Epstein-Barr virus causes a number of diseases, including infectious mononucleosis.

The infection is spread through kissing or other close contact with an infected person. Symptoms vary, but the most common are extreme fatigue, fever, sore throat, and

swollen lymph nodes.

A blood test is done to confirm the diagnosis.

Acetaminophen or nonsteroidal anti-inflammatory drugs can relieve fever and pain.

Infection with the Epstein-Barr virus (EBV) is very common. In the United States, about 50% of all children 5 years of age and nearly 95% of adults have had an EBV infection. Most of these infections cause symptoms similar to those of a cold or other mild viral infections. Sometimes adolescents and young adults develop different and more severe symptoms from EBV infection. This disease is called infectious mononucleosis. Infectious mononucleosis is named for the large numbers of white blood cells (mononuclear cells) in the bloodstream. Adolescents and young adults usually catch infectious mononucleosis by kissing or having other intimate contact with someone infected with EBV.

After the initial infection, EBV remains in the body, mainly in white blood cells, for life. Infected people shed the virus periodically in their saliva. They are most likely to infect others during shedding, which usually causes no symptoms.

Rarely, EBV contributes to the development of several uncommon types of cancer, such as Burkitt's lymphoma and certain cancers of the nose and throat. It is thought that specific viral genes alter the growth cycle of infected cells and cause them to become cancerous. EBV does not cause chronic fatigue syndrome (see Disorders of Unknown Cause: Chronic Fatigue Syndrome), as was once suspected.

Symptoms and Complications

EBV can cause a number of different symptoms, depending on the strain of the virus and several other, poorly understood factors. In most children younger than 5, the infection causes no symptoms. In adolescents and adults, it may or may not cause symptoms. The usual time between infection and the appearance of symptoms is thought to be 30 to 50 days. This interval is called the incubation period.

The four main symptoms of infectious mononucleosis are

Extreme fatigue Fever

Sore throat

Swollen lymph nodes

Not everyone has all four symptoms. Usually, the infection begins with a general feeling of illness (malaise) and fatigue that last several days to a week. These vague symptoms are followed by fever, sore throat, and swollen lymph nodes. The fever usually peaks at about 103° F (about 39° C) in the afternoon or early evening. The throat is often very sore, and puslike material may be present at the back of the throat. Most commonly, the lymph nodes

of the neck are swollen, but any lymph node may be swollen. In some people, the only symptom is swollen lymph nodes. Fatigue is usually most pronounced during the first 2 to 3 weeks and may last 6 weeks or more.

The spleen is enlarged in about 50% of people with infectious mononucleosis. In most infected people, an enlarged spleen causes few if any symptoms, but it may rupture, particularly if injured. The liver may also enlarge slightly. Less commonly, jaundice and swelling around the eyes occur. Skin rashes develop infrequently. However, people with an EBV infection who take the antibiotic ampicillin usually develop a rash. Other very rare complications include seizures, nerve damage, behavioral abnormalities, inflammation of the brain (encephalitis) or tissues covering the brain (meningitis), anemia, and blockage of airways by the swollen lymph nodes.

How long symptoms last varies. After about 2 weeks, symptoms subside, and most people can resume their usual activities. However, fatigue may persist for several more weeks and, occasionally, for months or longer.

Diagnosis

The symptoms of infectious mononucleosis also occur in many other viral and bacterial infections. Therefore, infectious mononucleosis is often unrecognized. Usually, a simple blood test known as a heterophil antibody or monospot test is done to confirm the diagnosis. Sometimes early in the infection or in young children, the monospot test is negative, and other specific antibody blood tests are necessary to confirm the diagnosis.

Often, a complete blood cell count is also done. Finding many characteristic mononuclear white blood cells (atypical lymphocytes) may be the first clue that the diagnosis is infectious mononucleosis.

