Materiały źródłowe

• #1 Infectious Mononucleosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4670567/

  EBV infection is extremely common worldwide and approximately 90% of adults become antibody-positive before the age of 30. […] The prevalence of EBV antibodies in preadolescent children is lower, varying from 20% to 80% depending on age and geographic location. […] Factors clearly related to early acquisition of primary EBV infection include geographic region and race/ethnicity. […] The age at which primary EBV infection is acquired may be increasing in developed countries. […] This is important to monitor because there is a complex interplay between age of acquisition, symptomatic versus asymptomatic infection, and the subsequent risk of EBV-associated cancers or autoimmune diseases. […] Kissing is the major route of transmission of primary EBV infection among adolescents and young adults.

• #1 Epstein-Barr Virus (EBV) Infection in Chinese Children: A Retrospective Study of Age-Specific Prevalence | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0099857

  Epstein-Barr Virus (EBV) is a globally prevalent herpesvirus associated with infectious mononucleosis and many malignancies. The survey on EBV prevalence appears to be important to study EBV-related diseases and determine when to administer prophylactic vaccine. […] EBV seroprevalence became more than 50% before age 3 in Chinese children, and exceed 90% after age 8. This study can be helpful to study the relationship between EBV and EBV-associated diseases, and supportive to EBV vaccine development and implementation. […] In our study, the EBV seropositivity rate was higher in newborn babies because maternal antibodies transfer through the placenta. […] In this retrospective study, the seroprevalence in both Beijing and Guangzhou reached about 90% after age 8. We can tell that more than 80% of Chinese children in these cities were infected with EBV after age 6, and after age 8, 90% became infected. […] Considering the high prevalence of the virus in the population and the simple route of transmission, the population should be vaccinated before broad infection when EBV prevalence is 50%.

• #2 Mononucleosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470387/

  It is estimated that up to 95% of adults in the world are eventually seropositive to EBV. Therefore, EBV is widely disseminated in all population groups. The traditional age group where peak incidence is noted, however, is in 15 to 24-year olds. Classically, the symptomatic infection is in adolescents, which is why laypersons may refer to the infection as the kissing disease. Mononucleosis is uncommon in adults: approximately 2% of all pharyngeal disease in adults is attributable to this disease. Adults are generally not susceptible to clinical illness because of previous exposure. In the United States, clinically evident infection occurs at rates estimated at 30 times higher in whites than in blacks. One explanation for this disparity is that if acquired at a young (childhood) age, EBV is often subclinical. This would suggest earlier EBV exposures in blacks, and a higher frequency of asymptomatic infection as young children.

• #2 Epidemiology of Epstein-Barr virus-associated pediatric lymphomas from Argentina

  http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S1665-11462016000100047

  More than 90% of the population is infected by Epstein-Barr virus (EBV), which has sophisticatedly evolved to survive silently in B cells for the life of infected individuals. […] In Argentina, EBV infection is mostly subclinical and 90% of patients are seropositive by the age of 3 years; therefore, its epidemiological characteristics resemble those of an underdeveloped or developing population. […] The age at primary infection varies substantially worldwide, and exposure to EBV is likely to be due to socioeconomic factors. […] The relatively few cases of EBV-positive HL in younger adults may be attributed to delayed primary EBV infection as suggested by the association with mononucleosis. […] The temporal risk variation in HL after IM suggests that the predilection for the younger adult age group may simply result from the combination of age and time since IM rather than from other mechanisms particular to HL in younger adults.

• #3 About Epstein-Barr Virus (EBV) | EBV and Mono | CDC

  https://www.cdc.gov/epstein-barr/about/index.html

  EBV is the most common cause of infectious mononucleosis, also called „mono.” This contagious disease is common among teens and adults. […] EBV can cause illnesses like infectious mononucleosis.

• #3 Mononucleosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470387/

  It is estimated that up to 95% of adults in the world are eventually seropositive to EBV. Therefore, EBV is widely disseminated in all population groups. The traditional age group where peak incidence is noted, however, is in 15 to 24-year olds. Classically, the symptomatic infection is in adolescents, which is why laypersons may refer to the infection as the kissing disease. Mononucleosis is uncommon in adults: approximately 2% of all pharyngeal disease in adults is attributable to this disease. Adults are generally not susceptible to clinical illness because of previous exposure. In the United States, clinically evident infection occurs at rates estimated at 30 times higher in whites than in blacks. One explanation for this disparity is that if acquired at a young (childhood) age, EBV is often subclinical. This would suggest earlier EBV exposures in blacks, and a higher frequency of asymptomatic infection as young children.

• #4 About Infectious Mononucleosis (Mono) | EBV and Mono | CDC

  https://www.cdc.gov/epstein-barr/about/mononucleosis.html

  Infectious mononucleosis is common among teenagers and young adults, especially college students. At least 1 out of 4 teenagers and young adults who get infected with EBV will develop infectious mononucleosis. […] EBV is the most common cause of infectious mononucleosis, but other viruses can cause this disease. Typically, these viruses spread most commonly through bodily fluids, especially saliva. […] There is no vaccine to protect against infectious mononucleosis. […] Healthcare providers typically diagnose infectious mononucleosis based on symptoms. […] Laboratory tests are not usually needed to diagnose infectious mononucleosis. However, specific tests may be needed for patients who do not have a typical case of infectious mononucleosis.

• #4 Epstein-Barr Virus (EBV) Infectious Mononucleosis (Mono): Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/784513-overview

  Epstein-Barr Virus (EBV) is among the most prevalent human viruses in the world. An estimated 90% of the global population is seropositive for EBV, with developed countries bearing a comparatively lower burden of EBV seroprevalence. Residents of developed countries also experience primary EBV infection at a later age. In the United States, the EBV seroprevalence for children and adolescents between ages 6-19 years is about 66.5%, with female, African-American, and Hispanic populations experiencing significantly higher rates of seropositivity. Significant seroprevalence differences exist by family income, with children in the lowest income quartile having 81.0% seroprevalence compared with 53.9% in the highest income quartile. In US institutions characterized by the presence of many young adults, such as universities and the armed forces, the annual incidence for infectious mononucleosis ranges from 11 to 48 cases per 1000 persons.

• #5 Infectious mononucleosis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/infectious-mononucleosis-1?embed_domain=hackmd.io%2F%40yIPUAFeCSL2JsU8smR5nJQ%2Fbnjhjgjghjghjghfavicon.icoradiopaedia-icon-144.pngfavicon.icoradiopaedia-icon-144.pngfavicon.icofavicon.icofavicon.ico

  Exposure to Epstein-Barr virus is extremely widespread: 90% of adults are seropositive. […] When acquired during childhood it often remains subclinical but of those who acquire it during adolescence or young adulthood, 25% will become symptomatic. […] In about 5% of cases, cytomegalovirus (CMV) is the causative pathogen for infectious mononucleosis.

• #5 Epstein-Barr Virus Fact Sheet – Stanford Environmental Health & Safety

  https://ehs.stanford.edu/reference/epstein-barr-virus-fact-sheet

  EBV infects 80 90% of all adults worldwide; mononucleosis is common in early childhood worldwide, typical disease occurs in developed countries mainly in young adults; Burkitts tumor is found worldwide but hyperendemic in highly malarial areas such as tropical Africa; carcinoma is worldwide but highest in Southeast Asia and China. […] Mononucleosis person-to-person by oropharyngeal route via saliva, possible spread via blood transfusion (not important route); Burkitts lymphoma primary infection occurs early in life or involves immunosuppression and reactivation of EBV later, malaria an important co-factor; NPC is associated with EBV infection in early life and reactivation later with epithelial invasion.

• #6 Infectious Mononucleosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4670567/

  The incubation period of infectious mononucleosis is approximately 6 weeks. […] Besides deep kissing, primary EBV infection can also be transmitted by blood transfusion, solid organ transplantation, or hematopoietic cell transplantation, but these routes account for relatively few cases overall. […] The way young children contract EBV is unknown. […] A reasonable supposition is that they are infected by their parents or siblings who are carriers of the virus and who intermittently shed it in their oral secretions. […] The assumption has been that the majority of primary EBV infections in children before puberty are asymptomatic but that is not necessarily so. […] The incidence of infectious mononucleosis is exceptionally low in Southeast Asia and equatorial Africa where EBV infection during childhood is nearly ubiquitous, thus it might be extrapolated that infectious mononucleosis does not have a strong correlation with either endemic Burkitt lymphoma or Hodgkin’s lymphoma in these areas.

