Primary Epstein-Barr virus infection

Samantha K. Dunmire, Priya S. Verghese, Henry H. Balfour

Research output: Contribution to journalReview articlepeer-review

252 Scopus citations


Epstein-Barr virus (EBV) infects about 90% of adults worldwide. It is the main cause of infectious mononucleosis, which is observed most frequently in adolescents. The disease can last several weeks and is characterized by lymphocytosis, sore throat, lymphadenopathy, and fatigue. Exposure to oral secretions during deep kissing has been identified as the major source for primary EBV infection in adolescents. Oral secretions are also thought to be the source for younger children through intimate intact or sharing food and eating utensils, although this has not been confirmed. Unlike most acute viral illnesses such as influenza, the incubation period of symptomatic primary EBV infection is unusually long, lasting about six weeks. Diagnosis is typically made by heterophile antibody tests and/or EBV-specific antibody tests. Long-term consequences may result from acquisition of the virus, including nasopharyngeal carcinoma and lymphomas. Nevertheless, there remains a surprising dearth of knowledge regarding the establishment of an immune response to persistent EBV infection, especially during the incubation period. This lack of knowledge has impaired our ability to develop an effective prophylactic EBV vaccine, despite various attempts. Our greatest challenges in EBV research are to develop a prophylactic vaccine and devise treatment strategies for persons already infected with EBV.

Original languageEnglish (US)
Pages (from-to)84-92
Number of pages9
JournalJournal of Clinical Virology
StatePublished - May 2018

Bibliographical note

Funding Information:
This article was supported by grants from the University of Minnesota International Center for Antiviral Research and Epidemiology , the Richard M. Schulze Family Foundation , the Randy Shaver Cancer Research and Community Fund , and the University of Minnesota Foundation .

Publisher Copyright:
© 2018 Elsevier B.V.


  • Epstein-Barr virus
  • Immune responses
  • Infectious mononucleosis
  • Mono
  • Primary infection
  • Vaccine


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