Parental Oral Secretions a Potential Source for Epstein-Barr Virus in Children

Although Epstein-Barr virus (EBV) acquisition in childhood is preferable to adolescence in terms of illness severity, early HBV infection may increase the risk of developing chronic EBV-related diseases.

Epstein-Bar virus (EBV) DNA found in oral secretions of 28% of parents visiting clinics with children younger than 8 years may represent a source of EBV infection in young children, according to research published in Clinical Infectious Diseases.

Oral washes from 800 parents who brought children <8 years of age for routine clinic visits were tested via real-time quantitative polymerase chain reaction for EBV DNA. In total, 221 parents had EBV DNA in their oral wash, and the mean quantity of DNA in positive samples was 5000 copies/mL. Oral EBV DNA was also more prevalent in parents identifying as nonwhite vs white (P =.0004) and in fathers vs mothers (P =.04). The positive samples were further assayed for encapsidated DNA: 40.3% of positive samples were encapsidated DNA, which is potentially more infectious than naked EBV DNA.

The results were derived from a sample from the Minneapolis-St. Paul area and may not be representative of the larger population. Analysis of risk factors was also limited and did not include socioeconomic factors.  The investigators also noted that they tested parents only once; as EBV DNA shedding can be intermittent, they may have missed parents not actively shedding at the time of the clinic visit. EBV-specific antibodies were also not measured; therefore, discrepancies in the proportions of EBV-naive parents between comparison groups may influence the results.  The investigators conclude, however, that even in worst-case scenario estimates that 10% of white parents are EBV naive compared to 0% of those identifying as nonwhite, the results would remain significant.

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The higher prevalence of EBV DNA among parents identifying with ethnic/racial categories other than white is consistent with observations that children from these groups acquire primary EBV infection earlier in life. The prevalence data combined with the data showing that approximately 40% of positive samples were encapsidated strengthens the likelihood that parental oral secretions may be a source of infection in children. It is still unclear how the timing of EBV infection relates to risk factors for several other diseases. It is unclear if parents should be instructed to minimize salivary exchange with children. However, the investigators concluded that “all things considered, preventing primary EBV infection is an important public health goal.”


Cederberg LE, Rabinovitch MD, Grimm-Geris JM, et al. Epstein-Barr virus DNA in parental oral secretions: a potential source of infection for their young children. [published online May 28, 2018]. Clin Infect Dis. doi: 10.1093/cid/ciy464