• #6 Reframing Burkitt lymphoma: virology not epidemiology defines clinical variants – Rochford – Annals of Lymphoma

  https://aol.amegroups.org/article/view/7665/html

  Three clinical variants of BL have been described based on the epidemiology of the cancer: endemic, sporadic and immunodeficiency-associated (ID). The most common, and the variant initially described by Burkitt, is the endemic form of BL. Endemic BL (eBL) is a pediatric cancer with a peak incidence between 68 years of age and a predominance in males. eBL is found in regions of the world where malaria transmission is year-round, predominantly sub-Saharan Africa and Papua New Guinea. eBL presents extranodally, frequently in the jaw in younger children and abdominally in older children. Recent studies indicate a changing pattern of presentation with less tumors occurring in the jaw than historically reported. EBV is detected in ~95% of cases. […] In contrast to eBL, cases of sporadic BL (sBL) occur throughout the world. It is a rare malignancy and can occur in both children, young adults as well as the elderly. sBL represents ~50% of childhood lymphomas but less than 3% of all lymphomas in USA and Western Europe. The incidence of sBL in US children was reported to be 2.5 cases per million person-years. In contrast to eBL, EBV is detected in only 10-30% of sBL. In one study, 38% of pediatric sBL were found to be EBV-positive. sBL, like eBL, also occurs more frequently in males, typically presents within the abdominal region and is found in lymph nodes as well as extranodally.

• #7 Mononucleosis epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Mononucleosis_epidemiology_and_demographics

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

• #8 Infectious Mononucleosis: Rapid Evidence Review | AAFP

  https://www.aafp.org/pubs/afp/issues/2023/0100/infectious-mononucleosis.html

  Most cases of infectious mononucleosis are caused by the Epstein-Barr virus (EBV), although approximately 10% of cases are caused by cytomegalovirus (CMV). Infection with EBV is most common in childhood and adolescence, and males and females are affected equally. Studies show that two-thirds of children and adolescents six to 19 years of age in the United States and more than 95% of adults 20 to 25 years of age in the United Kingdom are seropositive. In wealthier nations, infectious mononucleosis mostly affects adolescents and young adults 15 to 24 years of age (6 to 8 cases per 1,000 person-years), particularly those living in communal environments, such as dormitories or military barracks (11 to 48 cases per 1,000 person-years). […] The primary mode of disease transmission is through close personal contact with a person who is infected, particularly their saliva, including sharing eating utensils or water bottles, kissing, or through sexual intercourse. The incubation period for EBV infection is 32 to 49 days, during which the patient is contagious. Viral replication is first detected in the oral cavity and has also been isolated in genital secretions.

• #9 Infectious mononucleosis – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/infectious-mononucleosis/

  General: Approx. 9095% of adults are EBV-seropositive worldwide. […] Peak incidence: (of symptomatic disease): 1524 years of age […] Incidence: 5/1000 per year.

• #10 Infectious Mononucleosis: Symptoms and Treatment | Doctor

  https://patient.info/doctor/infectious-mononucleosis

  The annual incidence is approximately 5 cases per 1,000 persons. Over 95% of adults worldwide have been infected with EBV. […] Peak incidence is in the 15-24 year old age group. […] Clinical infection is most common in populations with many young adults, such as active-duty military personnel and college students. […] Glandular fever is rare during the first year of life because of passive immunity received from maternal antibodies. […] Glandular fever is less commonly seen in developing countries. […] There is no seasonal variation or any male or female predisposition. […] In the United States, clinically evident infection is 30 times more common in white people than Black people. However evidence of EBV infection is the same in both groups. It is thought that Black people are more likely to be exposed to EBV infection at a younger age when asymptomatic infection is more common.

• #11 Epstein-Barr Virus (EBV) Infectious Mononucleosis (Mono): Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/784513-overview

  Epstein-Barr Virus (EBV) is among the most prevalent human viruses in the world. An estimated 90% of the global population is seropositive for EBV, with developed countries bearing a comparatively lower burden of EBV seroprevalence. Residents of developed countries also experience primary EBV infection at a later age. In the United States, the EBV seroprevalence for children and adolescents between ages 6-19 years is about 66.5%, with female, African-American, and Hispanic populations experiencing significantly higher rates of seropositivity. Significant seroprevalence differences exist by family income, with children in the lowest income quartile having 81.0% seroprevalence compared with 53.9% in the highest income quartile. In US institutions characterized by the presence of many young adults, such as universities and the armed forces, the annual incidence for infectious mononucleosis ranges from 11 to 48 cases per 1000 persons.

• #12 Infectious mononucleosis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/infectious-mononucleosis-1?embed_domain=hackmd.io%2F%40yIPUAFeCSL2JsU8smR5nJQ%2Fbnjhjgjghjghjghfavicon.icoradiopaedia-icon-144.pngfavicon.icoradiopaedia-icon-144.pngfavicon.icofavicon.icofavicon.ico

  Exposure to Epstein-Barr virus is extremely widespread: 90% of adults are seropositive. […] When acquired during childhood it often remains subclinical but of those who acquire it during adolescence or young adulthood, 25% will become symptomatic. […] In about 5% of cases, cytomegalovirus (CMV) is the causative pathogen for infectious mononucleosis.

• #13 Infectious Mononucleosis: Rapid Evidence Review | AAFP

  https://www.aafp.org/pubs/afp/issues/2023/0100/infectious-mononucleosis.html

  Most cases of infectious mononucleosis are caused by the Epstein-Barr virus (EBV), although approximately 10% of cases are caused by cytomegalovirus (CMV). Infection with EBV is most common in childhood and adolescence, and males and females are affected equally. Studies show that two-thirds of children and adolescents six to 19 years of age in the United States and more than 95% of adults 20 to 25 years of age in the United Kingdom are seropositive. In wealthier nations, infectious mononucleosis mostly affects adolescents and young adults 15 to 24 years of age (6 to 8 cases per 1,000 person-years), particularly those living in communal environments, such as dormitories or military barracks (11 to 48 cases per 1,000 person-years). […] The primary mode of disease transmission is through close personal contact with a person who is infected, particularly their saliva, including sharing eating utensils or water bottles, kissing, or through sexual intercourse. The incubation period for EBV infection is 32 to 49 days, during which the patient is contagious. Viral replication is first detected in the oral cavity and has also been isolated in genital secretions.

• #14 Mononucleosis epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Mononucleosis_epidemiology_and_demographics

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

• #15 Infectious mononucleosis – WikiLectures

  https://www.wikilectures.eu/w/Infectious_mononucleosis

  Infectious mononucleosis is one of the relatively common diseases in the Czech Republic (22.5 thousand cases per year). […] The source of the infection is a sick person or a healthy carrier. People in the convalescent stage can also be healthy carriers as EBV remains in the body in a latent form throughout one’s life and can be reactivated (as with other herpes infections). The population is infected in early age, and children under 2 years of age usually have no symptoms. The highest incidence is in adolescence and young adults between 15 to 24 years of age. Infectious mononucleosis is almost non-existent in adults over 40 years. […] The disease is reported, but isolation is not necessary. Prophylaxis and prevention do not exist.

• #16 Infectious Mononucleosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4670567/

  EBV infection is extremely common worldwide and approximately 90% of adults become antibody-positive before the age of 30. […] The prevalence of EBV antibodies in preadolescent children is lower, varying from 20% to 80% depending on age and geographic location. […] Factors clearly related to early acquisition of primary EBV infection include geographic region and race/ethnicity. […] The age at which primary EBV infection is acquired may be increasing in developed countries. […] This is important to monitor because there is a complex interplay between age of acquisition, symptomatic versus asymptomatic infection, and the subsequent risk of EBV-associated cancers or autoimmune diseases. […] Kissing is the major route of transmission of primary EBV infection among adolescents and young adults.

• #17 Pathogen Safety Data Sheets: Infectious Substances – Epstein-Barr virus – Canada.ca

  https://www.canada.ca/en/public-health/services/laboratory-biosafety-biosecurity/pathogen-safety-data-sheets-risk-assessment/epstein-barr-virus.html

  EBV infection is very prevalent, occurring in more than 90% of individuals during the first two decades of life worldwide. […] The combined global incidence of EBV-attributed BL, HL, NPC, and gastric carcinoma (GC) in 2017 was an estimated 265,000 cases, including 164,000 deaths, representing a 36% increase in incidence and 19% increase in mortality from 1990. […] In developing countries, primary infection occurs mainly in young children and is often asymptomatic. […] In developed countries, primary EBV infection mainly manifests as IM and affects adolescents and young adults. […] Endemic BL occurs frequently in young children in the equatorial regions of Africa and Papua New Guinea and has an incidence of 50-100 cases per 1,000,000 individuals. […] In contrast, EBV-associated sporadic lymphoma occurs in children and young adults and has no specific geographic distribution, with an incidence of 2-3 cases per 1,000,000 individuals.

• #18 Infectious Mononucleosis: Symptoms and Treatment | Doctor

  https://patient.info/doctor/infectious-mononucleosis

  The annual incidence is approximately 5 cases per 1,000 persons. Over 95% of adults worldwide have been infected with EBV. […] Peak incidence is in the 15-24 year old age group. […] Clinical infection is most common in populations with many young adults, such as active-duty military personnel and college students. […] Glandular fever is rare during the first year of life because of passive immunity received from maternal antibodies. […] Glandular fever is less commonly seen in developing countries. […] There is no seasonal variation or any male or female predisposition. […] In the United States, clinically evident infection is 30 times more common in white people than Black people. However evidence of EBV infection is the same in both groups. It is thought that Black people are more likely to be exposed to EBV infection at a younger age when asymptomatic infection is more common.

