What is Epstein-Barr Virus (HHV-4)?

It’s the Herpes Virus That Causes Mono.

Epstein-Barr virus is one of the most common human viruses; most people will be infected at some point in their lives ...

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Disclaimer: This information isn’t a substitute for professional medical advice, diagnosis, or treatment. You should never rely upon this article for specific medical advice. If you have any questions or concerns, please talk to your doctor.

Epstein-Barr virus (EBV), also known as human herpesvirus 4 (HHV-4), is very, very common — it infects an estimated 95 percent of people worldwide (1). Most of us are infected as children.

EBV usually spreads through bodily fluids, primarily saliva. If you use an infected person’s toothbrush, drink from their water bottle, or kiss them, you may get infected but you may or may not get sick. Once the virus enters your body, it stays there, inactive, for the rest of your life.

What Are the Symptoms of Mononucleosis?

EBV is the most common cause of mononucleosis (aka, mono). You may have heard it called the “kissing disease.” It can take 4 to 6 weeks after you’re infected before symptoms arise. Symptoms usually last 2 to 4 weeks, but you might feel fatigued for several more weeks and, in some cases, months. Symptoms include:

  • Fever
  • Sore throat
  • Swollen lymph glands, which might feel tender or painful. This is a sign your body is fighting off an infection.
  • Fatigue
  • Muscle aches or weakness
  • Skin rash
  • Headache
  • Loss of appetite
  • Enlargement of the spleen. It’s recommended you avoid contact sports for 3 to 4 weeks to avoid splenic rupture, a rare complication.

How Do You Treat Mononucleosis?

If you have mono or an EBV infection, the CDC advises drinking fluids to stay hydrated, getting plenty of rest, and taking OTC meds for pain and fever.

Talk to a doctor if you have an unusually painful or persistent sore throat or if you’re having a hard time breathing or swallowing because of swollen tonsils; these symptoms can be caused by secondary bacterial infections that may require treatment with antibiotics.

What Else is EBV Linked To?

EBV has been linked to an increased risk for certain types of cancer, such as Burkitt lymphoma. EBV has also been associated with ear infections and diarrhea in children and Guillain-Barre syndrome.


  1. https://www.emjreviews.com/hematology/article/epstein-barr-virus-a-biological-overview-and-clinicopathological-changes-of-two-epstein-barr-virus-related-lymphoproliferative-disorders-in-a-world-health-organization-who-2017-repo/ Oliveira, CC. Epstein–Barr Virus: A Biological Overview and Clinicopathological Changes of Two Epstein–Barr Virus-Related Lymphoproliferative Disorders in a World Health Organization (WHO) 2017 Report. EMJ. 2018;3[3]:99-107.

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