Epstein-Barr Virus

What is Epstein-Barr virus?

Epstein-Barr virus (EBV) is a very common viral infection that spreads through saliva and body fluids. EBV is a type of herpesvirus called herpesvirus 4. Most cases of EBV don’t cause symptoms. Other cases, especially in adolescents and young adults, can lead to infectious mononucleosis.

Once you get EBV, the infection stays within your body for your entire life in a dormant state where it's inactive or sleeping. You can reactivate the virus and experience symptoms again, regardless of when you first acquired the virus.

Who does Epstein-Barr virus affect?

Most cases of Epstein-Barr virus affect children, teenagers and young adults, but anyone can get the virus.

How common is Epstein-Barr virus?

Epstein-Barr virus is very common. In the U.S, an estimated 50% of all children up to 5 years of age and about 95% of adults experience an EBV infection in their lifetime.

How do you get Epstein-Barr virus?

Epstein-Barr virus is contagious and easily spreads through saliva (spit). You can get EBV by sharing items that make contact with an infected person’s saliva. Most people get EBV by drinking from the same glass or kissing someone with the virus.

Is Epstein-Barr virus contagious?

Yes, Epstein-Barr virus is contagious. The virus can spread during the incubation period (amount of time when someone has exposure to the virus to when they experience symptoms), which is between four to six weeks.

The virus spreads easily through saliva (spit) but can spread through other body fluids. You can get EBV from an infected person by:

• Coughing or sneezing.
• Kissing.
• Sexual contact (blood and semen).
• Sharing objects like a toothbrush, utensils or a cup.
• Touching items a child might have put in their mouth or drooled on.

If you have EBV, you don’t have to show symptoms to pass the virus onto someone else. Once you get the infection, it will live in your body in a dormant (sleeping or inactive) state. Certain events can trigger EBV to wake up (reactivate) and make it contagious to others, potentially causing symptoms in the host. Events that trigger EBV reactivation include:

• Stress.
• Weak immune system.
• Menopause or hormone changes.

What causes Epstein-Barr virus?

Close person-to-person contact causes the highly contagious Epstein-Barr virus. The virus spreads easily through saliva (spit) and other body fluids like blood and semen. The virus can also spread through blood transfusions or organ transplants.

How does Epstein-Barr virus affect my body?

The virus attaches to white blood cells (lymphocyte B cells) in your body. White blood cells help fight infection. When the virus attaches to your white blood cells, your cells are unable to fight the infection properly and you experience symptoms.

What are the symptoms of Epstein-Barr virus?

Symptoms range in severity for each person diagnosed with Epstein-Barr virus. Symptoms include:

• Sore throat and throat inflammation (swelling).
• Fatigue or feeling extremely tired.
• Fever.
• Swollen lymph nodes (a bean-shaped organ in your neck).
• Rashes on your skin.
• Enlarged spleen and liver.

Children diagnosed with Epstein-Barr virus either don’t show symptoms or their symptoms are similar to short-term illnesses like a cold or the flu. Teenagers or adults who get the virus may show symptoms between two to four weeks, but symptoms could linger for months, especially fatigue.

Do symptoms of Epstein-Barr virus reactivate?

Once you get Epstein-Barr virus, the infection deactivates (latent) or goes to sleep. The infection could wake up (reactivate), especially if you have a weakened immune system. Sometimes the virus does not cause symptoms in the host but it is still contagious to others.

How is Epstein-Barr virus diagnosed?

It can be challenging for your healthcare provider to diagnose Epstein-Barr virus because the symptoms are similar to other common illnesses. Your healthcare provider will ask you about your symptoms, how long you’ve had them and if you’ve come into contact with anyone who might have the virus. Your provider might offer a blood test to confirm the diagnosis.

What tests diagnose Epstein-Barr virus?

To confirm your diagnosis, your provider will perform a blood test called Epstein-Barr virus antibody test. This test takes a sample of your blood to detect antibodies that cause EBV. Your provider may need to repeat the test between 10 days to two weeks after the first test because antibodies might not show up early in your diagnosis.