• #19 Epidemiology of Epstein-Barr virus-associated pediatric lymphomas from Argentina

  http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S1665-11462016000100047

  More than 90% of the population is infected by Epstein-Barr virus (EBV), which has sophisticatedly evolved to survive silently in B cells for the life of infected individuals. […] In Argentina, EBV infection is mostly subclinical and 90% of patients are seropositive by the age of 3 years; therefore, its epidemiological characteristics resemble those of an underdeveloped or developing population. […] The age at primary infection varies substantially worldwide, and exposure to EBV is likely to be due to socioeconomic factors. […] The relatively few cases of EBV-positive HL in younger adults may be attributed to delayed primary EBV infection as suggested by the association with mononucleosis. […] The temporal risk variation in HL after IM suggests that the predilection for the younger adult age group may simply result from the combination of age and time since IM rather than from other mechanisms particular to HL in younger adults.

• #20 Epstein-Barr Virus (EBV) Infection in Chinese Children: A Retrospective Study of Age-Specific Prevalence | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0099857

  Epstein-Barr Virus (EBV) is a globally prevalent herpesvirus associated with infectious mononucleosis and many malignancies. The survey on EBV prevalence appears to be important to study EBV-related diseases and determine when to administer prophylactic vaccine. […] EBV seroprevalence became more than 50% before age 3 in Chinese children, and exceed 90% after age 8. This study can be helpful to study the relationship between EBV and EBV-associated diseases, and supportive to EBV vaccine development and implementation. […] In our study, the EBV seropositivity rate was higher in newborn babies because maternal antibodies transfer through the placenta. […] In this retrospective study, the seroprevalence in both Beijing and Guangzhou reached about 90% after age 8. We can tell that more than 80% of Chinese children in these cities were infected with EBV after age 6, and after age 8, 90% became infected. […] Considering the high prevalence of the virus in the population and the simple route of transmission, the population should be vaccinated before broad infection when EBV prevalence is 50%.

• #21 Pathogen Safety Data Sheets: Infectious Substances – Epstein-Barr virus – Canada.ca

  https://www.canada.ca/en/public-health/services/laboratory-biosafety-biosecurity/pathogen-safety-data-sheets-risk-assessment/epstein-barr-virus.html

  EBV infection is very prevalent, occurring in more than 90% of individuals during the first two decades of life worldwide. […] The combined global incidence of EBV-attributed BL, HL, NPC, and gastric carcinoma (GC) in 2017 was an estimated 265,000 cases, including 164,000 deaths, representing a 36% increase in incidence and 19% increase in mortality from 1990. […] In developing countries, primary infection occurs mainly in young children and is often asymptomatic. […] In developed countries, primary EBV infection mainly manifests as IM and affects adolescents and young adults. […] Endemic BL occurs frequently in young children in the equatorial regions of Africa and Papua New Guinea and has an incidence of 50-100 cases per 1,000,000 individuals. […] In contrast, EBV-associated sporadic lymphoma occurs in children and young adults and has no specific geographic distribution, with an incidence of 2-3 cases per 1,000,000 individuals.

• #22 Infectious mononucleosis (glandular fever)

  https://www.health.vic.gov.au/infectious-diseases/infectious-mononucleosis-glandular-fever

  Infectious mononucleosis (glandular fever) is an acute viral infection that mainly affects young adults. […] Occurrence is worldwide and widespread in early childhood in developing countries. In developed countries, the age of infection is delayed until older childhood or young adulthood. The infection is most commonly seen in high-school and university students. Only 50 per cent of those infected will develop clinical disease. […] Infectious diseases surveillance in Victoria.

• #23 Epstein-Barr Virus (EBV) Infectious Mononucleosis (Mono): Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/784513-overview

  Epstein-Barr Virus (EBV) is among the most prevalent human viruses in the world. An estimated 90% of the global population is seropositive for EBV, with developed countries bearing a comparatively lower burden of EBV seroprevalence. Residents of developed countries also experience primary EBV infection at a later age. In the United States, the EBV seroprevalence for children and adolescents between ages 6-19 years is about 66.5%, with female, African-American, and Hispanic populations experiencing significantly higher rates of seropositivity. Significant seroprevalence differences exist by family income, with children in the lowest income quartile having 81.0% seroprevalence compared with 53.9% in the highest income quartile. In US institutions characterized by the presence of many young adults, such as universities and the armed forces, the annual incidence for infectious mononucleosis ranges from 11 to 48 cases per 1000 persons.

• #24 Epstein-Barr Virus (EBV) Infectious Mononucleosis (Mono): Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/784513-overview

  Epstein-Barr Virus (EBV) is among the most prevalent human viruses in the world. An estimated 90% of the global population is seropositive for EBV, with developed countries bearing a comparatively lower burden of EBV seroprevalence. Residents of developed countries also experience primary EBV infection at a later age. In the United States, the EBV seroprevalence for children and adolescents between ages 6-19 years is about 66.5%, with female, African-American, and Hispanic populations experiencing significantly higher rates of seropositivity. Significant seroprevalence differences exist by family income, with children in the lowest income quartile having 81.0% seroprevalence compared with 53.9% in the highest income quartile. In US institutions characterized by the presence of many young adults, such as universities and the armed forces, the annual incidence for infectious mononucleosis ranges from 11 to 48 cases per 1000 persons.

• #25 Infectious Mononucleosis: Rapid Evidence Review | AAFP

  https://www.aafp.org/pubs/afp/issues/2023/0100/infectious-mononucleosis.html

  Most cases of infectious mononucleosis are caused by the Epstein-Barr virus (EBV), although approximately 10% of cases are caused by cytomegalovirus (CMV). Infection with EBV is most common in childhood and adolescence, and males and females are affected equally. Studies show that two-thirds of children and adolescents six to 19 years of age in the United States and more than 95% of adults 20 to 25 years of age in the United Kingdom are seropositive. In wealthier nations, infectious mononucleosis mostly affects adolescents and young adults 15 to 24 years of age (6 to 8 cases per 1,000 person-years), particularly those living in communal environments, such as dormitories or military barracks (11 to 48 cases per 1,000 person-years). […] The primary mode of disease transmission is through close personal contact with a person who is infected, particularly their saliva, including sharing eating utensils or water bottles, kissing, or through sexual intercourse. The incubation period for EBV infection is 32 to 49 days, during which the patient is contagious. Viral replication is first detected in the oral cavity and has also been isolated in genital secretions.

• #26 Mononucleosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470387/

  It is estimated that up to 95% of adults in the world are eventually seropositive to EBV. Therefore, EBV is widely disseminated in all population groups. The traditional age group where peak incidence is noted, however, is in 15 to 24-year olds. Classically, the symptomatic infection is in adolescents, which is why laypersons may refer to the infection as the kissing disease. Mononucleosis is uncommon in adults: approximately 2% of all pharyngeal disease in adults is attributable to this disease. Adults are generally not susceptible to clinical illness because of previous exposure. In the United States, clinically evident infection occurs at rates estimated at 30 times higher in whites than in blacks. One explanation for this disparity is that if acquired at a young (childhood) age, EBV is often subclinical. This would suggest earlier EBV exposures in blacks, and a higher frequency of asymptomatic infection as young children.

• #27 Mononucleosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470387/

  It is estimated that up to 95% of adults in the world are eventually seropositive to EBV. Therefore, EBV is widely disseminated in all population groups. The traditional age group where peak incidence is noted, however, is in 15 to 24-year olds. Classically, the symptomatic infection is in adolescents, which is why laypersons may refer to the infection as the kissing disease. Mononucleosis is uncommon in adults: approximately 2% of all pharyngeal disease in adults is attributable to this disease. Adults are generally not susceptible to clinical illness because of previous exposure. In the United States, clinically evident infection occurs at rates estimated at 30 times higher in whites than in blacks. One explanation for this disparity is that if acquired at a young (childhood) age, EBV is often subclinical. This would suggest earlier EBV exposures in blacks, and a higher frequency of asymptomatic infection as young children.

