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Prognosis

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The illness has a variable course. In many cases symptoms resolve in 2-4 weeks. However in some cases fatigue, malaise, and anorexia may last for weeks or even months.

There is evidence that, in patients with infectious mononucleosis, the chronic symptom of fatigue is reported in up to one half of patients (1). Poor physical functioning consistently predicts delayed recovery (1).

After the resolution of IM symptoms, EBV may remain dormant or latent in B lymphocytes and in oropharyngeal epithelial cells for life (2) (15 – 20% of infected patients may become long term carriers) (3). Asymptomatic reactivations can occur from time to time in these patients (2).

No strong data exist to date to routinely implicate EBV as an aetiological agent of chronic fatigue syndrome. (4)

References:

  1. Candy B et al. Recovery from infectious mononucleosis: a case for more than symptomatic therapy? A systematic review. Br J Gen Pract 2002; 52: 844-51
  2. Center for Disease Control (CDC) 2006. National Center for Infectious Diseases - Epstein-Barr virus and Infectious Mononucleosis
  3. Health Protection Agency (HPA) 2009. HPA North West - Glandular fever
  4. Katz BZ. Update on chronic fatigue syndrome and Epstein-Barr virus. Pediatr Ann. 2002 Nov;31(11):741-4.

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