Mononucleosis: Can it recur? (2023)

Can mononucleosis come back? I thought that once you get mono you can't get it again.

Most people who have mononucleosis, also called mono, will have it only once. The disease often goes away in 2 to 4 weeks after causing symptoms such as fever and fatigue.

Mono is caused by a viral infection. Most cases of mononucleosis are caused by the Epstein-Barr virus (EBV). Once you catch the virus, you carry it for the rest of your life.

Some studies suggest that it's possible to get mononucleosis again after you recover from mono linked toEBV. More research is needed to understand the extent, if any, that this happens in otherwise healthy adults. But overall, it's highly unlikely to happen. Most people will never have another bout of mono caused byEBV.

After you recover from mononucleosis caused byEBV, it's possible to get mono again from a different source. It doesn't come back, but instead is a new infection. Some causes of mono other thanEBVare:

  • Cytomegalovirus.
  • Toxoplasmosis.
  • HIV.
  • Rubella.
  • Hepatitis A, B or C.
  • Adenovirus.

Talk to your health care provider if you've had mononucleosis before and you think you have symptoms of it again. Mono symptoms can include:

  • Extreme tiredness.
  • Head and body aches.
  • Fever.
  • Sore throat.
  • Swollen lymph nodes in the neck and underarms.
  • Rash.

Other illnesses can cause these symptoms as well. See your health care provider to get diagnosed.

If you do have mono, your provider may suggest you avoid sports. This is because the spleen can swell during a mono infection. And a swollen spleen can be damaged by pressure on the stomach during sports.

This could happen during a contact sport. It could happen in a sport where the stomach presses on something, such as an uneven bar in gymnastics. It also could happen when stomach muscles are used, as in weightlifting.


Pritish K. Tosh, M.D.

From Mayo Clinic to your inbox

Sign up for free and stay up to date on research advancements, health tips, current health topics, and expertise on managing health.Click here for an email preview.

To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail.

Feb. 11, 2023

  1. About Epstein-Barr virus. Centers for Disease Control and Prevention. Accessed Jan. 17, 2023.
  2. Sullivan JL. Clinical manifestations and treatment of Epstein-Barr infection. Accessed Jan 13, 2023.
  3. Aronson MD. Infectious mononucleosis. Accessed Jan 13, 2023.
  4. Infectious mononucleosis. Merck Manual Professional Version. Accessed Jan 13, 2023.
  5. Kerr J. Epstein-Barr virus (EBV) reactivation and therapeutic inhibitors. Journal of Clinical Pathology. 2019; doi:10.1136/jclinpath-2019-205822.
  6. Sim B, et al. Risk factors and outcome of concurrent and sequential multiviral cytomegalovirus, Epstein-Barr virus, BK virus, adenovirus and other viral reactivations in transplantation. Current Opinion in Infectious Diseases. 2022; doi:10.1097/QCO.0000000000000888.
  7. About infectious mononucleosis. Centers for Disease Control and Prevention. Accessed Jan. 17, 2023.
  8. Tosh PK (expert opinion). Mayo Clinic. Jan. 27, 2023.
  9. Zhang XY, et al. Recurrence of infectious mononucleosis in adults after remission for 3 years: A case report. World Journal of Clinical Cases. 2022; doi:10.12998/wjcc.v10.i12.3951.
  10. Bakal D, et al. Splenomegaly from recurrent infectious mononucleosis in an NCAA Division I athlete. Current Sports Medicine Reports. 2021; doi:10.1249/JSR.0000000000000887.

See more Expert Answers



Is it possible to have a mono relapse? ›

Some studies suggest that it's possible to get mononucleosis again after you recover from mono linked to EBV . More research is needed to understand the extent, if any, that this happens in otherwise healthy adults. But overall, it's highly unlikely to happen.

How many times can mono reactivate? ›

Most people who have infectious mononucleosis (mono) will have it only once. Rarely, however, mononucleosis symptoms may recur months or even years later. Most cases of mononucleosis are caused by infection with the Epstein-Barr virus (EBV).

What causes mono to flare back up? ›

Typically your immune system can keep it inactive, but there are rare cases where it does reactivate. What causes mono flare-ups? Several factors are potential risks for having a mono flare-up. Stress, illnesses that suppress your immune system, and some cancers allow the virus to reactivate.

