Mononucleosis epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]


Majority of mononucleosis syndromes are caused by Epstein-Barr virus, and most people become infected with EBV sometime during their lives with an estimated 90%-95% of persons greater than 21 years of age demonstrating antibody to EBV.[1][2] In the United States, the disease occurs most often among older children and young adults; however, in certain socioeconomically depressed areas the infection affects young children who remain asymptomatic. Additionally, the dormant feature combined with long (4 to 6 week) incubation period of the disease, makes epidemiological control of the disease impractical.

Epidemiology and Demographics


  • In the United States, as many as 95% of adults between 35 and 40 years of age have been infected with approximately 50% of the population seroconverts during early childhood.
  • Children if infected with EBV usually remain asymptomatic and hence are indistinguishable from the other mild, brief illnesses of childhood. However, when the infection occurs during adolescence or young adulthood, it causes acute infectious mononucleosis 35% to 50% of the time.


  • True outbreaks of infectious mononucleosis are extremely rare.
  • A substantial number of pseudo-outbreaks have been reported and linked to laboratory error.[3][4][5]


  1. Henle G, Henle W, Clifford P, Diehl V, Kafuko GW, Kirya BG, Klein G, Morrow RH, Munube GM, Pike P, Tukei PM, Ziegler JL (1969). "Antibodies to Epstein-Barr virus in Burkitt's lymphoma and control groups". Journal of the National Cancer Institute. 43 (5): 1147–57. PMID 5353242. Unknown parameter |month= ignored (help); |access-date= requires |url= (help)
  2. Pereira MS, Blake JM, Macrae AD (1969). "EB virus antibody at different ages". British Medical Journal. 4 (5682): 526–7. PMC 1630375. PMID 4902364. Unknown parameter |month= ignored (help); |access-date= requires |url= (help)
  3. Armstrong CW, Hackler RL, Miller GB (1986). "Two pseudo-outbreaks of infectious mononucleosis". Pediatric Infectious Disease. 5 (3): 325–7. PMID 3014455. |access-date= requires |url= (help)
  4. Herbert JT, Feorino P, Caldwell GG (1977). "False-positive epidemic infectious mononucleosis". American Family Physician. 15 (2): 119–21. PMID 835452. Unknown parameter |month= ignored (help); |access-date= requires |url= (help)
  5. "Pseudo-Outbreak of Infectious Mononucleosis -- Puerto Rico, 1990". Retrieved 2012-12-19.

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