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Understanding Stealth Pathogens in Chronic Infections

Last Updated on 8 March 2024 by Brisbane Livewell Clinic

Research strongly indicates that stealth pathogens may cause chronic fatigue, disturbed sleep, weight gain, fibromyalgia, neurological conditions and autoimmune diseases (1,2). Stealth pathogens are micro-organisms that hide in our cells and use tactics to evade or suppress our immune response and even lay dormant before reactivating (3,4).

These pathogens include Epstein Barr Virus (EBV), Borrelia Burgdorferi, Streptococcus and Hookworm. They are associated with glandular fever, Lyme disease, iron deficiency anaemia and PANDAS (a paediatric auto-immune condition) (2,3,4,5,6,7).  Groundbreaking research has linked EBV to developing Multiple Sclerosis (MS). And now medical researchers from Stanford University have revealed EBV triggers MS by priming the immune system to attack the nervous system (8.9).

Furthermore, EBV has been linked to other autoimmune conditions such as Rheumatoid arthritis, Sjogren’s Syndrome, and Systemic Lupus Erythematosis.  The common factor linking EBV to these conditions is a deficient or exhausted immune response that fails to respond to the virus and its stealth strategies (2). 

Who is more susceptible to stealth pathogen infection?

EBV affects most of us at some stage of our lives; only a small percentage will go on to have an autoimmune condition, chronic fatigue or other conditions.  The course of a stealth pathogen infection is determined by the viral or bacterial load, each individual’s immune system which is determined by their genes and infection history. Importantly, several environmental factors influence the capacity of a person’s immune response (2).

Environmental factors that may reduce the immune response to stealth pathogens

  • Vitamin D deficiency. Sunlight and Vitamin D are thought to protect against autoimmunity by increasing the number of immune cells available to fight a viral infection (2).
  • Obesity has been shown to impact cellular immune response to infection and create a state of chronic immune-driven inflammation that contributes to the pathogenesis of these conditions (2).
  • Other major environmental factors promoting the development of auto-immune conditions are sunburn, cigarette smoking and exposure to silica dust (2).

Support your immune health

  • Lifestyle
  • The following changes can positively impact your immune health based on the research above.
  • Quit smoking
  • Maintain a healthy body mass index (BMI)
  • Safe sun exposure to increase vitamin D, but avoid sunburn

Feed the immune system

  • The following nutrients are important to our immune response and a deficiency in one or all of these may reduce the immune system’s capacity to fight infection (10). 
  • Vitamin A impacts many aspects of innate immune response; a deficiency alters the immune response and increases vulnerability to infection (10). Food containing vitamin A include carrots, apricots, egg yolk, barley grass, cod liver oil
  • Vitamin D has immune regulatory properties (10). Food containing vitamin D include herring, calamari, chlorella, cod liver oil, cheese, egg yolk, sprouted seeds
  • Vitamin E maintains and enhances the immune response by reducing free radicals and lipid peroxides (10). Food containing vitamin E include almonds, beef, corn, egg yolk, nuts and seeds, wheat germ
  • Zinc deficiency impairs many aspects of immune response (10).  Food containing zinc include nuts and seeds, oyster, poultry, liver, herbs, yeast spreads
  • Selenium protects against the immune suppressive effects of oxidative stress (10). Food containing selenium include alfalfa, barley, Brazil nuts, broccoli, fish, garlic, oat bran, cheese, eggs

Food as medicine

  • Garlic is not only an effective antimicrobial but research has found that garlic creates balance within the immune system and reduces inflammation (11).
  • Apigenin is a natural flavonoid found in fruits and vegetables and has been found to inhibit the reactivation of viral infection, particularly EBV (12).

Herbal heroes to the rescue

Herbal medicine provides an effective tool kit to support immune health and protect against stealth pathogens.  Herbs such as Myrrh, Chinese wormwood and Licorice have activity against stealth pathogens (13,14,15).  A skilled naturopath or herbalist can personalise a herbal formula to best support your health needs.