• #28 Epstein-Barr Virus (EBV) Infection in Chinese Children: A Retrospective Study of Age-Specific Prevalence | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0099857

  Epstein-Barr Virus (EBV) is a globally prevalent herpesvirus associated with infectious mononucleosis and many malignancies. The survey on EBV prevalence appears to be important to study EBV-related diseases and determine when to administer prophylactic vaccine. […] EBV seroprevalence became more than 50% before age 3 in Chinese children, and exceed 90% after age 8. This study can be helpful to study the relationship between EBV and EBV-associated diseases, and supportive to EBV vaccine development and implementation. […] In our study, the EBV seropositivity rate was higher in newborn babies because maternal antibodies transfer through the placenta. […] In this retrospective study, the seroprevalence in both Beijing and Guangzhou reached about 90% after age 8. We can tell that more than 80% of Chinese children in these cities were infected with EBV after age 6, and after age 8, 90% became infected. […] Considering the high prevalence of the virus in the population and the simple route of transmission, the population should be vaccinated before broad infection when EBV prevalence is 50%.

• #29 Infectious Mononucleosis: Symptoms and Treatment | Doctor

  https://patient.info/doctor/infectious-mononucleosis

  The annual incidence is approximately 5 cases per 1,000 persons. Over 95% of adults worldwide have been infected with EBV. […] Peak incidence is in the 15-24 year old age group. […] Clinical infection is most common in populations with many young adults, such as active-duty military personnel and college students. […] Glandular fever is rare during the first year of life because of passive immunity received from maternal antibodies. […] Glandular fever is less commonly seen in developing countries. […] There is no seasonal variation or any male or female predisposition. […] In the United States, clinically evident infection is 30 times more common in white people than Black people. However evidence of EBV infection is the same in both groups. It is thought that Black people are more likely to be exposed to EBV infection at a younger age when asymptomatic infection is more common.

• #30 Infectious Mononucleosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4670567/

  EBV infection is extremely common worldwide and approximately 90% of adults become antibody-positive before the age of 30. […] The prevalence of EBV antibodies in preadolescent children is lower, varying from 20% to 80% depending on age and geographic location. […] Factors clearly related to early acquisition of primary EBV infection include geographic region and race/ethnicity. […] The age at which primary EBV infection is acquired may be increasing in developed countries. […] This is important to monitor because there is a complex interplay between age of acquisition, symptomatic versus asymptomatic infection, and the subsequent risk of EBV-associated cancers or autoimmune diseases. […] Kissing is the major route of transmission of primary EBV infection among adolescents and young adults.

• #31 Clinical manifestations and treatment of Epstein-Barr virus infection – UpToDate

  https://www.uptodate.com/contents/clinical-manifestations-and-treatment-of-epstein-barr-virus-infection

  Most primary EBV infections throughout the world are subclinical. […] Approximately 90 to 95 percent of adults are EBV antibody seropositive; however, studies suggest that primary EBV infection may be occurring at a later age in children residing in the developed world. […] In a large public university in the United States, the seroprevalence of EBV antibodies among entering freshman declined from 64 percent in 2006 to 52 percent in 2022.

• #32 Infectious Mononucleosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4670567/

  EBV infection is extremely common worldwide and approximately 90% of adults become antibody-positive before the age of 30. […] The prevalence of EBV antibodies in preadolescent children is lower, varying from 20% to 80% depending on age and geographic location. […] Factors clearly related to early acquisition of primary EBV infection include geographic region and race/ethnicity. […] The age at which primary EBV infection is acquired may be increasing in developed countries. […] This is important to monitor because there is a complex interplay between age of acquisition, symptomatic versus asymptomatic infection, and the subsequent risk of EBV-associated cancers or autoimmune diseases. […] Kissing is the major route of transmission of primary EBV infection among adolescents and young adults.

• #33 Mononucleosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470387/

  It is estimated that up to 95% of adults in the world are eventually seropositive to EBV. Therefore, EBV is widely disseminated in all population groups. The traditional age group where peak incidence is noted, however, is in 15 to 24-year olds. Classically, the symptomatic infection is in adolescents, which is why laypersons may refer to the infection as the kissing disease. Mononucleosis is uncommon in adults: approximately 2% of all pharyngeal disease in adults is attributable to this disease. Adults are generally not susceptible to clinical illness because of previous exposure. In the United States, clinically evident infection occurs at rates estimated at 30 times higher in whites than in blacks. One explanation for this disparity is that if acquired at a young (childhood) age, EBV is often subclinical. This would suggest earlier EBV exposures in blacks, and a higher frequency of asymptomatic infection as young children.

• #34 Infectious Mononucleosis: Symptoms and Treatment | Doctor

  https://patient.info/doctor/infectious-mononucleosis

  The annual incidence is approximately 5 cases per 1,000 persons. Over 95% of adults worldwide have been infected with EBV. […] Peak incidence is in the 15-24 year old age group. […] Clinical infection is most common in populations with many young adults, such as active-duty military personnel and college students. […] Glandular fever is rare during the first year of life because of passive immunity received from maternal antibodies. […] Glandular fever is less commonly seen in developing countries. […] There is no seasonal variation or any male or female predisposition. […] In the United States, clinically evident infection is 30 times more common in white people than Black people. However evidence of EBV infection is the same in both groups. It is thought that Black people are more likely to be exposed to EBV infection at a younger age when asymptomatic infection is more common.

• #35 Mononucleosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470387/

  It is estimated that up to 95% of adults in the world are eventually seropositive to EBV. Therefore, EBV is widely disseminated in all population groups. The traditional age group where peak incidence is noted, however, is in 15 to 24-year olds. Classically, the symptomatic infection is in adolescents, which is why laypersons may refer to the infection as the kissing disease. Mononucleosis is uncommon in adults: approximately 2% of all pharyngeal disease in adults is attributable to this disease. Adults are generally not susceptible to clinical illness because of previous exposure. In the United States, clinically evident infection occurs at rates estimated at 30 times higher in whites than in blacks. One explanation for this disparity is that if acquired at a young (childhood) age, EBV is often subclinical. This would suggest earlier EBV exposures in blacks, and a higher frequency of asymptomatic infection as young children.

• #36 Epidemiology of Epstein-Barr virus infection and infectious mononucleosis in the United Kingdom | BMC Public Health | Full Text

  https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-09049-x

  1982/2325 individuals (85.3%) were EBV seropositive. […] Between 2002 and 2013, the incidence of IM (derived from hospital admissions data) increased. […] The incidence of IM requiring hospitalisation is increasing. […] We show that exposures associated with increased IM risk (i.e. late infection) include White ethnicity, normal/low body weight, lower deprivation, and never smoking, in keeping with international data. […] We found additional evidence of interaction between smoking, body weight, and ethnicity in determining IM risk. […] The observed similarities in gender variation in IM and seroconversion during teenage years between HES and serum data is compelling, as is the similarity in admission incidence by age between the UK and Denmark. […] Understanding the temporal trends and host determinants of EBV serostatus are essential for rational vaccine design and deployment.

• #37 Epidemiology of Epstein-Barr Virus infection and Infectious Mononucleosis in the United Kingdom | medRxiv

  https://www.medrxiv.org/content/10.1101/2020.01.21.20018317v1

  Epstein-Barr Virus (EBV) is a ubiquitous gamma-herpesvirus with which 95% of the healthy population is infected. […] Over recent decades, the age of primary EBV infection has become later, largely due to improved sanitation and living conditions. […] Between 2002 and 2013, the incidence of IM (derived from hospital admissions data) increased. […] We find that the incidence of IM requiring hospitalisation is increasing. […] Exposure associated with IM in a large, diverse East London cohort (n1,000,000) were low BMI, never-smoking, white ethnicity, and affluence.

• #38 Infectious Mononucleosis, Active Component, U.S. Armed Forces, 2002–2018 | Health.mil

  https://www.health.mil/News/Articles/2019/07/01/Infectious-Mononucleosis?page=4

  Infectious mononucleosis (IM) is an acute infectious illness characterized by swollen lymph nodes, fever, pharyngitis, fatigue, and head and body aches. This report describes the incidence rates, trends, and demographic correlates of IM among active component service members during 20022018. During the surveillance period, there were 23,780 incident cases of IM, resulting in an overall incidence rate of 104.2 cases per 100,000 person-years (p-yrs). The incidence of IM diagnoses was highest among the youngest age groups and decreased with increasing age. The rate of incident IM diagnoses was markedly higher among non-Hispanic white service members (123.4 per 100,000 p-yrs) compared to those in other race/ethnicity groups. The incidence of IM diagnoses among recruits (364.9 per 100,000 p-yrs) was 3.4 times that among other enlisted personnel (106.0 per 100,000 p-yrs) and 5.6 times that among officers (64.7 per 100,000 p-yrs). The incidence of IM diagnoses remained relatively stable during the surveillance period, at about 100 per 100,000 p-yrs.

