A Prospective Study of

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A Prospective Study of Primary Epstein-Barr
Virus Infection
HH Balfour Jr, KA Hogquist, CJ Holman, DO
Schmeling, BD Mullan, JA Ed, OA Odumade, W
Thomas, HE Vezina
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A Prospective Study of Primary Epstein-Barr Virus
Infection
Financial Disclosures
HH Balfour Jr and KA Hogquist have an
investigator- initiated research grant from
MedImmune, LLC
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A Prospective Study of Primary Epstein-Barr Virus
Infection
Step 1 Freshmen students screened for EBV VCA
IgG antibody. Antibody-negative subjects invited
to enroll in the surveillance study (Step 2).
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A Prospective Study of Primary Epstein-Barr Virus
Infection
Step 2 Clinic visits q8 wk until graduation
blood and oral wash obtained. Extra sick
visits. Graduates in vicinity seen in clinic q 6
months for up to 5 years after graduation.
Real-time symptom reporting by
internet Subjects prompted by weekly email Data
reviewed Health questionnaire Subjects
prompted monthly by email Data reviewed and
linked to risk score
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A Prospective Study of Primary Epstein-Barr Virus
Infection
Results Step 1
546 freshmen screened in the fall of 2006 and 2007
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A Prospective Study of Primary Epstein-Barr Virus
Infection
Results of Step 2 (Undergraduate Years)
____ Postgraduate follow-up is ongoing
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Primary EBV Infections by School Year
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Relative Severity of Primary EBV Infection in
University of Minnesota Undergraduates Followed
Prospectively
SOI score from Balfour et al. J Infect Dis
20051921505-12.
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Clinical Features of Primary EBV Infection
Feature Number of Subjects
() Sore throat 55 (93) Cx
lymphadenopathy 45 (76) Fatigue
39 (66) Headache 26 (44) Felt
Feverish 26 (44) Appetite ?
25 (42) Body aches 24
(41)
Median duration of illness, 15 days
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A Prospective Study of Primary Epstein-Barr Virus
Infection
Quantitative Viral Shedding
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CD8 T Cell Mononucleosis
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Correlation of Blood Viral Load and CD8
Lymphocytosis
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Risk Factors
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A Prospective Study of Primary Epstein-Barr Virus
Infection
Summary
38 of 18-year olds entering the University of
Minnesota were EBV-naïve The rate of primary EBV
infection was 20 per person-year observed 59/66
students (89) with primary EBV infection were
symptomatic Median duration illness, 15 days
oral shedding, 180 days Quantity of virus in
whole blood correlated with SOI score Deep
kissing was a risk factor for acquisition with or
without coitus Postgraduate follow-up and
additional risk factor analyses are underway