Treatment

There is no specific treatment. People with infectious mononucleosis may be as active as they want. However, because of the risk of rupturing the spleen, heavy lifting and contact sports should be avoided for 1 month, even if the spleen is not noticeably enlarged. Before such activities are resumed, doctors may wish to confirm that the spleen has returned to normal size.

Acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs, such as aspirin or ibuprofen ) can relieve fever and pain. However, aspirin should not be given to children because of the risk of Reye's syndrome, which can be fatal. Some complications, such as severe swelling of the airways, may be treated with corticosteroids. Currently available antiviral drugs have little effect on the symptoms of infectious mononucleosis and should not be used.

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Epstein-Barr Virus and Infectious Mononucleosis

 

DISEASE INFORMATION

Epstein-Barr virus, frequently referred to as EBV, is a member of the herpesvirus family and one of the most common human viruses. The virus occurs worldwide, and most people become infected with EBV sometime during their lives. In the United States, as many as 95% of adults between 35 and 40 years of age have been infected. Infants become susceptible to EBV as soon as maternal antibody protection (present at birth) disappears. Many children become infected with EBV, and these infections usually cause no symptoms or are indistinguishable from the other mild, brief illnesses of childhood. In the United States and in other developed countries, many persons are not infected with EBV in their childhood years. When infection with EBV occurs during adolescence or young adulthood, it causes infectious mononucleosis 35% to 50% of the time.

Symptoms of infectious mononucleosis are fever, sore throat, and swollen lymph glands. Sometimes, a swollen spleen or liver involvement may develop. Heart problems or involvement of the central nervous system occurs only rarely, and infectious mononucleosis is almost never fatal. There are no known associations between active EBV infection and problems during pregnancy, such as miscarriages or birth defects. Although the symptoms of infectious mononucleosis usually resolve in 1 or 2 months, EBV remains dormant or latent in a few cells in the throat and blood for the rest of the person's life. Periodically, the virus can reactivate and is commonly found in the saliva of infected persons. This reactivation usually occurs without symptoms of illness.

EBV also establishes a lifelong dormant infection in some cells of the body's immune system. A late event in a very few carriers of this virus is the emergence of Burkitt's lymphoma and nasopharyngeal carcinoma, two rare cancers that are not normally found in the United States. EBV appears to play an important role in these malignancies, but is probably not the sole cause of disease.

Most individuals exposed to people with infectious mononucleosis have previously been infected with EBV and are not at risk for infectious mononucleosis. In addition, transmission of EBV requires intimate contact with the saliva (found in the mouth) of an infected person. Transmission of this virus through the air or blood does not normally occur. The incubation period, or the time from infection to appearance of symptoms, ranges from 4 to 6 weeks. Persons with infectious mononucleosis may be able to spread the infection to others for a period of weeks. However, no special precautions or isolation procedures are recommended, since the virus is also found frequently in the saliva of healthy people. In fact, many

healthy people can carry and spread the virus intermittently for life. These people are usually the primary reservoir for person-to-person transmission. For this reason, transmission of the virus is almost impossible to prevent.

The clinical diagnosis of infectious mononucleosis is suggested on the basis of the symptoms of fever, sore throat, swollen lymph glands, and the age of the patient. Usually, laboratory tests are needed for confirmation. Serologic results for persons with infectious mononucleosis include an elevated white blood cell count, an increased percentage of certain atypical white blood cells, and a positive reaction to a "mono spot" test.

There is no specific treatment for infectious mononucleosis, other than treating the symptoms. No antiviral drugs or vaccines are available. Some physicians have prescribed a 5-day course of steroids to control the swelling of the throat and tonsils. The use of steroids has also been reported to decrease the overall length and severity of illness, but these reports have not been published.

It is important to note that symptoms related to infectious mononucleosis caused by EBV infection seldom last for more than 4 months. When such an illness lasts more than 6 months, it is frequently called chronic EBV infection. However, valid laboratory evidence for continued active EBV infection is seldom found in these patients. The illness should be investigated further to determine if it meets the criteria for chronic fatigue syndrome, or CFS. This process includes ruling out other causes of chronic illness or fatigue.

