既往数据表明,IM 发病率为 50 例/10 万 -100 例/10 万,并在 15-19 岁时达到峰值。[10]Heath CW, Brodsky AL, Potolsky AI. Infectious mononucleosis in a general population. Am J Epidemiol. 1972;95:46-52.http://www.ncbi.nlm.nih.gov/pubmed/5007364?tool=bestpractice.com[11]Henke CE, Kurland LT, Elveback LR. Infectious mononucleosis in Rochester, Minnesota, 1950 through 1969. Am J Epidemiol. 1973;98:483-490.http://www.ncbi.nlm.nih.gov/pubmed/4767624?tool=bestpractice.com来自苏格兰的数据表明发病率有所下降;阳性年检测率从 1997 年的 174 例/10 万下降到了 2012 年的 67 例/10 万。[12]Visser E, Milne D, Collacott I, et al. The epidemiology of infectious mononucleosis in Northern Scotland: a decreasing incidence and winter peak. BMC Infect Dis. 2014 Mar 20;14:151.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3999936/http://www.ncbi.nlm.nih.gov/pubmed/24650116?tool=bestpractice.com
来自不同国家/地区的血清阳性率研究一致性显示,以往有超过 90% 的成人在 40 岁之前感染过 EB 病毒 (EBV)。[13]Pariente M, Bartolome J, Lorente S, et al. Age distribution of serological profiles of Epstein-Barr virus infection: review of results from a diagnostic laboratory [in Spanish]. Enferm Infecc Microbiol Clin. 2007;25:108-110.http://www.ncbi.nlm.nih.gov/pubmed/17288908?tool=bestpractice.com[14]Ternak G, Uj M, Szucs G, et al. Sero-epidemiologic study of Epstein-Barr virus markers in patients without mononucleosis at a department for infectious diseases. Orv Hetil. 1995;136:2727-2730.http://www.ncbi.nlm.nih.gov/pubmed/8532326?tool=bestpractice.com[15]Pereira MS, Blake JM, Macrae AD. EB virus antibody at different ages. Br Med J. 1969;4:526-527.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1630375/pdf/brmedj02060-0032.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/4902364?tool=bestpractice.com 一项在英国儿童和成人中进行的大型研究发现,EBV 血清阳性率从 5-14 岁年龄组中的 39% 上升到 35-40 岁年龄组中的 90%。[15]Pereira MS, Blake JM, Macrae AD. EB virus antibody at different ages. Br Med J. 1969;4:526-527.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1630375/pdf/brmedj02060-0032.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/4902364?tool=bestpractice.com 在美国 6-19 岁的儿童和青少年中,总血清阳性率为 66.5%,并且该比率从 6-8 岁儿童中的 54.1% 升高至 18-19 岁青少年中的 82.9%。[16]Dowd JB, Palermo T, Brite J, et al. Seroprevalence of Epstein-Barr virus infection in U.S. children ages 6-19, 2003-2010. PLoS One. 2013 May 22;8(5):e64921.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3661547/http://www.ncbi.nlm.nih.gov/pubmed/23717674?tool=bestpractice.com
在发展中国家,大多数儿童会在 4 岁时染上 EBV。[17]Schuster V, Kreth HW. Epstein-Barr virus infection and associated diseases in children. I. Pathogenesis, epidemiology and clinical aspects. Eur J Pediatr. 1992;151:718-725.http://www.ncbi.nlm.nih.gov/pubmed/1330572?tool=bestpractice.com 在发达国家,原发性 EBV 感染往往在较大年龄的人群中发生,约 25%-75% 的 EBV 感染人群会发生 IM。[18]Crawford DH, Macsween KF, Higgins CD, et al. A cohort study among university students: identification of risk factors for Epstein-Barr virus seroconversion and infectious mononucleosis. Clin Infect Dis. 2006;43:276-282.http://www.ncbi.nlm.nih.gov/pubmed/16804839?tool=bestpractice.com[19]Niederman JC, Evans AS, Subrahmanyan L, et al. Prevalence, incidence and persistence of EB virus antibody in young adults. N Engl J Med. 1970;282:361-365.http://www.ncbi.nlm.nih.gov/pubmed/4312365?tool=bestpractice.com 来自发达和某些发展中国家/地区的流行病学数据显示,原发性 EBV 感染持续转移至年长患者,使青少年和成人的重度感染发生率升高。[20]Takeuchi K, Tanaka-Taya K, Kazuyama Y, et al. Prevalence of Epstein Barr virus in Japan: trends and future prediction. Pathol Int. 2006;56:112-116.http://www.ncbi.nlm.nih.gov/pubmed/16497243?tool=bestpractice.com
IM 暴发不常见,可能是 EBV 传播效率较低所致。 IM 潜伏期约 30~50 日,但在幼儿中潜伏期可能较短。 无明显种族或性别易感性。 IM 发病率未显示季节性。