Mononucleosis

What Is the Epstein-Barr Virus?

Cathy Cassata
By Medically Reviewed by 
Reviewed:
Medically Reviewed

By age 35, almost everyone has been infected with Epstein-Barr virus, the most common cause of mononucleosis.

The Epstein-Barr virus (EBV) is in the herpes family of viruses, and is one of the most common human viruses in the world.

By age 35, almost everyone has antibodies to EBV, indicating they've been infected with the virus at some point in their life — whether or not they've ever had symptoms.

Epstein-Barr Virus and Mononucleosis

EBV is the most common cause of infectious mononucleosis, also known as glandular fever, "the kissing disease" or simply "mono."

Its characteristic symptoms are:

About 30 to 50 percent of the time EBV causes mono, but many EBV infections go unnoticed either because they don't cause symptoms, or the symptoms are easily confused with other signs of infections.

Teenagers and young adults are especially vulnerable: At least 25 percent of them will develop mono.

Epstein-Barr Virus Causes

EBV is contagious and typically spreads through bodily fluids, especially saliva and other mucous fluids.

Blood and semen can also transmit the virus during sexual contact, blood transfusions, and organ transplants.

You can get EBV by sharing drinking glasses, eating utensils, or toothbrushes with a person who has the virus.

There's no proof that disinfecting such objects will stop the spread of EBV. It's thought that the virus can survive as long as the contaminated object remains moist.

A person who's infected with EBV for the first time can spread the virus for weeks without realizing they're infected.

Once you've had an infection, EBV stays inactive and dormant in your body.

However, if the virus reactivates, you can potentially spread it to others, no matter how much time has passed since your initial infection.

Epstein-Barr Virus Symptoms

When symptoms of EBV occur, they usually go away in two to four weeks.

However, some people may feel fatigued for several weeks or even months.

Symptoms of EBV infection may include the following:

  • Fatigue
  • Fever
  • Inflamed throat
  • Swollen lymph nodes in your neck
  • Enlarged spleen
  • Abdominal pain caused by a swollen liver
  • Rash (sometimes referred to as a "mononucleosis rash")

Epstein-Barr Virus Diagnosis

Since symptoms of EBV resemble those of other illnesses, an infection can be difficult to diagnose.

However, there are blood tests that can confirm whether or not you've been infected with EBV.

The Monospot blood test, for example, checks your blood for the antibodies to EBV.

Epstein-Barr Virus Treatment

There is no treatment for EBV, but the following can help relieve symptoms:

  • Drinking lots of fluids
  • Getting plenty of rest
  • Taking over-the-counter (OTC) pain medications for pain and fever
  • Throat lozenges

Examples of OTC pain relievers and fever reducers include:

People under age 19 should not take aspirin during a viral illness (including mono or EBV) due to risk of Reye syndrome.

While there is no vaccine for EBV infection, you may prevent getting it by avoiding kissing or sharing drinks, food, or personal items (such as toothbrushes) with a person who has it.

Epstein-Barr Virus Complications

In addition to mono, EBV infection can lead to a number of other illnesses and complications, especially in people with compromised immune systems.

These complications include:

  • Viral meningitis, which involves swelling of the tissues that cover the brain and spinal cord
  • Brain swelling
  • Eye nerve swelling
  • Spinal cord swelling
  • Paralysis of facial muscles
  • Paralysis on one side of the body
  • Guillain-Barre syndrome
  • Sudden uncoordinated muscle movement
  • Sleep disorders
  • Psychoses
  • Negative effects on blood and bone marrow, creating an excessive number of white blood cells
  • Weakened immune system, leading to other infections

Epstein-Barr Virus and Cancer

Cancers associated with EBV infection include:

  • Burkitt lymphoma (lymphatic system cancer)
  • Nasopharyngeal carcinoma (upper throat cancer)
  • Hodgkin lymphoma and non-Hodgkin lymphoma (lymphatic system cancers)
  • Post-transplant lymphoproliferative disorder (too many white blood cells after an organ transplant)
  • Tumors, including soft tissue cancers and T-cell lymphomas

Other Conditions and Epstein-Barr Virus

EBV infection can also cause the following:

  • Pneumonia
  • Lung tissue scarring
  • Pancreas swelling
  • Heart muscle swelling
  • Raised, white patches on the tongue
  • Pus-filled tissue near the tonsils
  • Sinus infection (sinusitis)
  • Inflammation of the liver (hepatitis)
  • Lymph node swelling
  • Bacterial infection of the mastoid bone of the skull just behind the ear
  • Salivary gland swelling and injury
  • Blockage of the air passages in the nose and throat

Editorial Sources and Fact-Checking

  • Mononucleosis; Mayo Clinic.
  • About Epstein-Barr Virus (EBV); CDC.
  • Epstein-Barr Virus/Mononucleosis; NIH.
Show Less