Epstein-Barr virus is a relatively common infection that’s part of the herpesvirus family. That’s not to say, however, that the symptoms and stages of Epstein-Barr virus infection are the same as other viral infections in the same category. Epstein-Barr virus (EBV) is spread through bodily fluids like saliva and is contagious – therefore, it’s important to be aware of the stages of EBV in order to recognize the condition and make a correct diagnosis.
While we understand the life cycle of Epstein-Barr virus to some extent, research into the infection is ongoing. The virus has been linked to a wide range of symptoms and can have numerous effects on the body. Below, we’ll provide an overview of EBV stages of infection and the most common symptoms to look out for at each stage. However, please note that additional conditions may also present alongside or in place of those mentioned below, and a medical opinion is necessary to make a diagnosis.
Epstein-Barr virus stages
What are the four stages of Epstein-Barr virus?
Stage 1: Dormancy
Like other viruses in the herpesvirus family, EBV undergoes two major life cycles: latency and lysis – or, dormancy and reactivation. During the first of the EBV stages of infection, the virus lies dormant and is largely asymptomatic.
At this stage, the virus focuses on slowly reproducing and growing in preparation for activating an infection. This stage can take a very long time – ranging from weeks to years – and is likely to be undetected, as few symptoms present. Often, certain triggers are responsible for activating the virus, including stress or illness (times at which the immune system is generally weaker).
Stage 2: Mononucleosis
After a period of prolonged replication and fortification, the virus will likely become symptomatic. Typically, activation of EBV causes mononucleosis or “the kissing disease” (a nickname describing the common spread of the virus through saliva). Mononucleosis can cause extreme fever, fatigue, and pain in the body.
There is no way of knowing how severe or long-lasting symptoms will be, as this depends on the individual. Anyone can be affected, but teenagers and young adults are much more likely to develop mononucleosis than other age groups. The symptoms of mononucleosis may make it difficult to continue daily life as usual, impacting school attendance. Some sufferers may feel symptoms for a few weeks, while for others they may last for several months.
Stage 3: Effects on major organs
In the latter part of Stage 2, EBV will try to reach one of your major organs. In Stage 3, the virus is settling into its chosen destination. This is one of the most challenging stages of EBV as the virus may not be detected by the immune system.
For many people, EBV can remain dormant in the body for multiple years without any symptoms presenting. However, aggressive forms of the virus can have negative effects even during dormancy. The virus produces several toxic by-products as it replicates, and releases these during times when the body is unsuspecting or compromised. In this way, the immune system may struggle to fight off infection. Stage 3 of EBV can cause symptoms such as thyroid problems and lupus, as well as several other complications.
Stage 4: Spreading throughout the body
The final stage of the life cycle of Epstein-Barr virus can present numerous symptoms that are difficult to categorize, as they vary from person to person. EBV will produce different symptoms and even triggers on a case-by-case basis. For example, some sufferers may have persistent and unexplained aches and pains in their joints, while others may notice frequent migraines or insomnia.
The variety of neurological conditions linked to Stage 4 EBV makes diagnosing the cause and battling the symptoms an extremely difficult task. However, several laboratory tests for the virus exist that may help. An estimated 90% of adults have antibodies that display a previous EBV infection.
How long does it take for EBV levels to go down?
Although symptoms can be treated, Epstein-Barr virus itself has no cure. This means that following an active infection, the virus will remain in the body forever. However, it may not always be active and can lie dormant for many years (or a lifetime). Most people will only get mononucleosis once, and often reactivation of the virus may not cause any symptoms. Those with compromised immune systems are more likely to notice symptoms and should keep a close eye on their health. How long symptoms are present depends on many factors and is largely individual.
There is no way to make EBV levels go down quickly – the best thing to do (with the advice of a medical professional) is to rest, stay hydrated, and use over-the-counter pain relief if necessary. To avoid transmission of the virus, avoid sharing cups and kissing, and always use protection during sexual intercourse.