Can mono linger and reinfect you? ›

Once a person has had mononucleosis, the virus remains dormant in the throat and blood cells for the rest of that person's life. Once a person has been exposed to the Epstein-Barr virus, a person is usually not at risk for developing mononucleosis again.

Does mono ever flare up? ›

Mono flare-up

In rare cases, the symptoms can flare up months or even years later. EBV, which usually is what causes a mono infection, remains in your body for the rest of your life. It's usually in a dormant state, but the virus can be reactivated.

Can mono reactivate from stress? ›

Can mono come back with stress? Chronic stress can weaken your immune system, so it's possible that this could be one trigger leading to a bout of recurrent mono.

Do you always test positive for mono after having it? ›

A small number of people with mononucleosis may never have a positive test. The highest number of antibodies occurs 2 to 5 weeks after mono begins. They may be present for up to 1 year. In rare cases, the test is positive even though you do not have mono.

How do you get rid of reactivated mono? ›

Antiviral therapy such as ganciclovir and vidarabine. Immunosuppressive agents such as cyclosporine and corticosteroids. Immunomodulatory therapy such as interferon alpha and interferon-gamma. Cytotoxic chemotherapy such as anthracyclines, etoposide, cyclophosphamide, vincristine, and prednisone.

Can you get mono twice in a few months? ›

In most cases, you cannot be infected with mono twice. Once you've been infected with the virus, it will live in your body in an inactive state. Most people will not experience a re-infection and therefore not undergo mono symptoms twice. However, in rare cases, mono symptoms may recur months or even years later.

What are the symptoms of reactivated mono? ›

What Are the Symptoms of EBV Reactivation?
  • Swollen tonsils.
  • Extreme fatigue.
  • Rash.
  • Sore throat.
  • Headache.
  • Enlarged spleen (splenomegaly)
  • Swollen liver.
  • Swollen lymph nodes.
May 26, 2023

What are the 4 stages of Epstein Barr virus? ›

For EBV we have a six-stage model of infection (naive Blast, GC, memory, Immediate early lytic, Early lytic and Late lytic) where each stage may or may not be regulated by the immune response.

How do you know if Epstein Barr is active? ›

Blood tests for Epstein-Barr virus (EBV) antibodies are used to help diagnose EBV infection, the most common cause of infectious mononucleosis (mono), if a person is symptomatic but has a negative mono test.

Does mono weaken your immune system forever? ›

Mono itself doesn't weaken the immune system. In even rarer cases, mono can lead to something called chronic active EBV (CAEBV) disease. This is a serious condition in which mono symptoms last longer than six months. If you experience this or any of the symptoms we've listed below, seek medical attention.

What foods are not good for Epstein-Barr virus? ›

Avoiding sugar is also important for managing EBV symptoms, as sugar can increase inflammatory responses, impacting the immune system. Drinking water is also crucial in managing symptoms related to EBV.

What kills Epstein-Barr virus? ›

Is there a cure for Epstein-Barr virus? There is no cure for Epstein-Barr virus and there is no vaccine to prevent the spread of the virus. Treatment addresses the symptoms of the virus and symptoms should go away after two to four weeks.

How long does mono reactivation last? ›

Symptoms last around two to four weeks and may include: Swollen tonsils. Extreme fatigue. Rash.

How do you treat a mono flare up? ›

There's no specific therapy available to treat infectious mononucleosis. Antibiotics don't work against viral infections such as mono. Treatment mainly involves taking care of yourself, such as getting enough rest, eating a healthy diet and drinking plenty of fluids.

Does mono come in waves? ›

Mono usually comes in three stages for most people. The timeline can vary between individuals. The first stage (prodrome) can last up to two weeks. The second stage of mono (acute phase) can last up to six weeks.


Top Articles
Latest Posts
Article information

Author: Jeremiah Abshire

Last Updated: 15/11/2023

Views: 5373

Rating: 4.3 / 5 (74 voted)

Reviews: 89% of readers found this page helpful

Author information

Name: Jeremiah Abshire

Birthday: 1993-09-14

Address: Apt. 425 92748 Jannie Centers, Port Nikitaville, VT 82110

Phone: +8096210939894

Job: Lead Healthcare Manager

Hobby: Watching movies, Watching movies, Knapping, LARPing, Coffee roasting, Lacemaking, Gaming

Introduction: My name is Jeremiah Abshire, I am a outstanding, kind, clever, hilarious, curious, hilarious, outstanding person who loves writing and wants to share my knowledge and understanding with you.