DIAGNOSIS OF EBV INFECTIONS

In most cases of infectious mononucleosis, the clinical diagnosis can be made from the characteristic triad of fever, pharyngitis, and lymphadenopathy lasting for 1 to 4 weeks. Serologic test results include a normal to moderately elevated white blood cell count, an increased total number of lymphocytes, greater than 10% atypical lymphocytes, and a positive reaction to a "mono spot" test. In patients with symptoms compatible with infectious mononucleosis, a positive Paul-Bunnell heterophile antibody test result is diagnostic, and no further testing is necessary. Moderate-to-high levels of heterophile antibodies are seen during the first month of illness and decrease rapidly after week 4. False-positive results may be found in a small number of patients, and false-negative results may be obtained in 10% to 15% of patients, primarily in children younger than 10 years of age. True outbreaks of infectious mononucleosis are extremely rare. A substantial number of pseudo-outbreaks have been linked to laboratory error, as reported in CDC's Morbidity and Mortality Weekly Report, vol. 40, no. 32, on August 16, 1991.

When "mono spot" or heterophile test results are negative, additional laboratory testing may be needed to differentiate EBV infections from a mononucleosis-like illness induced by cytomegalovirus, adenovirus, or Toxoplasma gondii. Direct detection of EBV in blood or lymphoid tissues is a research tool and is not available for routine diagnosis. Instead, serologic testing is the method of choice for diagnosing primary infection.

EBV-Specific Laboratory TestsLaboratory tests are not always foolproof. For various reasons, false-positive and false-negative results can occur for any test. However, the laboratory tests for EBV are for the most part accurate and specific. Because the antibody response in primary EBV infection appears to be quite rapid, in most cases testing paired acute- and convalescent-phase serum samples will not demonstrate a significant change in antibody level. Effective laboratory diagnosis can be made on a single acute-phase serum sample by testing for antibodies to several EBV-associated antigens simultaneously. In most cases, a distinction can be made as to whether a person is susceptible to EBV, has had a recent infection, has had infection in the past, or has a reactivated EBV infection.

Antibodies to several antigen complexes may be measured. These antigens are the viral capsid antigen, the early antigen, and the EBV nuclear antigen (EBNA). In addition, differentiation of immunoglobulin G and M subclasses to the viral capsid antigen can often be helpful for confirmation. When the "mono spot" test is negative, the optimal combination of EBV serologic testing consists of the antibody titration of four markers: IgM and IgG to the viral capsid antigen, IgM to the early antigen, and antibody to EBNA.

IgM to the viral capsid antigen appears early in infection and disappears within 4 to 6 weeks. IgG to the viral capsid antigen appears in the acute phase, peaks at 2 to 4 weeks after onset, declines slightly, and then persists for life. IgG to the early antigen appears in the acute phase and generally falls to undetectable levels after 3 to 6 months. In many people, detection of antibody to the early antigen is a sign of active infection, but 20% of healthy people may have this antibody for years.

Antibody to EBNA determined by the standard immunofluorescent test is not seen in the acute phase, but slowly appears 2 to 4 months after onset, and persists for life. This is not true for some EBNA enzyme immunoassays, which detect antibody within a few weeks of onset.

Finally, even when EBV antibody tests, such as the early antigen test, suggest that reactivated infection is present, this result does not necessarily indicate that a patient's current medical condition is caused by EBV infection. A number of healthy people with no symptoms have antibodies to the EBV early antigen for years after their initial EBV infection.

Therefore, interpretation of laboratory results is somewhat complex and should be left to physicians who are familiar with EBV testing and who have access to the entire clinical picture of a person. To determine if EBV infection is associated with a current illness, consult with an experienced physician.

Additional Information about EBV Antibody Tests and InterpretationAntibody tests for EBV can measure the presence and/or the concentration of at least six specific EBV antibodies. By evaluating the results of these different tests, the stage of EBV infection can be determined. However, these tests are expensive and not usually needed for the diagnosis of infectious mononucleosis.

