Public Knowledge of Infectious Mononucleosis: A Cross-Sectional Survey in the Republic of Srpska (B&H)

Abstract

Infectious mononucleosis is a common viral disease, most frequently caused by the Epstein–Barr virus, predominantly affecting adolescents and young adults. Despite its high prevalence, misconceptions regarding disease etiology, transmission routes, and clinical manifestations remain widespread and may influence health-related behavior. The aim of this study was to assess the level of knowledge and awareness of infectious mononucleosis in the general population of the Republic of Srpska, with particular emphasis on disease etiology, transmission, symptom recognition, and prevention, from a health literacy perspective. A cross-sectional survey was conducted in October 2025 using an anonymous online questionnaire. The study included 225 participants aged 17–60 years. Descriptive statistical methods were applied, and differences in knowledge were analyzed according to basic sociodemographic characteristics. Although most respondents (82.7%) had heard of infectious mononucleosis, only 59.6% correctly identified the disease as viral in origin. Contact with saliva was recognized as the primary route of transmission by 65.3% of participants, while a substantial proportion reported incorrect transmission routes. Common symptoms such as fatigue and fever were widely recognized; however, specific clinically relevant manifestations, including splenomegaly and rash, were poorly identified. Women and younger respondents demonstrated higher levels of knowledge. The findings reveal important gaps in public knowledge of infectious mononucleosis, reflecting broader challenges related to health literacy. Targeted public health education focusing on accurate disease information and prevention may contribute to improved awareness, earlier recognition, and more appropriate health-related behavior.