Can the EBV virus have any complications in pregnancy? I have had EBV infection for almost four months and am now nine weeks pregnant. Over the past two weeks, my condition has worsened significantly. I am worried the virus will affect the placenta and oxygen to my baby.

Joan

There is quite a bit of confusion regarding EBV, or the Epstein-Barr virus. This is the virus that causes infectious mononucleosis ("mono"). In fact, infection with EBV can cause a range of illness -- from typical mono symptoms to unusual syndromes and complications to no symptoms at all, which is common when young children are infected. Typical mono symptoms include fever, sore throat, swollen lymph glands, weakness and fatigue. If there are no complications, the illness is over in less than one month. Fatigue is the only symptom that commonly lasts longer than a month.

Many people who are diagnosed with EBV infection based on their symptoms are probably not really infected with this virus, because many other illnesses can cause similar problems. The only way to make a definitive diagnosis of EBV infection is through blood testing. Several different tests can be used. The common tests are the heterophile test and the Monospot test. Both are relatively accurate in diagnosing EBV infection.

When you say that you have had EBV for almost four months, I am not sure what you mean. It would be highly unusual to have fever, sore throat and lymph-node swelling for this long. If you do have these symptoms, you absolutely need to be evaluated by a physician, because I would suspect another diagnosis. If you have only fatigue, then that could be from EBV -- but it could also be from a host of other problems, including, but not limited to, thyroid problems, depression and other infections.

The risk to a fetus from EBV infection seems to be low. First, it is rather uncommon for a pregnant woman to develop a new EBV infection, because most people are already immune by adulthood. There are few studies looking at EBV infection in pregnancy, although there are a few isolated reports of significant birth defects in babies born to newly infected mothers. However, prospective studies involving thousands of women have generally failed to prove infection in the fetus. I cannot say that there is no risk to your baby from EBV, but I think it would be unlikely that there will be a problem.

What I suggest you do is this: Ask your doctor what evidence there is that you really had EBV, and when she or she thinks you developed the infection. If it was more than a few weeks before you became pregnant, that would tend to lower your risk even further. Then, if you indeed had EBV infection during your pregnancy, you can consider testing the baby after birth. There are no data on preventing fetal infection by treatment before birth.