About Epstein Barr Virus (EBV) (Mononucleosis)

Infectious mononucleosis, also called “mono,” is a contagious disease. Epstein-Barr virus (EBV) is the most common cause of infectious mononucleosis. It is common among teenagers and young adults, especially college students. At least 25% of teenagers and young adults who get infected with EBV will develop infectious mononucleosis.

How is it transmitted?

EBV is the most common cause of infectious mononucleosis, but other viruses can cause this disease. Typically, these viruses spread most commonly through bodily fluids, especially saliva.

Signs and Symptoms

Typical symptoms of infectious mononucleosis usually appear 4 to 6 weeks after you get infected with EBV. Symptoms may develop slowly and may not all occur at the same time.

These symptoms include:

  • extreme fatigue
  • fever
  • sore throat
  • head and body aches
  • swollen lymph nodes in the neck and armpits
  • swollen liver or spleen or both
  • rash

Enlarged spleen and a swollen liver are less common symptoms. For some people, their liver or spleen or both may remain enlarged even after their fatigue ends.

Most people get better in 2 to 4 weeks; however, some people may feel fatigued for several more weeks. Occasionally, the symptoms of infectious mononucleosis can last for 6 months or longer.


You can help relieve symptoms of infectious mononucleosis by getting plenty of rest and staying well-hydrated.

Self-care options include:

  • Manage your fever and pain with acetaminophen (325mg “non-aspirin,” regular strength, 2-3 tabs) every 4-6 hours (not to exceed 3000mg in 24/hours) OR ibuprofen (200 mg, 2-3 tabs) ever 6-8 hours with food. You may alternate acetaminophen and ibuprofen every 3 hours
  • Prevent dehydration by drinking plenty of clear liquids (water, ginger ale, sport drinks, etc.)
  • Get plenty of rest

If you have infectious mononucleosis, you should not take amoxicillin as a rash may develop.

Alcohol use is discouraged as often there can be a transient liver inflammation associated with mono.

Because your spleen may become enlarged as a result of infectious mononucleosis, you should not participate in athletic activities. More than 50 percent of patients with mono develop splenic enlargement within the first two weeks of symptoms; as a result, the recommendation is to avoid activities that may cause splenic rupture for at least 4 weeks from time of diagnosis or until you fully recover.

NCAA athletes must come to Student Health for return-to-play clearance after 4 weeks.

If you have trouble swallowing, trouble breathing, abdominal pain, suffer a relapse (begin to feel much worse after having felt better), severe headache and/or neck pain/stiffness, confusion, lethargy, severe or persistent vomiting please call Student Health at 215-746-3535 and select the option to speak with a nurse.


There is no vaccine to protect against infectious mononucleosis. You can help protect yourself by not kissing or sharing drinks, food, or personal items, like toothbrushes, with people who have infectious mononucleosis.

Practice good hygiene:

  • Wash your hands with soap and warm water or an alcohol-based hand sanitizer that contains at least 60% alcohol
  • Cover your mouth and nose with a tissue when you cough or sneeze. If you don’t have a tissue, cough or sneeze into your sleeve or elbow



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(updated 3/3/2016)