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A friend of mine had a blood donation rejected because it showed he has syphilis. He had no symptoms and believes it was from a 20-year-old episode. He had three tests to confirm it. I didn't realize syphilis could be dormant and asymptomatic. I know people who suffered greatly from shingles so I got the Shringrix shot to avoid that fate. Why would most of us carry the Epstein-Barr and CMV?

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Syphilis can be very slow to progress, so your friend's story is not a huge surprise. There's an interesting side note about testing for it. The cheap screening test for syphilis--not the definitive one, only the cheap one--often gives a false positive in people who have systemic lupus. It can be the first clinical sign of SLE. So-called definitive testing for SLE has a noticeable false negative rate, so the cheap screening test for syphilis can be a way of reassuring yourself that whatever is wrong really isn't SLE. (I picked up so many random tidbits poking around to learn more about chronic illnesses...)

Epstein-Barr virus (EBV) and cytomegalovirus (CMV) usually spread via saliva and are endemic. Most people acquire CMV as small children. You know how little kids are. They put everything in their mouths, slobber all over it, and then share it with the next kid.

EBV causes what Americans call mononucleosis or what Brits call glandular fever. One of its nicknames is "kissing disease." It isn't quite as omnipresent as CMV or as easy to catch, but when teenagers start kissing each other, that's often how it spreads.

By age 30, about 90% or so of Westerners have both viruses. If you don't have them and acquire them while you are in a weakened condition, such as after major surgery, they can be life threatening.

Reactivation of either virus due to a weak immune system can have a variety of consequences. So-called AIDS dementia can be caused by reactivated CMV. Some late stage AIDS patients are blinded by it.

Reactivated or persistently active EBV is turning out to be involved somehow in a growing list of illnesses. I only say it is involved because being correlated with something does not necessarily mean it is the cause of that thing. Researchers repeatedly leap to a wrong conclusion that EBV is the actual cause of illnesses, then have to take a step back later when the root cause turns out to be something that allowed EBV to reactivate. Last year they did that about multiple sclerosis. It's showing up as active a lot in MS patients. It looks like it may be involved in the immune system's confused attacks on the myelin sheath. But that doesn't really prove it is the cause of MS--we don't know why it is getting to step out of latency enough to make the trouble happen.

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