Can a person contract infectious mononucleosis (mono) twice?

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Last updated: May 12, 2025View editorial policy

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From the Guidelines

Yes, you can get mono twice, but it's uncommon, and most people develop immunity after their first infection with Epstein-Barr virus (EBV). According to the 2013 recommendations by the Infectious Diseases Society of America (IDSA) and the American Society for Microbiology (ASM) 1, EBV is a cause of mononucleosis and lymphoproliferative disease in immunocompromised patients. While most people develop immunity after their first infection, reactivation of dormant EBV can occur, particularly in people with weakened immune systems due to stress, other illnesses, or immunosuppressive medications. Some key points to consider include:

  • Over 90% of the normal adult population has IgG class antibodies to VCA and EBNA antigens, indicating past infection 1
  • Antibodies to EBNA develop one to two or more months after primary infection and are detectable for life 1
  • Reactivation of EBV can occur, particularly in people with weakened immune systems 1 If you develop mono symptoms again, such as severe fatigue, sore throat, swollen lymph nodes, and fever, it is essential to see a healthcare provider for proper diagnosis. Treatment remains supportive, focusing on rest, hydration, and over-the-counter pain relievers like acetaminophen or ibuprofen for symptom management 1. The virus stays in your body for life after initial infection, with most people maintaining sufficient immunity to prevent recurrent symptoms, though the virus may occasionally shed without causing illness.

From the Research

Can You Get Mono Twice

  • The provided studies do not directly address the question of whether it is possible to get mono twice 2, 3, 4, 5, 6.
  • However, it is known that Epstein-Barr virus (EBV) infects 95% of the world population at some point in life, and most people are infected with EBV by the age of 20-30 2.
  • Once infected, the virus remains dormant in the body for life, but it is not clear if reactivation of the virus can cause symptoms of mono again 3, 5.
  • Some studies suggest that people who have had mono before may be less likely to develop symptoms if they are re-infected with EBV, but this is not conclusively proven 5, 6.
  • The main focus of the provided studies is on the diagnosis, treatment, and management of infectious mononucleosis, rather than the possibility of re-infection 2, 3, 4, 5, 6.

Key Points About Mono

  • Mono is usually caused by the Epstein-Barr virus (EBV) and most commonly affects adolescents and young adults aged 15-24 years 2, 3, 5, 6.
  • The symptoms of mono include fever, sore throat, fatigue, lymphadenopathy, and pharyngeal inflammation 2, 3, 5, 6.
  • The diagnosis of mono is typically made using a combination of clinical evaluation, laboratory tests, and serologic testing 2, 3, 5, 6.
  • Treatment for mono is mainly supportive, focusing on relieving symptoms and managing complications 2, 3, 5, 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Common questions about infectious mononucleosis.

American family physician, 2015

Research

Diagnosis and treatment of infectious mononucleosis.

American family physician, 1994

Research

Infectious Mononucleosis: An Updated Review.

Current pediatric reviews, 2024

Research

Infectious Mononucleosis: Rapid Evidence Review.

American family physician, 2023

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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