• #39 Epidemiology of Epstein-Barr virus-associated pediatric lymphomas from Argentina | Boletín Médico del Hospital Infantil de México (English Edition)

  https://www.elsevier.es/es-revista-boletin-medico-del-hospital-infantil-201-articulo-epidemiology-epstein-barr-virus-associated-pediatric-lymphomas-S2444340916300188

  More than 90% of the population is infected by Epstein-Barr virus (EBV), which has sophisticatedly evolved to survive silently in B cells for the life of infected individuals. […] In Argentina, EBV infection is mostly subclinical and 90% of patients are seropositive by the age of 3 years; therefore, its epidemiological characteristics resemble those of an underdeveloped or developing population. […] The age at primary infection varies substantially worldwide, and exposure to EBV is likely to be due to socioeconomic factors. […] EBV epidemiology in Argentina reflects a typical pattern of a developing country with primary infection in early childhood and the epidemiology of EBV-related lymphomas differs from that observed in developing countries. […] The risk of HL after IM suggests that the predilection for the younger adult age group may simply result from the combination of age and time since IM. […] Therefore, EBV infection in our pediatric patients shows a complex epidemiological pattern, very attractive to investigate.

• #40 Epidemiology of Epstein-Barr virus infection and infectious mononucleosis in the United Kingdom | BMC Public Health | Full Text

  https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-09049-x

  1982/2325 individuals (85.3%) were EBV seropositive. […] Between 2002 and 2013, the incidence of IM (derived from hospital admissions data) increased. […] The incidence of IM requiring hospitalisation is increasing. […] We show that exposures associated with increased IM risk (i.e. late infection) include White ethnicity, normal/low body weight, lower deprivation, and never smoking, in keeping with international data. […] We found additional evidence of interaction between smoking, body weight, and ethnicity in determining IM risk. […] The observed similarities in gender variation in IM and seroconversion during teenage years between HES and serum data is compelling, as is the similarity in admission incidence by age between the UK and Denmark. […] Understanding the temporal trends and host determinants of EBV serostatus are essential for rational vaccine design and deployment.

• #41 Infectious Mononucleosis, Active Component, U.S. Armed Forces, 2002–2018 | Health.mil

  https://www.health.mil/News/Articles/2019/07/01/Infectious-Mononucleosis?page=4

  Infectious mononucleosis (IM) is an acute infectious illness characterized by swollen lymph nodes, fever, pharyngitis, fatigue, and head and body aches. This report describes the incidence rates, trends, and demographic correlates of IM among active component service members during 20022018. During the surveillance period, there were 23,780 incident cases of IM, resulting in an overall incidence rate of 104.2 cases per 100,000 person-years (p-yrs). The incidence of IM diagnoses was highest among the youngest age groups and decreased with increasing age. The rate of incident IM diagnoses was markedly higher among non-Hispanic white service members (123.4 per 100,000 p-yrs) compared to those in other race/ethnicity groups. The incidence of IM diagnoses among recruits (364.9 per 100,000 p-yrs) was 3.4 times that among other enlisted personnel (106.0 per 100,000 p-yrs) and 5.6 times that among officers (64.7 per 100,000 p-yrs). The incidence of IM diagnoses remained relatively stable during the surveillance period, at about 100 per 100,000 p-yrs.

• #42 Infectious Mononucleosis: Rapid Evidence Review | AAFP

  https://www.aafp.org/pubs/afp/issues/2023/0100/infectious-mononucleosis.html

  Most cases of infectious mononucleosis are caused by the Epstein-Barr virus (EBV), although approximately 10% of cases are caused by cytomegalovirus (CMV). Infection with EBV is most common in childhood and adolescence, and males and females are affected equally. Studies show that two-thirds of children and adolescents six to 19 years of age in the United States and more than 95% of adults 20 to 25 years of age in the United Kingdom are seropositive. In wealthier nations, infectious mononucleosis mostly affects adolescents and young adults 15 to 24 years of age (6 to 8 cases per 1,000 person-years), particularly those living in communal environments, such as dormitories or military barracks (11 to 48 cases per 1,000 person-years). […] The primary mode of disease transmission is through close personal contact with a person who is infected, particularly their saliva, including sharing eating utensils or water bottles, kissing, or through sexual intercourse. The incubation period for EBV infection is 32 to 49 days, during which the patient is contagious. Viral replication is first detected in the oral cavity and has also been isolated in genital secretions.

• #43 Infectious Mononucleosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4670567/

  EBV infection is extremely common worldwide and approximately 90% of adults become antibody-positive before the age of 30. […] The prevalence of EBV antibodies in preadolescent children is lower, varying from 20% to 80% depending on age and geographic location. […] Factors clearly related to early acquisition of primary EBV infection include geographic region and race/ethnicity. […] The age at which primary EBV infection is acquired may be increasing in developed countries. […] This is important to monitor because there is a complex interplay between age of acquisition, symptomatic versus asymptomatic infection, and the subsequent risk of EBV-associated cancers or autoimmune diseases. […] Kissing is the major route of transmission of primary EBV infection among adolescents and young adults.

• #44 Mononucleosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470387/

  It is estimated that up to 95% of adults in the world are eventually seropositive to EBV. Therefore, EBV is widely disseminated in all population groups. The traditional age group where peak incidence is noted, however, is in 15 to 24-year olds. Classically, the symptomatic infection is in adolescents, which is why laypersons may refer to the infection as the kissing disease. Mononucleosis is uncommon in adults: approximately 2% of all pharyngeal disease in adults is attributable to this disease. Adults are generally not susceptible to clinical illness because of previous exposure. In the United States, clinically evident infection occurs at rates estimated at 30 times higher in whites than in blacks. One explanation for this disparity is that if acquired at a young (childhood) age, EBV is often subclinical. This would suggest earlier EBV exposures in blacks, and a higher frequency of asymptomatic infection as young children.

• #45 Infectious Mononucleosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4670567/

  The incubation period of infectious mononucleosis is approximately 6 weeks. […] Besides deep kissing, primary EBV infection can also be transmitted by blood transfusion, solid organ transplantation, or hematopoietic cell transplantation, but these routes account for relatively few cases overall. […] The way young children contract EBV is unknown. […] A reasonable supposition is that they are infected by their parents or siblings who are carriers of the virus and who intermittently shed it in their oral secretions. […] The assumption has been that the majority of primary EBV infections in children before puberty are asymptomatic but that is not necessarily so. […] The incidence of infectious mononucleosis is exceptionally low in Southeast Asia and equatorial Africa where EBV infection during childhood is nearly ubiquitous, thus it might be extrapolated that infectious mononucleosis does not have a strong correlation with either endemic Burkitt lymphoma or Hodgkin’s lymphoma in these areas.

• #46 Infectious Mononucleosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4670567/

  The incubation period of infectious mononucleosis is approximately 6 weeks. […] Besides deep kissing, primary EBV infection can also be transmitted by blood transfusion, solid organ transplantation, or hematopoietic cell transplantation, but these routes account for relatively few cases overall. […] The way young children contract EBV is unknown. […] A reasonable supposition is that they are infected by their parents or siblings who are carriers of the virus and who intermittently shed it in their oral secretions. […] The assumption has been that the majority of primary EBV infections in children before puberty are asymptomatic but that is not necessarily so. […] The incidence of infectious mononucleosis is exceptionally low in Southeast Asia and equatorial Africa where EBV infection during childhood is nearly ubiquitous, thus it might be extrapolated that infectious mononucleosis does not have a strong correlation with either endemic Burkitt lymphoma or Hodgkin’s lymphoma in these areas.

• #47 Mononucleosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470387/

  After exposure, the EBV infects the epithelial cells of the salivary glands and the oropharynx. Lymphocytes residing in the tonsils get exposed to the virus and then enter the bloodstream. Lymphoid hyperplasia is common and may be seen as generalized lymphadenopathy, tonsillitis, and hepatosplenomegaly.

• #48 Infectious Mononucleosis: Rapid Evidence Review | AAFP

  https://www.aafp.org/pubs/afp/issues/2023/0100/infectious-mononucleosis.html

  Most cases of infectious mononucleosis are caused by the Epstein-Barr virus (EBV), although approximately 10% of cases are caused by cytomegalovirus (CMV). Infection with EBV is most common in childhood and adolescence, and males and females are affected equally. Studies show that two-thirds of children and adolescents six to 19 years of age in the United States and more than 95% of adults 20 to 25 years of age in the United Kingdom are seropositive. In wealthier nations, infectious mononucleosis mostly affects adolescents and young adults 15 to 24 years of age (6 to 8 cases per 1,000 person-years), particularly those living in communal environments, such as dormitories or military barracks (11 to 48 cases per 1,000 person-years). […] The primary mode of disease transmission is through close personal contact with a person who is infected, particularly their saliva, including sharing eating utensils or water bottles, kissing, or through sexual intercourse. The incubation period for EBV infection is 32 to 49 days, during which the patient is contagious. Viral replication is first detected in the oral cavity and has also been isolated in genital secretions.

