Below is a description of a few common and chronic infections. Most of these are due to viruses which tend to stay in the body for long periods of time and directly or indirectly cause immune mediated damage or metabolic derangement. 

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1. EBV (Epstein Barr Virus):

EBV infects up to 80% of the population and almost every adult shows positive serology (antibodies) to the virus which often indicates past infection. Most people do not feel long term sequelae to the infection but up to 20% of the population can suffer from chronic persistent infection which can result in various symptoms such as fatigue. In addition, people can get re-infected with new virus or can get flare ups of the past / remote infection. Treatment is often directed to support the immune function.

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2. Lyme Disease:

Resulting from tick bite, Lyme disease is a bacterial infection which can cause long term damage. Although often associated with a rash, skin rash is usually seen in only 25% of the population infected with lyme disease. Some people may not remember a tick bite and therefore must be tested if symptoms suggest that an infection may be present. In the presence of healthy immune system, most people can recover from the infection on their own but those with compromised immune system or certain genetic predispositions, can suffer from long term effects such as fatigue, joint pains, cardiac dysfunction and neurological problems. In addition to specific antibiotics, supporting and strengthening the immune system is the key to treatment and recovery. 

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3. HSV (Herpes Simplex Virus):

HSV type 1 or type 2 infections can be transmitted through various routes. In the past, HSV infection was considered to be a sexually transmitted disease. After more data was gathered, it was concluded that HSV type 1 causes cold sores and HSV type 2 causes genital lesions. However, most recent body of knowledge suggests that there is quite a bit overlap between the two types and we might as well expect both types of herpes to be potential agents for oral or genital herpes. Therefore, having a blood test showing HSV type 1 or type 2 serology does not necessarily mean a sexually or non-sexually transmitted infection. Up to 70% adult population carries type 1 or type 2 serology and only a small percentage of such population gets oral or genital lesions. Blood tests can differentiate between recent or past infection. Long term virus burden can cause neurologic sequelae and therefore must be treated and monitored. 

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4. Miscellaneous Chronic Virus Infections:

a) CMV (Cytomegalovirus) infection can occur in healthy or immune-compromised population and can cause long term complications. 

b) Parvovirus infection can cause bone marrow suppression.

c) West Nile virus infection can cause chronic fatigue.

d) Hepatitis B and C infections can cause liver damage and increase the risk of liver cancer. 

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