Epstein-Barr can cause infectious mononucleosis, also known as 'glandular fever', 'Mono' and 'Pfeiffer's disease'. Infectious mononucleosis is caused when a person is first exposed to the virus during or after adolescence. Though once deemed "The Kissing Disease," recent research has shown that transmission of Mono not only occurs from exchanging saliva, but also from contact with the airborne virus. It is predominantly found in the developed world, and most children in the developing world are found to have already been infected by around 18 months of age. EBV antibody tests turn up almost universally positive. In the United States up to 95% of adults between 35 and 40 years of age have been infected.
Burkitt's lymphoma is a type of Non-Hodgkin's lymphoma and is most common in equatorial Africa and is co-existent with the presence of malaria. Malaria infection causes reduced immune surveillance of EBV immortalised B cells, so allowing their proliferation. This proliferation increases the chance of a mutation to occur. Repeated mutations can lead to the B cells escaping the body's cell-cycle control, so allowing the cells to proliferate unchecked, resulting in the formation of Burkitt's lymphoma. Burkitt's lymphoma commonly affects the jaw bone, forming a huge tumour mass. It responds quickly to chemotherapy treatment, namely cyclophosphamide, but recurrence is common.
Other B cell lymphomas arise in immunocompromised patients such as those with AIDS or who have undergone organ transplantation with associated immunosuppression (Post-Transplant Lymphoproliferative Disorder (PTLPD)). Smooth muscle tumors are also associated with the virus in malignant patients.
Nasopharyngeal carcinoma is a cancer found in the upper respiratory tract, most commonly in the nasopharynx, and is linked to the EBV virus. It is found predominantly in Southern China and Africa, due to both genetic and environmental factors. It is much more common in people of Chinese ancestry (genetic), but is also linked to the Chinese diet of a high amount of smoked fish, which contain nitrosamines, well known carcinogens (environmental).
Chronic fatigue syndrome
In the late 1980s and early 1990s, EBV became the favored explanation for chronic fatigue syndrome. It was noted that people with chronic exhaustion had EBV, although it was also noted EBV was present in almost everyone. In a four year study, the Centers for Disease Control and Prevention found no definitive association between CFS and EBV but it is still being studied by researchers.
Subjects perceive humans, parts of humans, animals, and inanimate objects as substantially smaller than in reality. Generally, the object perceived appears far away or extremely close at the same time. For example, a family pet, such as a dog, may appear the size of a mouse, or a normal car may look shrunk to scale. This leads to another name for the condition, Lilliput sight or Lilliputian hallucinations, named after the small people in Jonathan Swift's Gulliver's Travels. The condition is in terms of perception only; the mechanics of the eye are not affected, only the brain's interpretation of information passed from the eyes.
The syndrome is associated with, and perhaps in part caused by, the classical migraine headache. Occasionally, Alice in Wonderland syndrome is named as one of the first symptoms of mononucleosis. Micropsia can also be caused by complex partial epilepsy, and the actions of various psychoactive drugs (notably dextromethorphan).