• #49 Infectious Mononucleosis (EBV)

  https://www.atsu.edu/faculty/chamberlain/website/lectures/lecture/mono.htm

  Infectious mononucleosis is most commonly seen in young adults 15-25 years of age. […] Infection with EBV occurs worldwide among humans and usually occurs as a subclinical infection in early childhood. […] The incubation period is 12 months. Many patients cannot recall being exposed to EBV. […] About 70% of persons in the U.S. are infected with EBV by 30 years of age. […] It takes several exposures to EBV from an infected person to acquire EBV, since the virus is not very contagious. […] After recovery, the virus remains in the saliva for months. More than 90% of EBV-infected persons intermittently have lifelong shedding of virus even when asymptomatic. […] EBV is acquired by contact with infected cervical and oral secretions. Transmission can be via blood transfusions.

• #50 EPSTEIN-BARR VIRUS | Harrison’s Manual of Medicine

  https://harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623264/all/EPSTEIN_BARR_VIRUS?q=EPSTEIN-BARR+VIRUS

  EBV is a DNA virus in the family Herpesviridae that infects 90% of persons by adulthood. […] Infectious mononucleosis (IM) is a disease of young adults and is more common in areas with higher standards of hygiene; infection occurs at a younger age in areas with deficient standards of hygiene. […] EBV is spread by contact with oral secretions (e.g., by transfer of saliva during kissing) and is shed in oropharyngeal secretions by 90% of asymptomatic seropositive individuals.

• #51 Mononucleosis epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Mononucleosis_epidemiology_and_demographics

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

• #52 Epidemiology of Epstein-Barr virus infection and infectious mononucleosis in the United Kingdom | BMC Public Health | Full Text

  https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-09049-x

  1982/2325 individuals (85.3%) were EBV seropositive. […] Between 2002 and 2013, the incidence of IM (derived from hospital admissions data) increased. […] The incidence of IM requiring hospitalisation is increasing. […] We show that exposures associated with increased IM risk (i.e. late infection) include White ethnicity, normal/low body weight, lower deprivation, and never smoking, in keeping with international data. […] We found additional evidence of interaction between smoking, body weight, and ethnicity in determining IM risk. […] The observed similarities in gender variation in IM and seroconversion during teenage years between HES and serum data is compelling, as is the similarity in admission incidence by age between the UK and Denmark. […] Understanding the temporal trends and host determinants of EBV serostatus are essential for rational vaccine design and deployment.

• #53 The epidemiology of infectious mononucleosis in Northern Scotland: a decreasing incidence and winter peak | BMC Infectious Diseases | Full Text

  https://bmcinfectdis.biomedcentral.com/articles/10.1186/1471-2334-14-151

  Infection with Epstein-Barr virus (EBV) is almost ubiquitous in humans and generally occurs at two ages: infantile, which is usually asymptomatic and associated with poorer socioeconomic conditions, and adolescent, which causes infectious mononucleosis (IM) in ~25% cases. […] IM appears to be decreasing in incidence, which may be caused by changing environmental influences on immune systems. […] The annual rate of positive tests decreased progressively over the study period, from 174/100 000 (95% CI 171178) in 1997 to 67/100 000 (95% CI 6569) in 2012. […] A seasonal variation was also detected, with the disease peaking in late winter. […] Our analysis also demonstrated seasonal variation, with IM being about a third more common in February than August.

• #54 Epidemiology of Epstein-Barr virus infection and infectious mononucleosis in the United Kingdom | BMC Public Health | Full Text

  https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-09049-x

  1982/2325 individuals (85.3%) were EBV seropositive. […] Between 2002 and 2013, the incidence of IM (derived from hospital admissions data) increased. […] The incidence of IM requiring hospitalisation is increasing. […] We show that exposures associated with increased IM risk (i.e. late infection) include White ethnicity, normal/low body weight, lower deprivation, and never smoking, in keeping with international data. […] We found additional evidence of interaction between smoking, body weight, and ethnicity in determining IM risk. […] The observed similarities in gender variation in IM and seroconversion during teenage years between HES and serum data is compelling, as is the similarity in admission incidence by age between the UK and Denmark. […] Understanding the temporal trends and host determinants of EBV serostatus are essential for rational vaccine design and deployment.

• #55 Epidemiology of Epstein-Barr Virus infection and Infectious Mononucleosis in the United Kingdom | medRxiv

  https://www.medrxiv.org/content/10.1101/2020.01.21.20018317v1

  Epstein-Barr Virus (EBV) is a ubiquitous gamma-herpesvirus with which 95% of the healthy population is infected. […] Over recent decades, the age of primary EBV infection has become later, largely due to improved sanitation and living conditions. […] Between 2002 and 2013, the incidence of IM (derived from hospital admissions data) increased. […] We find that the incidence of IM requiring hospitalisation is increasing. […] Exposure associated with IM in a large, diverse East London cohort (n1,000,000) were low BMI, never-smoking, white ethnicity, and affluence.

• #56 The epidemiology of infectious mononucleosis in Northern Scotland: a decreasing incidence and winter peak | BMC Infectious Diseases | Full Text

  https://bmcinfectdis.biomedcentral.com/articles/10.1186/1471-2334-14-151

  Infection with Epstein-Barr virus (EBV) is almost ubiquitous in humans and generally occurs at two ages: infantile, which is usually asymptomatic and associated with poorer socioeconomic conditions, and adolescent, which causes infectious mononucleosis (IM) in ~25% cases. […] IM appears to be decreasing in incidence, which may be caused by changing environmental influences on immune systems. […] The annual rate of positive tests decreased progressively over the study period, from 174/100 000 (95% CI 171178) in 1997 to 67/100 000 (95% CI 6569) in 2012. […] A seasonal variation was also detected, with the disease peaking in late winter. […] Our analysis also demonstrated seasonal variation, with IM being about a third more common in February than August.

• #57 Infectious Mononucleosis, Active Component, U.S. Armed Forces, 2002–2018 | Health.mil

  https://www.health.mil/News/Articles/2019/07/01/Infectious-Mononucleosis?page=4

  Infectious mononucleosis (IM) is an acute infectious illness characterized by swollen lymph nodes, fever, pharyngitis, fatigue, and head and body aches. This report describes the incidence rates, trends, and demographic correlates of IM among active component service members during 20022018. During the surveillance period, there were 23,780 incident cases of IM, resulting in an overall incidence rate of 104.2 cases per 100,000 person-years (p-yrs). The incidence of IM diagnoses was highest among the youngest age groups and decreased with increasing age. The rate of incident IM diagnoses was markedly higher among non-Hispanic white service members (123.4 per 100,000 p-yrs) compared to those in other race/ethnicity groups. The incidence of IM diagnoses among recruits (364.9 per 100,000 p-yrs) was 3.4 times that among other enlisted personnel (106.0 per 100,000 p-yrs) and 5.6 times that among officers (64.7 per 100,000 p-yrs). The incidence of IM diagnoses remained relatively stable during the surveillance period, at about 100 per 100,000 p-yrs.

• #58 Infectious Mononucleosis, Active Component, U.S. Armed Forces, 2002–2018 | Health.mil

  https://www.health.mil/News/Articles/2019/07/01/Infectious-Mononucleosis?page=4

  This report demonstrates that the crude overall incidence rate of IM diagnoses among active component service members has remained stable over many years, at about 100 per 100,000 p-yrs. Compared to their respective counterparts, younger service members and, in particular, recruits had the highest overall rates of incident IM diagnoses as did females and non-Hispanic whites.

• #59 The epidemiology of infectious mononucleosis in Northern Scotland: a decreasing incidence and winter peak | BMC Infectious Diseases | Full Text

  https://bmcinfectdis.biomedcentral.com/articles/10.1186/1471-2334-14-151

  Infection with Epstein-Barr virus (EBV) is almost ubiquitous in humans and generally occurs at two ages: infantile, which is usually asymptomatic and associated with poorer socioeconomic conditions, and adolescent, which causes infectious mononucleosis (IM) in ~25% cases. […] IM appears to be decreasing in incidence, which may be caused by changing environmental influences on immune systems. […] The annual rate of positive tests decreased progressively over the study period, from 174/100 000 (95% CI 171178) in 1997 to 67/100 000 (95% CI 6569) in 2012. […] A seasonal variation was also detected, with the disease peaking in late winter. […] Our analysis also demonstrated seasonal variation, with IM being about a third more common in February than August.

• #60 Infectious Mononucleosis: Symptoms and Treatment | Doctor

  https://patient.info/doctor/infectious-mononucleosis

  The annual incidence is approximately 5 cases per 1,000 persons. Over 95% of adults worldwide have been infected with EBV. […] Peak incidence is in the 15-24 year old age group. […] Clinical infection is most common in populations with many young adults, such as active-duty military personnel and college students. […] Glandular fever is rare during the first year of life because of passive immunity received from maternal antibodies. […] Glandular fever is less commonly seen in developing countries. […] There is no seasonal variation or any male or female predisposition. […] In the United States, clinically evident infection is 30 times more common in white people than Black people. However evidence of EBV infection is the same in both groups. It is thought that Black people are more likely to be exposed to EBV infection at a younger age when asymptomatic infection is more common.