How is Epstein-Barr virus treated?

Treatment for Epstein-Barr virus addresses symptoms associated with the infection. Treatment includes:

• Staying hydrated and drinking plenty of fluids.
• Resting.
• Taking over-the-counter medicine for a fever and pain.

Getting enough rest is important to prevent symptoms from getting worse. It is especially important that you avoid excessive physical activity that could lead to a ruptured spleen if the virus causes your spleen to enlarge.

How soon after treatment will I feel better?

People infected with Epstein-Barr virus who experience symptoms usually feel better after two to four weeks. Others might have lingering symptoms of fatigue where they feel very tired for several weeks or months after their initial infection.

How can I prevent Epstein-Barr virus?

Since there is no vaccine for Epstein-Barr virus, you can take steps to prevent getting the virus by:

• Not sharing food or drinks with someone who has the virus.
• Not kissing someone who has the virus.
• Not sharing a toothbrush with someone who has the virus.
• Using protection when having sex with someone who has the virus.
• Washing your hands after touching something with saliva on it and not putting your hands near your mouth after touching an object that has saliva or drool on it.

Is there a cure for Epstein-Barr virus?

There is no cure for Epstein-Barr virus and there is no vaccine to prevent the spread of the virus. Treatment addresses the symptoms of the virus and symptoms should go away after two to four weeks.

Once infected with the virus, it lives in your body in a dormant (sleeping) state, which means it can reactivate and wake up if your body triggers it via stress or a weakened immune system. You can experience symptoms again if your body reactivates the virus.

Can I go to work or school if I have Epstein-Barr virus?

If you have symptoms of Epstein-Barr virus or have mononucleosis, you should avoid school or work or attending events where you are in close contact with others because the condition is highly contagious.

Your healthcare provider will suggest you stay home until you feel better and your symptoms start to fade. You may experience lingering symptoms, like fatigue, for several weeks after other symptoms go away.

When should I see my healthcare provider?

If you experience symptoms of Epstein-Barr virus, contact your healthcare provider. Treatment for the virus includes resting and taking over-the-counter medicine to alleviate pain and discomfort. If you experience severe pain or have a fever for several days, visit your provider immediately.

What questions should I ask my doctor?

• Can I go back to work or school?
• How do I prevent other members of my household from getting the virus?
• What over-the-counter medicine do you recommend for my symptoms?
• How do I prevent the virus from reactivating?

Can you get cancer from Epstein-Barr virus?

Although it is rare, Epstein-Barr virus can lead to certain types of cancer including:

• White blood cell cancer (Burkitt lymphoma).
• Cancer of the nose and throat (nasopharyngeal cancer).

Cancer from EBV is the result of viral genes from the virus that change the growth cycle of infected cells and cause them to become cancerous.

Is Epstein-Barr virus the same as herpes?

Epstein-Barr virus is in the human herpesvirus family and is also known as human herpesvirus 4. Symptoms of EBV are not the same as other viruses in the herpesvirus family like genital herpes. There are several common conditions that are in the human herpes virus family like chickenpox, shingles and mononucleosis. Some cases of EBV lead to mononucleosis.

Is Epstein-Barr virus a sexually transmitted infection?

Yes, Epstein-Barr virus can be a sexually transmitted infection (STI), but not every case is an STI. The virus can spread through bodily fluids like blood or semen, but most often spreads via saliva. EBV can lead to infectious mononucleosis that is sometimes called “the kissing disease.”

To avoid transmitting or receiving an STI, use protection when having sex.

A note from Cleveland Clinic

Most cases of Epstein-Barr virus don’t cause serious health problems but can disrupt your day-to-day activities like attending work or school. Make sure you stay hydrated and get a lot of rest to prevent the infection from taking a greater toll on your body. Prevent the spread of EBV by staying home if you have symptoms.