{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T06:42:48Z","timestamp":1782888168932,"version":"3.54.5"},"reference-count":34,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Immunity Inflam &amp; Disease"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study aimed to investigate the epidemiological trends, age\u2010 and sex\u2010related patterns, and clinical and immunological characteristics of Epstein\u2013Barr virus (EBV) infection among febrile children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We analyzed EBV DNA data from 9151 febrile children and serological antibody profiles from 6934 cases. A clinical cohort of 377 patients was further evaluated to compare primary infection (\n                      <jats:italic>N<\/jats:italic>\n                      = 246) versus reactivation (\n                      <jats:italic>N<\/jats:italic>\n                      = 131), as well as infectious mononucleosis (IM,\n                      <jats:italic>N<\/jats:italic>\n                      = 134) versus non\u2010IM (\n                      <jats:italic>N<\/jats:italic>\n                      = 112).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>EBV DNA positivity peaked in autumn (September\u2013October), whereas VCA\u2010IgM levels reached their highest in autumn\u2013winter. Primary infection was most prevalent in children aged 1\u20139 years, peaking in the 3\u20136\u2010year age group (58.4%), with higher rates observed in females. Reactivation rates increased with age, reaching 7.8% in children aged \u2265 9 years. Clinically, primary infection is characterized by increased EBV DNA loads, lymphocyte percentages, and atypical lymphocytes and elevated liver enzyme levels. In contrast, reactivation was associated with increased proportions of CD19+ and CD4+ lymphocytes. IM patients had higher lymphocyte percentages, atypical lymphocytes, and liver enzyme abnormalities than non\u2010IM patients did, who had higher neutrophil percentages and hsCRP levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>EBV infection in febrile children exhibits distinct seasonal, age\u2010related, and sex\u2010related patterns. Primary infection and IM are clinically distinguished by pronounced liver involvement and lymphocytosis, whereas reactivation and non\u2010IM infections present with different immunological profiles and nonspecific inflammation, providing valuable insights for differential diagnosis and clinical management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/iid3.70468","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T04:42:51Z","timestamp":1780548171000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Epidemiological Trends and Clinical Characteristics of Epstein\u2013Barr Virus Infection in Febrile Children in Zhejiang, China: A Retrospective Study"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-8015-5655","authenticated-orcid":false,"given":"Hao","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Laboratory 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