• #61 Infectious Mononucleosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4670567/

  Emerging evidence suggests that previous presentation with infectious mononucleosis can increase the risk of Hodgkin’s lymphoma. […] While associations between infectious mononucleosis and epithelial carcinomas have not been explored, the presence of EBV in tumors from nasopharyngeal and gastric carcinoma patients is well documented. […] It is possible that achieving a very high viral titer in the blood at any point in life predisposes individuals to subsequent EBV related cancers. […] In recent years, infectious diseases have been emerging as possible triggers for autoimmune disorders. […] EBV infection in particular has come to be highly associated with occurrence of multiple sclerosis. […] A causative role for EBV was supported by examination of the antibody profiles of patients with multiple sclerosis. […] The risk of multiple sclerosis increases positively with levels of circulating anti-EBNA antibodies. […] The ability to discriminate multiple sclerosis cases and controls was substantially enhanced by the inclusion of quantitative measures of the anti-EBNA-1 response to EBV infection.

• #62 Infectious Mononucleosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4670567/

  Emerging evidence suggests that previous presentation with infectious mononucleosis can increase the risk of Hodgkin’s lymphoma. […] While associations between infectious mononucleosis and epithelial carcinomas have not been explored, the presence of EBV in tumors from nasopharyngeal and gastric carcinoma patients is well documented. […] It is possible that achieving a very high viral titer in the blood at any point in life predisposes individuals to subsequent EBV related cancers. […] In recent years, infectious diseases have been emerging as possible triggers for autoimmune disorders. […] EBV infection in particular has come to be highly associated with occurrence of multiple sclerosis. […] A causative role for EBV was supported by examination of the antibody profiles of patients with multiple sclerosis. […] The risk of multiple sclerosis increases positively with levels of circulating anti-EBNA antibodies. […] The ability to discriminate multiple sclerosis cases and controls was substantially enhanced by the inclusion of quantitative measures of the anti-EBNA-1 response to EBV infection.

• #63 Epidemiology of Epstein-Barr virus-associated pediatric lymphomas from Argentina | Boletín Médico del Hospital Infantil de México (English Edition)

  https://www.elsevier.es/es-revista-boletin-medico-del-hospital-infantil-201-articulo-epidemiology-epstein-barr-virus-associated-pediatric-lymphomas-S2444340916300188

  More than 90% of the population is infected by Epstein-Barr virus (EBV), which has sophisticatedly evolved to survive silently in B cells for the life of infected individuals. […] In Argentina, EBV infection is mostly subclinical and 90% of patients are seropositive by the age of 3 years; therefore, its epidemiological characteristics resemble those of an underdeveloped or developing population. […] The age at primary infection varies substantially worldwide, and exposure to EBV is likely to be due to socioeconomic factors. […] EBV epidemiology in Argentina reflects a typical pattern of a developing country with primary infection in early childhood and the epidemiology of EBV-related lymphomas differs from that observed in developing countries. […] The risk of HL after IM suggests that the predilection for the younger adult age group may simply result from the combination of age and time since IM. […] Therefore, EBV infection in our pediatric patients shows a complex epidemiological pattern, very attractive to investigate.

• #64 Epidemiology of Epstein-Barr virus-associated pediatric lymphomas from Argentina

  http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S1665-11462016000100047

  EBV epidemiology in Argentina reflects a typical pattern of a developing country with primary infection in early childhood and the epidemiology of EBV-related lymphomas differs from that observed in developing countries. […] Given that in Argentina primary infection occurs at early age and is mostly subclinical, and HL prevail in patients 10 years old, a similar association may exist between primary EBV infection and HL risk in childhood. […] In Argentina, our group demonstrated an EBV association with pediatric BL in 37% of cases, including immunocompetent and immunocompromised patients. […] The risk of HL after IM suggests that the predilection for the younger adult age group may simply result from the combination of age and time since IM. […] A higher prevalence of EBV in lymphomas diagnosed in children 10 years old was demonstrated by our research group not only in pediatric HL, but also in BL and DLBCL.

• #65 Epstein-Barr Virus Fact Sheet – Stanford Environmental Health & Safety

  https://ehs.stanford.edu/reference/epstein-barr-virus-fact-sheet

  EBV infects 80 90% of all adults worldwide; mononucleosis is common in early childhood worldwide, typical disease occurs in developed countries mainly in young adults; Burkitts tumor is found worldwide but hyperendemic in highly malarial areas such as tropical Africa; carcinoma is worldwide but highest in Southeast Asia and China. […] Mononucleosis person-to-person by oropharyngeal route via saliva, possible spread via blood transfusion (not important route); Burkitts lymphoma primary infection occurs early in life or involves immunosuppression and reactivation of EBV later, malaria an important co-factor; NPC is associated with EBV infection in early life and reactivation later with epithelial invasion.

• #66 Reframing Burkitt lymphoma: virology not epidemiology defines clinical variants – Rochford – Annals of Lymphoma

  https://aol.amegroups.org/article/view/7665/html

  Three clinical variants of BL have been described based on the epidemiology of the cancer: endemic, sporadic and immunodeficiency-associated (ID). The most common, and the variant initially described by Burkitt, is the endemic form of BL. Endemic BL (eBL) is a pediatric cancer with a peak incidence between 68 years of age and a predominance in males. eBL is found in regions of the world where malaria transmission is year-round, predominantly sub-Saharan Africa and Papua New Guinea. eBL presents extranodally, frequently in the jaw in younger children and abdominally in older children. Recent studies indicate a changing pattern of presentation with less tumors occurring in the jaw than historically reported. EBV is detected in ~95% of cases. […] In contrast to eBL, cases of sporadic BL (sBL) occur throughout the world. It is a rare malignancy and can occur in both children, young adults as well as the elderly. sBL represents ~50% of childhood lymphomas but less than 3% of all lymphomas in USA and Western Europe. The incidence of sBL in US children was reported to be 2.5 cases per million person-years. In contrast to eBL, EBV is detected in only 10-30% of sBL. In one study, 38% of pediatric sBL were found to be EBV-positive. sBL, like eBL, also occurs more frequently in males, typically presents within the abdominal region and is found in lymph nodes as well as extranodally.

• #67 Pathogen Safety Data Sheets: Infectious Substances – Epstein-Barr virus – Canada.ca

  https://www.canada.ca/en/public-health/services/laboratory-biosafety-biosecurity/pathogen-safety-data-sheets-risk-assessment/epstein-barr-virus.html

  NPC is most common in southern China and accounts for approximately 20% of all adult cancers. […] NPC is extremely rare in Europe and North America, with an incidence rate is 1 per 100,000 individuals. […] EBV reactivation can occur due to external stress stimuli and by co-infection with certain viruses, including human simplex virus 1, human immunodeficiency virus (HIV), hepatitis viruses, and novel SARS-CoV-2, and may result in complications such as BL, HL, and other types of cancer. […] Monitor for clinical symptoms. […] Direct detection of the viral antigen can be done by staining for EBV nuclear antigen 1 (EBNA1) using anti-complement immunofluorescence. […] Tests for heterophile antibodies in mononucleosis, antibodies against viral capsid antigen (VCA), or anti-EBNA1 antibodies can also be used. […] An EBV DNA load 10,000 IU/mL in whole blood is proposed as a diagnostic cut-off value for chronic active EBV disease.

• #68 Pathogen Safety Data Sheets: Infectious Substances – Epstein-Barr virus – Canada.ca

  https://www.canada.ca/en/public-health/services/laboratory-biosafety-biosecurity/pathogen-safety-data-sheets-risk-assessment/epstein-barr-virus.html

  EBV infection is very prevalent, occurring in more than 90% of individuals during the first two decades of life worldwide. […] The combined global incidence of EBV-attributed BL, HL, NPC, and gastric carcinoma (GC) in 2017 was an estimated 265,000 cases, including 164,000 deaths, representing a 36% increase in incidence and 19% increase in mortality from 1990. […] In developing countries, primary infection occurs mainly in young children and is often asymptomatic. […] In developed countries, primary EBV infection mainly manifests as IM and affects adolescents and young adults. […] Endemic BL occurs frequently in young children in the equatorial regions of Africa and Papua New Guinea and has an incidence of 50-100 cases per 1,000,000 individuals. […] In contrast, EBV-associated sporadic lymphoma occurs in children and young adults and has no specific geographic distribution, with an incidence of 2-3 cases per 1,000,000 individuals.

• #69 Infectious Mononucleosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4670567/

  Emerging evidence suggests that previous presentation with infectious mononucleosis can increase the risk of Hodgkin’s lymphoma. […] While associations between infectious mononucleosis and epithelial carcinomas have not been explored, the presence of EBV in tumors from nasopharyngeal and gastric carcinoma patients is well documented. […] It is possible that achieving a very high viral titer in the blood at any point in life predisposes individuals to subsequent EBV related cancers. […] In recent years, infectious diseases have been emerging as possible triggers for autoimmune disorders. […] EBV infection in particular has come to be highly associated with occurrence of multiple sclerosis. […] A causative role for EBV was supported by examination of the antibody profiles of patients with multiple sclerosis. […] The risk of multiple sclerosis increases positively with levels of circulating anti-EBNA antibodies. […] The ability to discriminate multiple sclerosis cases and controls was substantially enhanced by the inclusion of quantitative measures of the anti-EBNA-1 response to EBV infection.

