Analysis index

Antibody demonstration: 1 ml serum

PCR: 5 ml EDTA-blood, 1 ml serum, 1 ml CSF, swab (dry)

VCA-IgG: < 0,75 – 0,99 index
VCA-IgM: < 0,50 – 0,99 index
EBNA-1-IgG: < 0,50 – 0,99 index
Immunoblot: please refer to findings report
EBV-PCR: < 100 IU/ml (detection limit)

Suspicion of infectious mononucleosis, lymph node swelling, angina, hepatitis, occasionally reactivation in immunosuppressed patients, Burkitt’s lymphoma, carcinoma of the nasopharynx

Incubation times:

Children: 10 days

Adults: 3 – 7 weeks

Febrile infection with swelling of cervical lymph nodes in addition to tonsillitis, pharyngitis, characteristic blood count (high proportion of lymphomonocytic cells) especially in the early phase of disease, hepatosplenomegaly with increased liver values, thrombocytopenia, neutropenia. In infants usually inapparent, in older adults often also inapparent or with an untypical course.

Complications: Duncan-syndrome with approximately 70 % lethal course. VCA-IgM-antibodies are pathognomonic for primary infection. Often these may be absent, especially in the early phase of the disease. If clinical suspicion of fresh infection persists, another VCA-IgM-evaluation after a few days is recommended. VCA-IgM-antibodies generally remain detectable for about 6 weeks, in individual cases for as long as 6 months.

CAUTION: Due to the long incubation period in adults, antibodies may have already fallen below the detection limit! In this case, an immunoblot is the method of choice. The absence of EBNA-1-antibodies can support the suspicion of acute infection. These antibodies show 6 – 8 weeks after onset of disease or even later (up to 6 months) and usually persist. Their demonstration indicates previous illness and rules out acute infection. EBV-reactivations can be recognized by a repeated increase in EA-IgG-antibodies, whilst VCA-IgM-antibodies may be absent. A reliable diagnosis can be given by EBV-PCR if necessary.