Epstein-Barr virus is a common, globally-occurring human virus and infection most frequently occurs during early childhood. In this age group, infection typically proves asymptomatic or causes a mild, unremarkable flu-like illness. Among teenagers and young adults, Epstein-Barr virus causes infectious mononucleosis. The most pronounced symptoms occur during the first two to three weeks of the illness, with complete resolution usually occurring within one to two months. Complications are rare.
Fever
Fever is a classic symptom of infectious mononucleosis. "The Merck Manual for Healthcare Professionals" reports that maximal fevers typically range from 103 degrees F to 105 degrees F, usually peaking in the late afternoon or early evening.
Sore Throat
Severe sore throat occurs in nearly all patients with infectious mononucleosis. In a review article published in "American Family Physician," Dr. Mark Ebell reported that approximately 98 percent of people with infectious mononucleosis present with sore throat. Inflammation of the throat and tonsils may be confused with strep throat. Laboratory testing provides information to accurately distinguish between infectious mononucleosis and strep throat.
Swollen Glands
Swollen glands, or lymph nodes, occur in the overwhelming majority of people with infectious mononucleosis. "The Merck Manual for Healthcare Professionals" points out that the lymph nodes of the neck and underarms are most frequently involved, although lymph nodes elsewhere in the body may also be affected.
Fatigue and Drowsiness
Profound fatigue and drowsiness are hallmark symptoms of infectious mononucleosis. The peak level of fatigue often occurs in the first few weeks of the illness. For most people with infectious mononucleosis, fatigue resolves more slowly than the other symptoms of the illness. In a seminal study on the natural history of infectious mononucleosis published in the "Journal of the American Board of Family Medicine," Dr. Thomas Rea and colleagues found that among those who presented with fatigue at the time of diagnosis, 64 percent experienced resolution by one month after diagnosis and 74 percent were fatigue-free by two months. According to the Centers for Disease Control and Prevention, symptoms of Epstein-Barr virus infection rarely persist for longer than four months.
Skin Rash
In an entry provided by Medline Plus, Dr. D. Scott Smith notes that rash may be an accompanying symptom of infectious mononucleosis. The study by Rea and colleagues found approximately 15 percent of patients with infectious mononucleosis present with skin rash.
Headache and Body Aches
Epstein-Barr virus infection may cause headache and body aches during the first few weeks of the illness. Rea and colleagues found that approximately 50 percent of patients with infectious mononucleosis reported headaches and approximately 25 percent reported muscle or joint aches.
References
- Centers for Disease Control and Prevention: Epstein-Barr Virus and Infectious Mononucleosis
- "American Family Physician"; Epstein-Barr Virus Infectious Mononucleosis; Mark H. Ebell, M.D., M.S.; October 2004
- World Health Organization: Epstein Barr Virus
- Merck Manual for Healthcare Professionals: Infectious Mononucleosis
- "Journal of the American Board of Family Medicine"; Prospective Study of the Natural History of Infectious Mononucleosis Caused by Epstein-Barr Virus; Thomas D. Rea, M.D., M.P.H., et al.; July-August 2001
