Infectious mononucleosis, often referred to as “mono” or “the kissing disease” is an infection caused by the Epstein-Barr Virus (EBV). The reason it’s called the “kissing disease” is because the virus is transmitted by saliva, so you can get it through kissing, but also from a cough or sneeze, or sharing a glass or utensils with someone who is infected with mononucleosis. Typically the infection is most common in adolescents, with 35-50% of them showing symptoms, but also can be seen in young children, but these cases often go unnoticed for lack of symptoms.
Greatest risk groups for mono include:
• Adolescents and young adults aged 15-25 years
• People with a problem with their immune system, or on immune system suppressing medications
Once being exposed to the virus through saliva, symptoms of the infection don’t tend to show up until about 4 to 6 weeks, this is called the incubation period. The incubation periods can be shorter in children. Once symptoms do show up, they typically tend to last one to two months, but can be longer.
• Sore throat
• Fatigue and general feeling of unwellness
• Swollen lymph nodes in the neck and armpits
• Swollen tonsils
• Muscle weakness
• Skin rash
• Swollen spleen (diagnosed by a doctor, and confirmed by imaging)
Your doctor can usually diagnose mono based on your presenting symptoms, and by performing a physical exam. Other tests your doctor will order include a white blood cell count and Epstein-Barr Virus antibodies to confirm your diagnosis, and an ultrasound to assess your spleen size.
Like most viruses, there is no treatment for infectious mononucleosis, and there are no vaccines to prevent it. The best treatment is getting lots of rest, drinking lots of fluids (water and juice), and eating a healthy diet. Over the counter pain relievers, like acetaminophen (Tylenol) or ibuprofen (Advil), may be helpful for pain or to reduce a fever. In some cases steroidal medications may be given to help ease some of the symptoms associated with mono.
The most common complication of mono is an enlarged spleen. Because the spleen is enlarged, it is at risk for rupture. It is best to avoid any vigorous activity and sports while you are infected with mono and for about a month after but may be longer based on your personal ultrasound results. It is for this reason that the spleen is monitored by ultrasound.
Mono can sometimes be hard to distinguish from other viral illness, like the flu. If treating the symptoms at home with rest, healthy diet and plenty of fluids doesn’t seem to be helping, then it is best to see your family doctor.
– Dr. Christina Cesareo and Dr. G Paul Dempsey