What is Epstein-Barr virus (EBV)?
Epstein-Barr virus (EBV) is a common virus that causes mononucleosis, or mono. You might hear mono called the “kissing disease.” This is because it often spreads through saliva (spit).
Many people get EBV when they are children or teens. Most people recover from EBV infection without problems.
After infection, the virus stays in the body and usually does not cause symptoms or problems. But if a person has a weak immune system, the virus can sometimes become active and cause illness. This is known as reactivation. In rare cases, the virus can affect the brain, spinal cord, nerves, heart, or lungs.
Symptoms of Epstein-Barr virus infection
EBV often causes no symptoms in babies and young children. Symptoms may not appear until 4–6 weeks after infection.
Signs and symptoms of EBV infection include:
- Fever
- Sore throat
- Swollen lymph nodes, mainly in the neck
- Feeling very tired
- Enlarged spleen
- Enlarged liver
- Rash
Mono rash
A skin rash can sometimes be a symptom of mononucleosis. A rash can also develop if a person takes certain antibiotics during EBV infection. If your child takes ampicillin or amoxicillin while they are ill with mononucleosis, they may develop a rash that is not necessarily caused by an allergy to the medication.
Mononucleosis symptoms usually last 2–4 weeks. Some people feel tired and weak for months. Your child can return to school or work once they feel better.
If your child has mono, their liver and spleen might be larger than normal. A health care provider can check for this. Your child’s care team may recommend avoiding contact sports and strenuous activities for several weeks. This is to prevent spleen rupture. If your child has severe abdominal (belly) pain at any time while they have mono, call your health care provider or go to the emergency room right away.
Diagnosis of Epstein-Barr virus infection
Your health care provider will do a physical exam and ask about symptoms. A blood test can be used to check for antibodies to EBV. Different tests may be used to determine if the infection is recent or occurred in the past.
Epstein-Barr virus in children with weak immune systems
If your child has cancer, sickle cell disease, or another serious illness, their immune system might be weaker than normal. When the immune system is weak, EBV can be serious. It can cause heart, lung, brain, bone marrow, and blood problems. EBV can also cause cancer in some people.
If a test shows the virus is present, your care team will watch for signs of illness when your child has certain treatments, such as a stem cell (bone marrow) transplant. Most children with EBV do not need to be kept away from others unless your care team says so.
Treatment of Epstein-Barr virus infection
There is no specific treatment for EBV infection. Most people with EBV do not have any problems. If people with healthy immune systems get mono, they usually recover in 2–4 weeks.
For infectious mononucleosis, care providers suggest:
- Rest
- Drinking fluids to prevent dehydration
- Medicines to treat fever or discomfort, such as acetaminophen or ibuprofen. Talk to your care team about what medicines are safe for your child. Do not give aspirin unless directed by your health care provider. The use of aspirin by children has been linked to a rare but serious condition called Reye syndrome.
People with weak immune systems may have complications from EBV. Talk to your care team if you have questions about EBV, mono, or your child’s immune system.
If your child develops a serious illness because of EBV, care providers will treat that illness. For example, if your child has pneumonia or heart problems, care providers will treat those conditions.
How Epstein-Barr virus spreads
EBV spreads from one person to another, usually through saliva. In rare cases, it can also spread through sexual contact, blood transfusions, or organ transplant.
A person with the infection can spread EBV by:
- Kissing someone
- Sharing eating tools such as spoons, forks, or plates
- Drinking out of the same glass, can, or bottle
- Sharing a toothbrush
A child with a weak immune system should not share eating or drinking items or toothbrushes.
When to call your care team
EBV may cause serious health problems in patients with weak immune systems.
Call the care team if your child has:
- High fever
- Sore throat that makes it hard to swallow or breathe
- Extreme tiredness that does not go away
- Trouble breathing
- Chest pain
- Weakness in the arms and legs
- Dehydration
- Belly pain, especially in the upper left side
- Swelling in the neck or throat
- Yellowing of skin or eyes
- Severe headache, neck stiffness, or confusion
How to prevent Epstein-Barr virus infection
Questions to ask your care team
