A person can acquire Epstein-Barr virus (EBV) via contact with body fluids, particularly saliva. While most people will contract EBV at some point, many will not experience any symptoms.

However, some individuals with an EBV infection develop health conditions such as mononucleosis, or glandular fever. This mainly affects teens and young adults.

In some rare cases, EBV appears to contribute to autoimmune conditions, certain cancers, and other complications.

This article reviews EBV, its symptoms, diagnosis, treatment options, and long-term effects.

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EBV is a type of herpes virus and is very common. Nearly 95% of adults worldwide have had EBV.

People mainly acquire the virus via saliva, particularly through kissing or sharing food and drink with people who have EBV. Transmission via contact with semen, blood transfusion, or organ transplantation is also possible.

However, in most people, EBV never causes any symptoms. For others, EBV can result in mononucleosis, lingering fatigue, and other conditions.

EBV is among the viruses that stay in the body after a person contracts it. Rather than going away completely after infection, it lies dormant. The virus can sometimes reactivate later if the immune system becomes compromised or stressed.

The most common health condition the EBV directly causes is mononucleosis. Other names for mononucleosis include mono, glandular fever, or the kissing disease. This condition mainly affects teens and young adults.

Most people get better from mononucleosis on their own. Some people experience lingering fatigue that may last weeks or months.

Does EBV cause chronic fatigue syndrome?

Scientists have long theorized that EBV might be involved in the development of myalgic encephalitis/chronic fatigue syndrome (ME/CFS). A 2020 study suggests a high rate of active EBV in people with ME/CFS, but research has not yet proven EBV alone causes the condition. There may be multiple factors involved.

Does EBV cause cancer?

Scientists have found associations between EBV and certain types of cancer. According to a 2022 review, previous research has found that having EBV, or higher amounts of the virus in the blood, has links to:

However, it is important to note that having EBV does not guarantee a person will get these cancers. Most people have had EBV, and yet these cancers are rare overall. They also have many other risk factors, such as genetics.

Does EBV cause multiple sclerosis?

EBV may contribute to the development of multiple sclerosis (MS). A 2022 review notes that the severity of the EBV infection likely correlates to the likelihood of MS in those with a genetic predisposition to the condition.

EBV infections do not always cause symptoms. In children, EBV is usually asymptomatic. On the other hand, teenagers and adults are more likely to experience mononucleosis. The symptoms may include:

Mononucleosis may last between 2 and 4 weeks. In some cases, people may experience fatigue that lasts for several weeks or months.

Doctors can often diagnose mononucleosis based on symptoms. However, they may recommend a blood test to detect whether EBV antibodies are present.

The tests for EBV include:

  • EBV nuclear antigen (EBNA): This can indicate a person has had an EBV infection. These types of antibodies gradually appear in the months following an EBV infection. EBNA antibodies remain in the body, and this test can detect them throughout an individual’s life.
  • Early antigen (EA): This test can detect whether a person currently has an active EBV infection. This is because these types of antibodies usually become undetectable several months after the initial infection. However, they can persist in some individuals.
  • Viral capsid antigen (VCA): These antibodies appear early in an EBV infection and remain present for 4–6 weeks afterward. There are two types of VCA antibodies: anti-VCA immunoglobulin M (IgM) and anti-VCA immunoglobulin G (IgG). While the anti-VCA IgM typically disappears a few weeks after the infection, the anti-VCA IgG remains in the body for life.
  • Heterophile antibody testing (Monospot): This test can detect EBV antibodies but is not always reliable. It is a simple and inexpensive test that doctors may use in urgent care settings.

The combination of these results and a person’s general health conditions can help doctors determine whether a person currently has an active EBV infection or if they had it in the past.

There is no specific treatment available specifically for EBV. However, researchers are trying to develop a vaccine.

In the meantime, treatment for mononucleosis typically focuses on improving the symptoms. Doctors may recommend:

  • resting
  • drinking plenty of fluids
  • taking over-the-counter medications to reduce fever and pain

If mononucleosis leads to an enlarged spleen, doctors may recommend avoiding contact sports or wearing additional protective gear until a person fully recovers to prevent any risk of rupture.

As EBV is a virus, antibiotics do not have any effect.

Most people who get mononucleosis do not experience complications, but they are possible.


After the initial infection, EBV becomes dormant in the body and stops causing symptoms. However, certain factors can sometimes trigger EBV symptoms again. For example, a 2022 study found that a COVID-19 infection can reactivate EBV.

Mononucleosis complications

In rare cases, mononucleosis can lead to complications, such as:

Some of these complications are treatable with surgery or medications. Some, such as myocarditis, may improve over time.

Chronic EBV

Rarely, people can develop chronic active EBV (CAEBV). This happens when the immune system is not able to manage the infection, and so the virus remains active instead of becoming dormant.

Initially, people with CAEBV experience the usual symptoms of mononucleosis, but they do not recover. Instead, they develop persistent or recurring symptoms, such as:

Some treatments can help with CAEBV. However, the condition can lead to cancer, organ failure, sepsis, or death.

Here are some answers to common questions about EBV.

Is EBV serious?

EBV can be serious in individuals who are vulnerable to infections or who experience complications. However, for the majority, EBV is not life threatening. Most people do not experience any symptoms after contracting the virus.

How long does it take for EBV to go away?

EBV itself does not go away. After causing an infection, the virus becomes dormant inside the body. How long the symptoms of an EBV infection last and whether they reactivate again in the future depends on a person’s immune system and overall health.

For those with mononucleosis, the symptoms usually resolve in 2–4 weeks. Some people experience fatigue for several weeks or months after the virus becomes dormant.

EBV is a widespread viral infection that a person typically contracts through saliva. About 95% of the worldwide population has had an EBV infection. However, in most cases, people do not experience any symptoms.

The most common illness EBV causes is mononucleosis. Symptoms include fever, sore throat, swollen lymph nodes, and fatigue. There is no cure for mononucleosis or EBV, but the symptoms usually resolve on their own.

In rare cases, mononucleosis can lead to complications, such as spleen rupture and chronic active EBV. Research has also revealed links between EBV and a higher risk of certain cancers and MS.