It is not appropriate for CDC to interpret test results or to handle counseling for the public. We suggest that questions be directed to a local physician who is familiar with the patient's history and laboratory test results. In addition, CDC cannot recommend specific physicians for referral. Our general recommendation is for patients to consult with an infectious disease specialist or their local or state public health department.

SUMMARY OF INTERPRETATION

The diagnosis of EBV infection is summarized as follows:

SusceptibilityIf antibodies to the viral capsid antigen are not detected, the patient is susceptible to EBV infection.

Primary InfectionPrimary EBV infection is indicated if IgM antibody to the viral capsid antigen is present and antibody to EBV nuclear antigen, or EBNA, is absent. A rising or high IgG antibody to the viral capsid antigen and negative antibody to EBNA after at least 4 weeks of illness is also strongly suggestive of primary infection. In addition, 80% of patients with active EBV infection produce antibody to early antigen.

Past InfectionIf antibodies to both the viral capsid antigen and EBNA are present, then past infection (from 4 to 6 months to years earlier) is indicated. Since 95% of adults have been infected with EBV, most adults will show antibodies to EBV from infection years earlier. High or elevated antibody levels may be present for years and are not diagnostic of recent infection.

ReactivationIn the presence of antibodies to EBNA, an elevation of antibodies to early antigen suggests reactivation. However, when EBV antibody to the early antigen test is present, this result does not automatically indicate that a patient's current medical condition is caused by EBV. A number of healthy people with no symptoms have antibodies to the EBV early antigen for years after their initial EBV infection. Many times reactivation occurs subclinically.

Chronic EBV InfectionReliable laboratory evidence for continued active EBV infection is very seldom found in patients who have been ill for more than 4 months. When the illness lasts more than 6 months, it should be investigated to see if other causes of chronic illness or CFS are present.

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Epstein-Barr Virus Infection, Symptoms and TreatmentBy AliciaC

The Epstein-Barr virus (EBV) is very common in the human population. In the United States, ninety to ninety five percent of people between the ages of thirty five and forty have been infected by the virus. Once a person has been infected, the virus stays in their body for the rest of their life. It may produce no noticeable effects, may produce symptoms that resemble flu, or may cause health problems such as mononucleosis and some types of cancer.

Vegetables Boost the Immune System: Photo by Cooee

Infection by the Epstein-Barr Virus

The Epstein-Barr virus is a member of the herpes family of viruses, and like its relatives, such as the cold sore virus, goes through periods of activity and dormancy. When the virus is active, it may make the infected person ill or may produce no symptoms. Even if someone is experiencing no problems from the EBV activity in their bodies, they are infectious. The active virus reproduces and enters the person’s saliva, a process known as “shedding.” The virus can then be transferred to other people. When the virus is dormant, it is hiding in an inactive form in B lymphocytes, which are a kind of white blood cell, and is said to be in a “latent” state. The latent virus can be reactivated by illness or by stress.

The virus is passed from one person to another inside saliva. The saliva can be transferred during kissing or by sharing food, drinks or eating utensils with an infected person. Touching infected saliva and then touching the mouth or nose can also transmit the virus. Coughing and sneezing can spread the virus through saliva and mucus droplets, but scientists have found that this is a weak method of virus transfer. Direct saliva contact is far more likely to cause an EBV infection. Tears can sometimes transmit the virus. Very rarely, the Epstein-Barr virus can be transmitted from one person to another in blood.

When infected saliva enters someone’s body, the virus first infects the tissues of the mouth and nose. The virus then reproduces, enters the salivary glands and spreads to other areas of the body.

Symptoms of an Epstein-Barr Virus Infection

People may not realize that they are carrying the Epstein-Barr virus in their bodies because the active virus may cause no symptoms, the virus may be dormant or people may think that they are suffering from a cold or influenza when the Epstein-Barr virus is making them ill.

