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OVERVIEW

What is mononucleosis?

Mononucleosis (often called “mono”) is contagious illness.  It’s usually caused by the Epstein-Barr virus but can be caused by other viruses, too. It’s spread through saliva. For this reason, it’s sometimes called the kissing disease. It’s most common in teens and young adults. However, anyone at any age can get it.

SYMPTOMS

What are the symptoms of mono?

Some of the symptoms of mono are similar to those of a cold or flu. Symptoms often don’t appear until 4 to 6 weeks after you’ve been exposed to the virus. Symptoms may not come at the same time, and they may come on gradually. Symptoms of mono include:

• Fatigue
• Fever
• Sore throat
• Weakness
• Swollen glands in your neck and armpits
• Swollen spleen or liver
• Loss of appetite
• Rash

Symptoms in young children are generally mild, while symptoms in adolescents and young adults tend to be more severe.

CAUSES & RISK FACTORS

What causes mono?

Most cases of mono are caused by the Epstein-Barr virus. The virus is found in saliva, mucus, and other body fluids. It can be passed between people many ways. It passed through exposure to a cough or sneeze. It can be passed by sharing food utensils (such as drinking glasses, spoons, and forks). It even can be passed from one person to another through kissing.

DIAGNOSIS & TESTS

How is mono diagnosed?

Your healthcare provider will probably first ask you some questions about your symptoms. They may do a physical exam and look for:

• Swollen lymph nodes in your neck
• Swollen tonsils
• Swollen liver or spleen

Your healthcare provider may order blood tests to confirm the diagnosis. One common test used to diagnose mono is called the Monospot test. Sometimes other blood tests are needed if the results of the Monospot test aren’t clear.

PREVENTION

Can mono be prevented or avoided?

There is no vaccine to prevent mono. The best thing you can do to avoid it is to stay away from anyone you know who has it. Don’t kiss or share utensils or other personal items with someone who is sick (or has symptoms).

TREATMENT

There isn’t a cure for mono. But the virus will go away on its own. Symptoms usually last about 4 weeks. The main goal of treatment is to relieve your symptoms. The following list includes tips on treatment:

• Sleep helps your body fight infection.
• Drink plenty of fluids. They help prevent dehydration.
• If you have a sore throat, gargle with salt water or suck on throat lozenges, hard candy or flavored frozen desserts (such as Popsicles).
• You may want to take acetaminophen (one brand name: Tylenol) or ibuprofen (some brand names: Advil, Motrin) to relieve pain and fever. Do not give aspirin to children. Aspirin should be avoided because it has been associated with a disease called Reye’s syndrome in children. Reye’s syndrome is a serious illness that can lead to death.

Do I need an antibiotic?

Antibiotics are not effective against mono. Mono is caused by a virus and antibiotics don’t work against viruses. If you have a bacterial infection in addition to having mono (such as strep throat), your healthcare provider may give you an antibiotic to treat that infection. Taking antibiotics for mono may cause an itchy rash.

What about sports and exercise?

Avoid sports, physical activities or exercise of any kind until your healthcare provider tells you it’s safe. Moving around too much puts you at risk of rupturing your spleen, especially if it is enlarged. You need to avoid physical activities and contact sports for about 3 to 4 weeks after you’ve had mono – or until your healthcare provider tells you it’s safe.

Living with mono

Most people feel better in 2 to 4 weeks. Fatigue may last for several more weeks. In some cases, symptoms can last for 6 months or longer. In addition, mono can sometimes have complications. The main complication is the enlargement of the spleen. The spleen is like a large gland. It’s located in the upper part of your abdomen on the left side. It helps filter your blood. In severe cases of mono, the spleen can rupture (tear open).

A ruptured spleen is rare in people who have mono. But it’s wise to be aware of the signs:

• Sharp pain in the left upper part of your abdomen (under the left chest)
• Feeling lightheaded
• Feeling confused
• Blurred vision
• Fainting

Other complications can include anemia, nervous system problems, or hepatitis with jaundice. These could cause symptoms including:

• Breathing difficulty
• Persistent high fevers (38.6 C/101.5 F or higher)
• Severe headache
• Weakness in arms or legs
• Yellow color in your eyes or skin (jaundice)
• Trouble swallowing

Contact your healthcare provided if you notice any of the above symptoms.