• #70 Risk of inflammatory bowel disease following hospitalisation with infectious mononucleosis: nationwide cohort study from Denmark | Nature Communications

  https://www.nature.com/articles/s41467-024-52195-8

  Infectious mononucleosis (IM) is suspected to be associated with inflammatory bowel disease (IBD) development. […] Here we show an increased risk for IBD diagnosis following IM hospitalisation, indicating an association between severe EBV disease and later IBD development. […] We identified a total of 496 (incidence rate (IR): 0.67/1000 persons) and 3982 (IR: 0.50/1000 persons) IBD cases diagnosed in the severe IM and matched cohort, respectively. […] The crude hazard ratio (HR) for IBD diagnosis following severe IM was 1.35 (95% CI: 1.231.48). […] This association was found in both females (HR: 1.36; 95% CI: 1.201.55) and males (HR: 1.34; 95% CI: 1.171.54) but only significantly associated with IBD in those diagnosed with IM at 1519 years (HR: 1.41; 95% CI: 1.221.62), 2024 years (HR: 1.41; 95% CI: 1.081.82), and 2529 years (HR: 1.60; 95% CI: 1.092.33).

• #71 Infectious mononucleosis (glandular fever)

  https://www.health.vic.gov.au/infectious-diseases/infectious-mononucleosis-glandular-fever

  Infectious mononucleosis (glandular fever) is an acute viral infection that mainly affects young adults. […] Occurrence is worldwide and widespread in early childhood in developing countries. In developed countries, the age of infection is delayed until older childhood or young adulthood. The infection is most commonly seen in high-school and university students. Only 50 per cent of those infected will develop clinical disease. […] Infectious diseases surveillance in Victoria.

• #72 About Infectious Mononucleosis (Mono) | EBV and Mono | CDC

  https://www.cdc.gov/epstein-barr/about/mononucleosis.html

  Infectious mononucleosis is common among teenagers and young adults, especially college students. At least 1 out of 4 teenagers and young adults who get infected with EBV will develop infectious mononucleosis. […] EBV is the most common cause of infectious mononucleosis, but other viruses can cause this disease. Typically, these viruses spread most commonly through bodily fluids, especially saliva. […] There is no vaccine to protect against infectious mononucleosis. […] Healthcare providers typically diagnose infectious mononucleosis based on symptoms. […] Laboratory tests are not usually needed to diagnose infectious mononucleosis. However, specific tests may be needed for patients who do not have a typical case of infectious mononucleosis.

• #73 Pathogen Safety Data Sheets: Infectious Substances – Epstein-Barr virus – Canada.ca

  https://www.canada.ca/en/public-health/services/laboratory-biosafety-biosecurity/pathogen-safety-data-sheets-risk-assessment/epstein-barr-virus.html

  NPC is most common in southern China and accounts for approximately 20% of all adult cancers. […] NPC is extremely rare in Europe and North America, with an incidence rate is 1 per 100,000 individuals. […] EBV reactivation can occur due to external stress stimuli and by co-infection with certain viruses, including human simplex virus 1, human immunodeficiency virus (HIV), hepatitis viruses, and novel SARS-CoV-2, and may result in complications such as BL, HL, and other types of cancer. […] Monitor for clinical symptoms. […] Direct detection of the viral antigen can be done by staining for EBV nuclear antigen 1 (EBNA1) using anti-complement immunofluorescence. […] Tests for heterophile antibodies in mononucleosis, antibodies against viral capsid antigen (VCA), or anti-EBNA1 antibodies can also be used. […] An EBV DNA load 10,000 IU/mL in whole blood is proposed as a diagnostic cut-off value for chronic active EBV disease.

• #74 Pathogen Safety Data Sheets: Infectious Substances – Epstein-Barr virus – Canada.ca

  https://www.canada.ca/en/public-health/services/laboratory-biosafety-biosecurity/pathogen-safety-data-sheets-risk-assessment/epstein-barr-virus.html

  NPC is most common in southern China and accounts for approximately 20% of all adult cancers. […] NPC is extremely rare in Europe and North America, with an incidence rate is 1 per 100,000 individuals. […] EBV reactivation can occur due to external stress stimuli and by co-infection with certain viruses, including human simplex virus 1, human immunodeficiency virus (HIV), hepatitis viruses, and novel SARS-CoV-2, and may result in complications such as BL, HL, and other types of cancer. […] Monitor for clinical symptoms. […] Direct detection of the viral antigen can be done by staining for EBV nuclear antigen 1 (EBNA1) using anti-complement immunofluorescence. […] Tests for heterophile antibodies in mononucleosis, antibodies against viral capsid antigen (VCA), or anti-EBNA1 antibodies can also be used. […] An EBV DNA load 10,000 IU/mL in whole blood is proposed as a diagnostic cut-off value for chronic active EBV disease.

• #75 Infectious mononucleosis – WikiLectures

  https://www.wikilectures.eu/w/Infectious_mononucleosis

  Infectious mononucleosis is one of the relatively common diseases in the Czech Republic (22.5 thousand cases per year). […] The source of the infection is a sick person or a healthy carrier. People in the convalescent stage can also be healthy carriers as EBV remains in the body in a latent form throughout one’s life and can be reactivated (as with other herpes infections). The population is infected in early age, and children under 2 years of age usually have no symptoms. The highest incidence is in adolescence and young adults between 15 to 24 years of age. Infectious mononucleosis is almost non-existent in adults over 40 years. […] The disease is reported, but isolation is not necessary. Prophylaxis and prevention do not exist.

• #76 Isolation Table | UCSF Health Hospital Epidemiology and Infection Prevention

  https://infectioncontrol.ucsfmedicalcenter.org/isolation-table?page=3

  Epstein-Barr virus (including infectious mononucleosis) Condition Isolation Duration of Isolation Comment Standard

• #77 Mononucleosis epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Mononucleosis_epidemiology_and_demographics

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

• #78 Infectious Mononucleosis, Active Component, U.S. Armed Forces, 2002–2018 | Health.mil

  https://www.health.mil/News/Articles/2019/07/01/Infectious-Mononucleosis?page=4

  An average of 1,398 service members per year were diagnosed with IM during 20022018. Incidence rates were highest among the youngest age groups, recruit trainees, females, non-Hispanic whites, and health care workers. The crude overall incidence of IM diagnoses was 104.2 per 1,000 p-yrs; annual rates remained relatively stable over the 17-year surveillance period. […] Symptomatic cases of IM can result in 2 weeks or more of limited duty, resulting in 2,797 weeks or more of lost duty time per year. Recruit trainees with IM may need to be recycled. Cases with possible splenic enlargement may be cautioned or prevented from strenuous physical activities for up to 4 weeks after onset of IM. […] Because IM is common among young adults living in close proximity and because it has a relatively long duration of symptoms, IM has the potential to reduce military operational readiness by contributing to lost or limited duty time. The purpose of this report is to describe the overall incidence rates, trends, morbidity and health care burden, and demographic correlates of IM among active component service members during 20022018.

• #79 Epidemiology of Epstein-Barr virus infection and infectious mononucleosis in the United Kingdom | springermedizin.de

  https://www.springermedizin.de/epidemiology-of-epstein-barr-virus-infection-and-infectious-mono/18078278

  The finding that effects differ between ethnicities is intriguing. These traits may be proxies for different exposures between different ethnicities. […] Understanding the temporal trends and host determinants of EBV serostatus are essential for rational vaccine design and deployment. […] Our data suggest that, in the UK, EBV seroconversion is taking place earlier in life, that overall EBV seroprevalence remains very high (95% of 21-25 year olds), IM incidence is increasing, and there are several environmental exposures associated with IM risk (ethnicity, deprivation, smoking, and BMI).

• #80 About Infectious Mononucleosis (Mono) | EBV and Mono | CDC

  https://www.cdc.gov/epstein-barr/about/mononucleosis.html

  Infectious mononucleosis is common among teenagers and young adults, especially college students. At least 1 out of 4 teenagers and young adults who get infected with EBV will develop infectious mononucleosis. […] EBV is the most common cause of infectious mononucleosis, but other viruses can cause this disease. Typically, these viruses spread most commonly through bodily fluids, especially saliva. […] There is no vaccine to protect against infectious mononucleosis. […] Healthcare providers typically diagnose infectious mononucleosis based on symptoms. […] Laboratory tests are not usually needed to diagnose infectious mononucleosis. However, specific tests may be needed for patients who do not have a typical case of infectious mononucleosis.

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