Mononucleosis, Glandular Fever, Epstein Barr

Filed in Articles and Presentations on August 22, 2014

Herbal MedicineThese are all words used to describe the same viral infection.  This disease is caused by a strain of the herpes family of viruses, and is spread by saliva, touching, nasal secretions from an infected person to another.  So for example if a person coughs or blows their nose in the vicinity of another person the virus can be transferred.  Originally it was called the kissing disease as it was believed human contact had to be made but we now know today that this is not the case.  It is believed the incubation period is 4-6 weeks but can be much shorter.  Infectious mononucleosis is caused by a virus called Epstein Barr which is part of the Herpes virus family. It is a very nasty infection with long term consequences.  There may be fever, sore throats, headaches, fatigue, and glandular swelling causing pain under the arms, groin and neck.  Eyes are often affected as the disease can progress through the neural pathways and eyes are located directly in the path of the trigeminal nerve. An enlarged spleen is present in about 50% of patients.  Fatigue is a very common symptom and bed rest is advised for an extended period. About 50% of patients who do not have supportive medicine may be ill for months.  The virus is always latent in the body once it has been exposed to Mono and the person is immunocompromised for life.  The virus also has what is known as a lytic cycle i.e. a cycle of replication which plants have been shown to break and thus control proliferation of the virus in the body.

Family doctor diagnosis is by physical examination and confirmation by blood work. Blood work shows a proliferation of T cells and B lymphocytes.  The blood cell shape is permanently altered by infectious mono.  This in turn can affect breathing due to the poor delivery of iron and oxygen to tissues.  Bloodwork should not be confused with similar diseases such as the Cytomegalovirus.  IgM elevation usually indicates current infection and Immunoglobulin Gg will show a previous infection.  There is currently nothing in the conventional world to treat this infectious disease.  A doctor usually gives aspirin and tells the patient ‘to get over it.  In our current lifestyle pattern this is not helpful.   There are tremendous pressures to return to work and many people live alone with no support structure.  There should be a minimum period of 6 weeks off work as otherwise you will infect other people.  Bed rest is a very unfashionable practice but in this kind of disease it is very important because the longer term consequences particularly in adults can be extensive.

Clinical depression and fatigue may persist for months.   This particular virus attacks cells in the spleen resulting in the potential for thrombocytopenia, splenic haemorrhages, and secondary infections such as pneumonia and meningitis as the immune system is so depleted.  Renal failure, Guillain-Barre, auto immune haemolytic anaemia and lymphoma are rare but not as rare as you might think.  MS patients can be a long term consequence of Mono.  Rheumatoid arthritis is a well-known disease whose origin lies in viral infections.  The Epstein Barr virus is directly implicated in Hodgkin and Non-Hodgkin’s lymphoma as well as the mouth condition called leukoplakia.  Swelling of the brain and cranial nerve palsies are not uncommon.   I have had patients who have developed Lymphomas directly as a result of getting Mono. Kaposi’s sarcoma is a form of tumour most often associated with those who have AIDS.  This feature of an Aids patient is triggered by the exposure to the human herpes virus 8.   Yes, the same group of viruses involved in Mono.

From a Medical Herbalist point of view Mono is a lovely condition to treat as it responds very well to our anti – viral plants (known also to be effective against SARS!).   There is a wide range of plants and one can use those most suited to the particular presentation of Mono in a patient.  Equally we have plants which specifically can treat the spleen to ensure optimisation of the balance between red and white blood cells and to limit the viral damage.  Many of these plants have good scientific evidence behind them which is why the only optimum resolution of SARS is the use of Elderberry!  These plants are not available in the relevant medium or dose over the counter so please do not self-treat!.  Unless the patient receives immediate support following the first infection of Mono they may have years of poor health.  The immediate focus is to control the likely proliferation of the virus via the lymphatic’s and spleen as well as support the liver where such pathogens are broken down for excretion by the body.  Echinacea spp. is a particularly helpful plant in this context but only in high doses and concentrations (not available over the counter). Echinacea spp is an immunomodulatory plant which supports and develops the immune system with particular effect on the respiratory system. It has an interferon like effect on viruses without any of the side effects synthetic interferon drugs have.   McGill University has done much ground breaking research with this plant.   Another very effective Canadian plant is golden seal – Hydrastis canadensis but again at therapeutic doses not available over the counter.  Golden Seal increases blood supply to the spleen and activates liver phagocytic function.  The Epstein Barr virus has a lipid covering so it is essential to use plants which can break this lipid envelope.  The berberines contained in plants like Golden seal are particularly useful in this context.

However what is sensible is a dietary regime high in fruits and vegetables, and low in extra sugars as in protein powders, processed foodstuffs.   Citrus fruits are particularly effective in Mono – liquidise lemons, limes, oranges so that you eat the pulp and rind.  Later on just the juice is needed but dilute with water for two reasons, the high sugar content of fruit and those lemons can strip the outer covering of your teeth of their protective enamel.  Do not overdose on Vitamin C as it causes diahorrea!   Make sure you add plenty of garlic, onions and a Vitamin B complex supplement can be helpful.  A good way to ease a sore throat is to take a lemon liquidised add, chopped garlic, teaspoon of honey and eight ounces of hot water – stir and when cooler drink everything in it.

Selected references:

Malignancies associated with epstein-barr virus: pathobiology, clinical features, and evolving treatments. Neparidze N, Lacy J.  Clin Adv Hematol Oncol. 2014 Jun;12(6):358-71

Epstein-barr virus, the germinal centre and the development of hodgkin’s lymphoma. Mohamed G, Vrzalikova K, Cader Z, Vockerodt M, Nagy E, Flodr P, Yap LF, Diepstra A, Kluin P, Rosati S, Murray P. J Gen Virol. 2014 Jun 3. pii: vir.0.066712-0. doi: 10.1099/vir.0.066712-0

Parthenolide induces apoptosis and lytic cytotoxicity in Epstein-Barr virus-positive Burkitt lymphoma. Li Y, Zhang, Fu M, Yao Q, Zhuo H, Lu Q, Niu X, Zhang P, Pei Y, Zhang K. Mol

Inhibitory effect of herbal remedies on 12-O-tetradecanoylphorbol-13-acetate-promoted Epstein-Barr virus early antigen activation. Kapadia GJ, Azuine MA, Tokuda H, Hang E, Mukainaka T, Nishino H, Sridhar R.  Pharmacol Res. 2002 Mar;45(3):213-20. d Rep. 2012 Sep;6(3):477-82. doi: 10.3892/mmr.2012.959.

Inhibitory effect of Epstein-Barr virus activation by Citrus fruits, a cancer chemopreventor Iwase Y, Takemura Y, Ju-ichi M, Kawaii S, Yano M, Okuda Y, Mukainaka T, Tsuruta A, Okuda M, Takayasu J, Tokuda H, Nishino H.  Cancer Lett. 1999 May 24;139(2):227-36.

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