When teenagers and young adults are infected by the Epstein-Barr virus they have a thirty five to fifty percent chance of developing mononucleosis, which is also called mono, glandular fever or the kissing disease. Mononucleosis may sometimes develop in people of other ages. The term “glandular fever” refers to the fact that the lymph glands under the arms, in the groin and especially in the neck become swollen, and to the fact that the person develops a high temperature. Someone suffering from mononucleosis may also experience a sore throat, swollen tonsils, headache, chills, muscle aches, loss of appetite, a spotty rash, extreme fatigue and a general feeling of illness and discomfort, which is known as “malaise.” There may also be swelling of the eyelids. The blood usually contains more white blood cells than normal, and they may have an unusual appearance.

In about fifty percent of mononucleosis cases, the spleen may become enlarged. There may also be hepatitis and jaundice (a yellow color to the skin and the white part of the eyes). Very rarely, the heart, lungs or nervous system may be affected.

Mononucleosis symptoms develop about four to six weeks after the initial infection by EBV. Acute mononucleosis symptoms last for around two to four weeks, but the fatigue may be experienced for several months. Mononucleosis may sometimes occur in a chronic state that lasts for much longer or that reappears at intervals for years.

The Epstein-Barr virus causes or contributes to some kinds of cancer, including Burkitt’s lymphoma, nasopharyngeal carcinoma and some cases of Hodgkin (or Hodgkin's) lymphoma. It may also cause some cases of chronic fatigue syndrome and multiple sclerosis, although this is less certain.

Fruits Boost the Immune System: Photo by Scott Liddell

Treatment For an Epstein-Barr Virus Infection

Rest and plenty of fluids are usually prescribed for an active Epstein-Barr infection that is producing mononucleosis or flu-like symptoms. Pain and fever reducers like aspirin, ibuprofen and acetaminophen should help. Children shouldn’t be give aspirin since they may develop Reye’s syndrome, a very dangerous condition involving swelling of the brain. Antibiotics don’t affect viruses, but may be prescribed if the person’s weakened body has developed a bacterial infection as well as an EBV infection.

If the spleen is swollen there is a possibility that it could rupture. Corticosteroids may be prescribed to reduce swelling in the spleen and in the throat. Precautions need to be taken to avoid spleen rupture during exercise.

Strengthening the Immune System

Scientists are continuing to study the Epstein-Barr virus and are learning more about it. Recent research had discovered that the virus can infect more areas of the body than was previously thought and that it may cause or contribute to more disorders than we previously realized.

Since most of us have already been infected by the Epstein-Barr virus, we need to do what we can to help our immune systems control the virus. Usually when the virus is reactivated after the initial infection no symptoms are produced, but this is not always the case. Eating a nutritious diet will strengthen the immune system. We should avoid habits known to weaken the immune system, like eating too much sugar, fat and alcohol. We do need to eat some fats, but these should be healthy fats, like omega-3 and monounsaturated fats. Smoking suppresses the immune system so should be avoided.

We should try to maintain a healthy weight, since being very overweight has been shown to lower immunity to diseases. Regular exercise boosts the activity of the immune system and reduces emotional stress. Activities such as yoga and tai chi can also help reduce emotional stress. To decrease physical stress, we should get an adequate amount of sleep and try to avoid other infections. Although exercise is important, very intense exercise or exercising for too long or too often without giving the body a chance to recover will contribute to physical stress within the body and should be avoided.

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What is the Epstein-Barr virus?

The Epstein-Barr virus, also called EBV, is an extremely common virus that infects most people at one time or another during their lifetimes. Epstein-Barr virus infection generally causes a minor cold-like or flu-like illness, but, in some cases, there may be no symptoms of infection.

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In adolescents and young adults, the Epstein-Barr virus can cause mononucleosis, which is a more serious illness. Epstein-Barr virus infection has also been linked to the development of certain rare cancers including Burkitt's lymphoma and nasopharyngeal carcinoma.

