THE COURSE OF INFECTIOUS MONONUCLEOSIS IN ADULTS AND CHILDREN

Abstract

Infectious mononucleosis (IM), commonly caused by the Epstein-Barr virus (EBV), is a significant health condition worldwide due to its high prevalence and impact on various age groups. Over 90% of the global population is infected with EBV by adulthood, making it one of the most ubiquitous human viruses [1]. The clinical syndrome of IM (often called “glandular fever”) typically manifests when EBV infection is acquired during adolescence or young adulthood. In contrast, children often contract EBV at an earlier age, especially in lower-income regions, but usually experience either mild illness or no recognizable symptoms [2]. This age-dependent difference in disease expression makes IM particularly relevant: it is a leading cause of prolonged fever and lymphadenopathy in teens and young adults, while frequently underdiagnosed in younger children due to its subtle presentation in that group. From a global perspective, socio-demographic factors influence the timing of EBV infection. In many developing countries and densely populated areas, most children are infected in early childhood (with seroprevalence exceeding 50% before age 3), reducing the incidence of adolescent IM [3]. Conversely, in developed countries with higher hygiene and living standards, primary EBV infection is often delayed until the second decade of life, resulting in a higher proportion of symptomatic IM cases in that age group [5].

Understanding the characteristics of IM across different ages is clinically important because the disease can disrupt schooling or work during the acute illness and occasionally leads to serious complications. Moreover, EBV’s impact extends beyond the acute infection: a symptomatic primary EBV infection (IM) in adolescence has been associated with increased risks of certain malignancies such as Hodgkin lymphoma later in life [4]. Therefore, a comprehensive, age-stratified understanding of infectious mononucleosis has global public health relevance. This article examines IM in children versus adults, highlighting epidemiological trends, clinical course differences, immune response variations, and management strategies, to inform better recognition and care of this disease in different populations.

Keywords

Infectious mononucleosis, Epstein-Barr virus (EBV), Children, Adults, Epidemiology, Clinical presentation, Immunological response, Complications