Kissing Disease - Epstein Barr Virus or Something Else?

Kissing Disease - Epstein Barr Virus or Something Else?

Written by Daniel Roytas (MHSc Human Nutrition), BHSc (Naturopathy), Dip. RM

Glandular fever (also known as the kissing disease), was first described by Emil Pfeiffer in 1889. Pfeiffer classified glandular fever as an infectious disease that resulted in fever, swelling of the lymph nodes and organ enlargement of the liver or spleen¹. The term “infectious mononucleosis” was first coined by Sprunt and Evans in the 1920’s to further describe glandular fever, after discovering a group of students with a similar illness including elevated lymphocytes, atypical mononuclear cells and pharyngitis^1,2. In the 1960’s, a herpes-type "virus" was discovered in cell lines of Burkitt’s lymphomas, leukemic tissue and specimen samples taken from healthy donors³. It wasn’t until 1968 that Epstein Barr Virus (EBV) was said to be cause of glandular fever, after antibodies to that same herpes-type "virus" were found in sick individuals⁴. This study is considered the unequivocal proof that EBV is the cause of glandular fever, however upon further investigation of the scientific literature, it turns out there is much more to this story.

How can it be that a positive antibody test is proof of an infectious virus? Surely there must be experimental proof showing that healthy people become sick after being exposed to EBV, or to the bodily fluids of a sick person? Well, you might be shocked to learn that such experiments have actually been undertaken, and we are not just talking about one or two insignificant, small scale experiments either. There are in fact dozens of scientific experiments where scientists and doctors tried to infect healthy people with glandular fever by exposing them to the bodily fluids of individuals infected with mononucleosis (EBV).

More than 70 scientific experiments involving hundreds of people were conducted from 1930’s all the way through to to the early 1960’s, attempting to make healthy people sick with glandular fever. Doctors and scientists took the blood, mucous, lymphatic fluid and nasopharyngeal washings from people acutely ill with glandular fever. These bodily fluids were then exposed to healthy people via means of swabbing their throats with the infected bodily fluids, spraying the fluids in to their mouths and noses and even injecting these fluids subcutaneously and intramuscularly. The doctors and scientists became so eager in their attempts to infect healthy people, they even injected people with monkey blood containing the so called "virus". Despite their increasingly desperate attempts, they were unable to make healthy participants sick^5–7.

Given that EBV is claimed to be not only the cause of glandular fever, but also the potential cause of conditions such as fibromyalgia and chronic fatigue, one would expect that there would be solid evidence establishing it as the cause of these diseases. Yet the experimental evidence yielding consistently negative results suggests otherwise. If we are to continue blaming EBV as the cause of disease, then surely there must be evidence that exists somewhere in the scientific literature proving this beyond a shadow of a doubt. Whilst I am not saying that this evidence does not exist, it is certainly not easily identifiable, which is surprising considering glandular fever is such a common illness (affecting up to 95% of the global population)⁸.

This then raises the question, what scientific evidence are we actually relying on to prove EBV is the cause of disease? In order to prove that EBV, or any virus is the cause of disease, the virus must first be isolated and then  exposed to a healthy individual which results in disease. To date, such an experiment has never been conducted and therefore, to say EBV causes disease, is a  statement based on little more than belief, not science. 

References

1. Graser F. Hundert Jahre Pfeiffersches Drüsenfieber. Klinische Pädiatrie. 1991;203(03):187-190. doi:10.1055/s-2007-1025428
2. Mohseni M, Boniface MP, Graham C, Doerr C. Mononucleosis (Nursing).; 2022.
3. Henle G, Henle W, Diehl V. Relation of Burkitt’s tumor-associated herpes-ytpe virus to infectious mononucleosis. Proceedings of the National Academy of Sciences. 1968;59(1):94-101. doi:10.1073/pnas.59.1.94
4. Niederman JC. Infectious Mononucleosis. JAMA. 1968;203(3):205. doi:10.1001/jama.1968.03140030037009
5. Evans AS. Experimental attempts to transmit infectious mononucleosis to man. Yale J Biol Med. 1947;20(1):19-26.
6. Evans AS. Fruther Experimental Attempts to Transmit Infectious Mononucleosis to Man. Journal of Clinical Investigation. 1950;29(5):508-512. doi:10.1172/JCI102287
7. Niederman JC, Scott RB. Studies on infectious mononucleosis: attempts to transmit the disease to human volunteers. Yale J Biol Med. 1965;38(1):1-10.
8. Kuri A, Jacobs BM, Vickaryous N, et al. Epidemiology of Epstein-Barr virus infection and infectious mononucleosis in the United Kingdom. BMC Public Health. 2020;20(1):912. doi:10.1186/s12889-020-09049-x