Strep and Mono: Bonnie & Clyde or Crips & Bloods?

A recent study published in the Journal of Infectious Diseases provides a great illustration of the intricate interplay between humans and 2 microbes, highlighting how pathogens interact with each other in order to facilitate their spread. 

The study is focused on the interaction between Group A streptococcus (GAS)--the cause of "strep throat"--and Epstein-Barr Virus (EBV), the cause of infectious mononucleosis.

As 20% of children are colonized with Group A streptococcus and EBV persistently infects 90% of the population, the two pathogens may have important influences on each other given that both of their habitats are the oropharynx.

EBV infects cells in two manners, lytically and latentenly. The lytic type of infection results in active viral replication, viral shedding and cell death facilitating spread. The latent type of infection, on the other hand, is relatively quiescent. Understanding what causes the switch from latency to a lytic infection is of great interest.

In this study, it was determined that GAS colonization can prompt EBV to emerge from latency and become lytic and enhance its presence in saliva thereby increasing the likelihood that it will spread to other humans. 

I think that this paper is fascinating because it highlights the fact that pathogens interact, not only with the host, but, with each other in an elaborate manner that impacts transmission. 

EBV's exploitation of GAS colonization is akin to one criminal exploiting the distraction that the presence of a rival criminal creates to go on a crime spree of contagion. Or maybe they're more like Bonnie and Clyde?