Epstein-Barr Virus Treatment

The Epstein-Barr virus (EBV) is one of the most common infections in humans. This infection is active worldwide, and somewhere around 95% of people get infected with this virus during their lifetimes. EBV is also known as human herpesvirus 4.

EBV infection usually doesn’t cause symptoms and, therefore, often isn't treated. The symptoms it does cause, however, typically are treatable. Symptomatic Epstein-Barr infections are generally in the form of infectious mononucleosis, the treatment for which is over-the-counter fever and pain medications, hydration, and rest. 

Woman sick at home with high fever

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When someone is first infected with EBV in childhood, they usually have no symptoms. Or, they may have nonspecific symptoms; at one point, your child may randomly run a fever, which could be due to EBV or one of many other childhood illnesses.

Interestingly, this infection is most aggressive during the late-adolescent and young adult years (15–24). At least one in four Epstein-Barr infections at this age will cause problematic symptoms. When an EBV infection becomes problematic, it’s called infectious mononucleosis. Commonly referred to as mono, this condition can be caused by other viruses, too.

Symptoms of infectious mononucleosis include:

  • Deep exhaustion and fatigue
  • Fever
  • Sore or inflamed throat
  • Swollen lymph nodes in the neck or swollen tonsils
  • Rash

Symptoms can last anywhere from two to four weeks but may last six months or longer or cause other complications.

Uncommon symptoms of infectious mononucleosis include an enlarged spleen or swollen liver lasting long after other symptoms have cleared.

Mononucleosis Treatment


When you’re sick with infectious mononucleosis or EBV infection, your healthcare provider will likely recommend you stay home, get a lot of rest, and drink plenty of clear fluids. If your throat hurts, you can try gargling with warm salt water or sucking on lozenges.

Listen to your body. If you’re feeling tired, stay in bed. You may need to take time off from work or school and have someone help out around the house.

Even when you’re feeling better, it’s essential to take it easy. And avoid contact sports until you’re fully recovered—at least three weeks after you get sick—as too much activity can rupture an enlarged spleen.


Instead of prescribing anything, your healthcare provider will probably recommend you rely on over-the-counter medications to control fever, aches, sore throat, and pain. These include pain relievers like Tylenol (acetaminophen), Advil (ibuprofen), and Aleve (naproxen). Take these medications as directed or as your healthcare provider recommends. Never give aspirin to children.

These medications will not cure or kill the virus; they only help relieve the symptoms. Get rest to ensure you feel better as soon as possible. 

Because infectious mononucleosis is caused by a virus and not bacteria, antibiotics will not help unless you have a secondary, bacterial infection. Antiviral drugs don’t shorten the length of symptoms or impact their severity either and are not typically recommended for infectious mononucleosis.

Steroids are also not recommended and don’t seem to decrease the disease's length or severity.

Vaccine Development

There is no vaccine against the Epstein-Barr virus, though vaccines are in the works. While the virus is common and most people are asymptomatic and recover, EBV is associated with certain cancers and poses some potential long-term complications, even death.

The goal of vaccines would be to prime the immune system to prevent these complications and cancers. 

Chronic Active Epstein-Barr Virus Treatment

Sometimes, symptoms of the Epstein-Barr virus and infectious mononucleosis don’t go away. They may worsen and cause long-term complications, or the virus may reappear when the person's immune system is weakened. If the illness lasts longer than six months, it is called chronic active Epstein-Barr virus (CAEBV)—a rare syndrome that can be deadly.

EBV becomes chronic when the patient’s immune system can’t control the virus. Their white blood cells become infected, and the levels of the virus in their blood stay high.

Patients typically have fevers and swollen lymph nodes, spleen, and liver, as well as lowered blood cell counts. These periods of symptoms may be interspersed with times when the patient feels healthier, but in CAEBV, the virus's blood levels stay high. 

This lowered blood cell count leaves the patient open to secondary infections, organ failure, and white blood cell cancers. Any of these can cause death in CAEBV patients.

While symptoms of the Epstein-Barr virus can be treated, the disease's root cause—the virus—cannot. Antivirals don't work, there is no vaccine, and other typical treatment methods for viruses, such as interferon, haven’t been successful.

There’s no current standard approach to EBV-related diseases and complications because many of the therapies tried haven’t been successful. The best treatment can do is ease symptoms and the conditions caused by the infection.

When a patient has CAEBV, the only real treatment is a stem cell transplant to repair the immune system, helping the body fight off the virus. But even if the transplant is successful, it's possible the virus can return. Research suggests this transplant be performed early in the disease, preventing potential organ damage and failure and decreasing the relapse rate.


To avoid catching the Epstein-Barr virus and getting infectious mononucleosis or CAEBV, avoid other people's bodily fluids (especially saliva). Typical mono symptoms don’t show up until four–six weeks after the initial viral infection. An infected person can walk around spreading the virus for weeks before they have symptoms.

You can also pass the virus on after you’ve recovered from infectious mononucleosis because the virus stays in your body and can reawaken, especially if your immune system is weakened by another infection, by medications, or by other conditions.

If you’re worried about catching infectious mononucleosis, it’s essential to avoid other people's saliva, as EBV infects the mouth's cells. A few quick tips:

  • Don’t kiss people who may be sick or exposed to EBV.
  • Don’t share drinks with others.
  • Don’t share utensils, toothbrushes, or other objects exposed to saliva or other bodily fluids. 
  • Cover up coughs and sneezes.

Other ways the Epstein-Barr virus can spread include through blood transfusions, bodily fluids being passed during sexual contact, or organ transplants.


Infectious mononucleosis is a serious disease, but most patients will recover completely. Being stuck in bed for weeks straight isn't fun, however, and the symptoms are pesky and can be long-lasting.

Get rest, drink lots of fluids, suck on lozenges, hard candy, or frozen ice pops, and try gargling with salt water if your throat hurts. Eat when you feel well enough for it.

Be gentle on your body. It’s fighting off a virus and is trying to heal. Gather up your favorite movies or shows for a binge-watching session. Ask your family and friends for help with meals and other household tasks. If you’re not feeling better after several weeks, consult your healthcare provider. 

A Word From Verywell

Almost everyone gets a case of the Epstein-Barr virus at some time in their lives. Most of these cases are asymptomatic. The most critical time of life to be mindful of catching this virus is during the college years.

By reducing risk of exposure, young adults can avoid missing school or work for weeks due to infectious mononucleosis. Thankfully, if you are exposed and develop mono, you have a good chance of recovering fully within several weeks.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Centers for Disease Control About Epstein-Barr virus (EBV)

  3. Centers for Disease Control. About mono (infectious mononucleosis)

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  5. Rühl J, Leung CS, Münz C. Vaccination against the Epstein–Barr virus. Cell Mol Life Sci. 2020;77(21):4315-4324. doi:10.1007/s00018-020-03538-3

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By Jennifer Welsh
Jennifer Welsh is a Connecticut-based science writer and editor with over ten years of experience under her belt. She’s previously worked and written for WIRED Science, The Scientist, Discover Magazine, LiveScience, and Business Insider.