From the Research
Epstein-Barr Virus (EBV) remains contagious as long as the virus is actively shedding, which can occur intermittently for weeks to months after initial infection, even when symptoms have resolved. Most people are most contagious during the acute phase of infection when they have symptoms like fever and sore throat. However, EBV can continue to be shed in saliva for up to 18 months after infection in some cases 1. The virus spreads primarily through saliva via kissing, sharing drinks or food, or close contact with respiratory secretions. This prolonged shedding period explains why EBV (which causes infectious mononucleosis or "mono") spreads so effectively, particularly among adolescents and young adults. The virus establishes lifelong latent infection in B lymphocytes after initial infection, and periodic reactivation throughout life can lead to asymptomatic viral shedding in saliva even years later, though contagiousness during these reactivations is generally lower than during primary infection 2, 3. To reduce transmission, avoid sharing personal items and close contact with others while symptomatic. Some key points to consider include:
- The incubation period of symptomatic primary EBV infection is about six weeks 4
- EBV-specific antibody profiles are the best choice for staging EBV infection 3
- The treatment of splenic infarction, a potential complication of EBV infection, is always conservative without any fatal outcomes 1
- Primary EBV infection can present with rare manifestations, such as severe ulcerative oesophagitis, in immunocompetent individuals 5