In summary, Stealth Pathogens from viruses, bacteria, fungi and parasites have mechanisms to evade our immune system and become chronic.  This may lead to symptoms such as fatigue, aches, pains, interrupted sleep patterns, neurological symptoms and autoimmunity.  Having a diet rich in vegetables and fruit, daily sun exposure, and maintaining a healthy weight can positively impact your immune defences.  When extra support is needed, herbal medicine and nutritional support have been shown to enhance your immune health and protect against  Stealth Pathogens.


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1. Proal A, Marshall T. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome in the Era of the Human Microbiome: Persistent Pathogens Drive Chronic Symptoms by Interfering With Host Metabolism, Gene Expression, and Immunity. Front Pediatr. 2018;6:373. Published 2018 Dec 4. doi:10.3389/fped.2018.00373
2. Houen G, Trier NH. Epstein-Barr Virus and Systemic Autoimmune Diseases. Front Immunol. 2021;11:587380. Published 2021 Jan 7. doi:10.3389/fimmu.2020.587380
3. Bienvenu A, Martinez E, Bonazzi M. Undercover Agents of Infection: The Stealth Strategies of T4SS-Equipped Bacterial Pathogens. Toxins (Basel). 2021;13(10):713. Published 2021 Oct 9. doi:10.3390/toxins13100713
4. Tagawa T, Serquiña A, Kook I, Ziegelbauer J. Viral non-coding RNAs: Stealth strategies in the tug-of-war between humans and herpesviruses. Semin Cell Dev Biol. 2021;111:135-147. doi:10.1016/j.semcdb.2020.06.015
5. Pabst C, Subasic K. CE: PANDAS: Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infection. Am J Nurs. 2020;120(8):32-37. doi:10.1097/01.NAJ.0000694332.85367.d0
6. Coburn J, Garcia B, Hu LT, et al. Lyme Disease Pathogenesis. Curr Issues Mol Biol. 2021;42:473-518. doi:10.21775/cimb.042.473
7. Pearson MS, Tribolet L, Cantacessi C, et al. Molecular mechanisms of hookworm disease: stealth, virulence, and vaccines [published correction appears in J Allergy Clin Immunol. 201 2 Oct;130(4):852. Valerio, Maria Adela [corrected to Valero, Maria Adela]]. J Allergy Clin Immunol. 2012;130(1):13-21. doi:10.1016/j.jaci.2012.05.029
8. Bjornevik, K., Cortese, M., Healy, B. C., Kuhle, J., Mina, M. J., Leng, Y., … & Ascherio, A. (2022). Longitudinal analysis reveals high prevalence of Epstein-Barr virus associated with multiple sclerosis. Science, 375(6578), 296-301.
9. Study identifies how Epstein-Barr virus triggers multiple sclerosis | News Center | Stanford Medicine
10. Calder PC. Feeding the immune system. Proc Nutr Soc. 2013;72(3):299-309. doi:10.1017/S0029665113001286
11. Wu CC, Fang CY, Cheng YJ, et al. Inhibition of Epstein-Barr virus reactivation by the flavonoid apigenin. J Biomed Sci. 2017;24(1):2. Published 2017 Jan 5. doi:10.1186/s12929-016-0313-9
12 Arreola R, Quintero-Fabián S, López-Roa RI, et al. Immunomodulation and anti-inflammatory effects of garlic compounds. J Immunol Res. 2015;2015:401630. doi:10.1155/2015/401630
13. https://www.researchgate.net/publication/348962467_Amazing_Benefits_of_Myrrh
14. Feng X, Cao S, Qiu F, Zhang B. Traditional application and modern pharmacological research of Artemisia annua L. Pharmacol Ther. 2020;216:107650. doi:10.1016/j.pharmthera.2020.107650
15. Wang L, Yang R, Yuan B, Liu Y, Liu C. The antiviral and antimicrobial activities of licorice, a widely-used Chinese herb. Acta Pharm Sin B. 2015;5(4):310-315. doi:10.1016/j.apsb.2015.05.005


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