an infected child
When a person is infected with EBV for the first time, this is known as primary infection. EBV can be spread for weeks after primary infection, even if the infected person isn’t experiencing symptoms. After this period of contagion ends, EBV remains in your body in a latent, or inactive, state. In people with healthy immune systems, EBV rarely reactivates. However, if a person has Lyme disease or another illness that lowers immunity, it’s much more likely that they’ll experience symptoms of this re-activated opportunistic infection.
What are the symptoms of EBV infection?
Although children with EBV are often asymptomatic, teenagers and adults do sometimes experience symptoms like:
- Throat pain and inflammation
- Swollen lymph nodes (usually in the neck)
- Enlarged liver and/or spleen
How is EBV infection diagnosed and treated?
Because EBV symptoms resemble those of so many other illnesses, it can be a difficult infection to diagnose. A blood test can be used to detect EBV antibodies. According to the CDC, approximately nine out of ten adults possess antibodies that indicate they’ve been infected with EBV in the past.
While the medical community doesn’t have a specific treatment for EBV (or a vaccine to prevent it), people experiencing EBV symptoms can follow recommendations similar to the ones given to people with the flu. These include making sure you drink plenty of fluids to stay hydrated, getting as much rest as possible, and taking over-the-counter pain medications when needed.
For people with Lyme disease who are experiencing EBV reinfection, staying well-hydrated and well-rested are critical for illness management, especially since they may already be struggling with fatigue and other symptoms associated with Lyme disease.
Understanding Lyme disease means broadening our knowledge of Lyme co-infections, including opportunistic and re-activated opportunistic infections that fall under this umbrella term. When we learn how to recognize these illnesses, we get a better idea of how best to treat them.