Epstein-Barr virus is very contagious and spreads from person to person through intimate contact with the saliva of a person who has the Epstein-Barr virus. About 95% of all adults have had an Epstein-Barr virus infection at some point in their lives, according to the Centers for Disease Control and Prevention (Source: CDC).

Treatment of most viral diseases begins with preventing the spread of the disease with basic hygiene measures. However, controlling the spread of the Epstein-Barr virus is extremely difficult because it is so common and because it is possible to spread the Epstein-Barr virus even when a person does not appear sick. Many healthy people who have had an Epstein-Barr virus infection continue to carry the virus in their saliva, which means they can spread it to others throughout their lifetimes. However, avoiding contact with another person's saliva by not sharing drinking glasses or toothbrushes is still a good general disease prevention measure.

There is currently no specific cure for an Epstein-Barr virus infection. Treatment includes measures to help relieve symptoms and keep the body as strong as possible until the disease runs its course. This includes rest, medications to ease body aches and fever, and drinking plenty of fluids. People who are in good health can generally recover from an Epstein-Barr virus infection at home with supportive care, such as rest, fluids and pain relievers.

Corticosteroids may be prescribed in some cases of mononucleosis. Antibiotics are ineffective against the Epstein-Barr virus, but may be prescribed if a secondary bacterial infection develops, such as bacterial tonsillitis.

Serious or life-threatening complications, such as encephalitis, ruptured spleen, or hepatitis, may develop in some cases of Epstein-Barr virus infection or mononucleosis, which is often caused by the Epstein-Barr virus.  

Seek prompt medical care if you, or your child, have symptoms of mononucleosis, such as extreme fatigue, swollen lymph nodes, or a cold- or flu-like illness that is not getting better. Seek immediate medical care (call 911) if you, or someone you are with, have life-threatening symptoms, such as shortness of breath, seizure, confusion or delirium, or a change in alertness or consciousness.

What are the symptoms of an Epstein-Barr virus infection?

Symptoms of an Epstein-Barr virus infection vary greatly among individuals. Toddlers and adults may experience no symptoms at all, but are still capable of spreading the infection.

General symptoms of an Epstein-Barr virus infection

Symptoms of an Epstein-Barr virus infection are often mild, vague, and similar to symptoms of a cold or the flu. Symptoms include:

Body aches Cough

Fatigue

Headache

Low-grade fever

Malaise

Runny or stuffy nose or nasal congestion

Sneezing

Sore throat

Swollen tonsils

Symptoms of mononucleosis caused by the Epstein-Barr virus

In adolescents and young adults who develop mononucleosis, which is often caused by the Epstein-Barr virus, symptoms generally begin about four to six weeks after exposure to the virus. Early symptoms are similar to symptoms of a cold or the flu. As mononucleosis progresses, symptoms become more severe and can include:

Enlarged spleen Extreme fatigue

Painful swollen glands (lymph nodes) in the neck, armpits or groin

Rash

Serious symptoms that might indicate a life-threatening condition

In rare cases, an Epstein-Barr virus infection or mononucleosis can result in serious or life-threatening complications, such as meningitis, hepatitis or ruptured spleen. Seek immediate medical care (call 911) if you, or someone you are with, have any of the following symptoms:

Change in alertness or level of consciousness or passing out Dizziness

High fever (higher than 101 degrees Fahrenheit)

Left upper abdominal pain (possible rupture of spleen)

Lethargy or unresponsiveness

Rash of small reddish purple spots

Respiratory or breathing problems, such as shortness of breath, difficulty breathing, labored breathing, wheezing, not breathing, or choking

Seizure

Stiff neck

Yellowing of the skin and whites of the eyes (jaundice)

What causes an Epstein-Barr virus infection?

Epstein-Barr virus is a member of the herpesvirus family of viruses. The Epstein-Barr virus is contagious and spreads from person to person through intimate contact in which saliva is exchanged. This is why mononucleosis, which is often caused by the Epstein-Barr virus, is commonly referred to as “the kissing disease.”

The Epstein-Barr virus can spread from person to person by such activities as:

Kissing Sharing unwashed water bottles, drinking glasses, eating utensils and dishes, and

personal items used in and around the mouth, such as toothbrushes and lip balm

Spitting in the face near or in the mouth, or on the lips

What are the risk factors for catching the Epstein-Barr virus?

The Epstein-Barr virus can occur in any age group or population. Almost everybody will develop an Epstein-Barr virus infection at some point during their lives, but a number of factors increase the risk of catching the disease.

Risk factors include any activity that exposes you to the saliva of a person who carries the Epstein-Barr virus. Carriers of the Epstein-Barr virus may not appear ill but can still spread the disease. Risk factors include:

Kissing Sharing unwashed water bottles, drinking glasses, eating utensils and dishes, and

personal items used in and around the mouth, such as toothbrushes and lip balm

Spitting in the face near or in the mouth, or on the lips

Reducing your risk of catching an Epstein-Barr virus infection

The Epstein-Barr virus is an extremely common virus that infects most people at one time or another during their lifetimes. In addition, many people who have had an Epstein-Barr virus infection may carry the virus in their saliva after they are no longer sick, which means they can continue to spread the infection.

Because of this, there is little that can be done to prevent its spread. However, avoiding contact with another person's saliva by not sharing unwashed water bottles or drinking or eating utensils and toothbrushes is still a good disease prevention measure. Washing hands frequently throughout the day with soap and warm water for at least 15 seconds is a good habit that can help prevent the spread of infectious diseases in general.

How is an Epstein-Barr virus infection treated?

There is currently no cure for an Epstein-Barr virus infection. Treatment includes measures aimed at relieving symptoms so that you are comfortable enough to get the rest you need to keep up your strength and recover without developing complications. Treatment of an Epstein-Barr virus infection includes:

Acetaminophen (Tylenol) or ibuprofen (Advil or Motrin), which reduce fever and minimize other symptoms of infection, such as headache, sore throat and body aches

Corticosteroid drugs, which reduce the swelling of the tonsils and throat that can occur in mononucleosis

Drinking extra fluids

Getting extra rest and sleep

Antibiotics are not prescribed for Epstein-Barr virus infections because they are ineffective against viruses. However, antibiotics may be prescribed if a person develops a secondary bacterial infection as a complication of an Epstein-Barr virus infection, such as bacterial tonsillitis. Antiviral drugs that are currently available also have no effect in treating Epstein-Barr virus.

People with an Epstein-Barr virus infection or other viral infection should not use aspirin or products that contain aspirin because of the risk of developing a rare but life-threatening condition called Reye syndrome. Reye syndrome has been linked to taking aspirin during a viral illness, such as an Epstein-Barr virus infection, the common cold or the flu.

Complementary and traditional treatments

Complementary and traditional treatments will not cure an Epstein-Barr virus infection but may help to increase comfort, promote rest, and maintain strength during an Epstein-Barr virus infection. Treatments include:

Chicken soup, which can help break up nasal congestion and provides easy-to-digest nutrients and extra fluids to help keep up your strength

Supplements or products that contain vitamin C, echinacea or zinc

What are the possible complications of an Epstein-Barr virus infection?

Rarely, Epstein-Barr virus infection or mononucleosis caused by the Epstein-Barr virus can cause serious, even life-threatening complications. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of an Epstein-Barr virus infection or mononucleosis include:

Anemia Behavioral abnormalities

Blockage of airways by the swollen lymph nodes

Certain cancers, such as Burkitt's lymphoma and nasopharyngeal carcinoma

Fatigue that lasts for weeks or months

Hepatitis

Meningitis (inflammation of the tissues covering the brain) and encephalitis (inflammation of the brain)

Nerve damage

Ruptured spleen

Secondary bacterial infection such as bacterial tonsillitis

Seizure

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