Infectious Mononucleosis (Mono)
By: Trever Jones 2006.03.05
What is Mononucleosis?
Infectious mononucleosis is also known as "The Kissing Disease" and as glandular fever. It is mainly found in individuals between the ages of 10 and 30 years old. It is usually caused by the Epstein-Barr virus (EBV). EBV, which is a member of the herpes virus family, is very common, and most people (in the US, 95% of adults over the age of 35) have been infected with it at some time, although many don’t realize they have had it. When young children are infected with the virus, they usually either have no symptoms, or they are impossible to tell apart from other mild illnesses of childhood. When infection with EBV occurs during adolescence or young adulthood, it causes mono from 35% to 50% of the time. Not everyone who is exposed to the virus will develop mono.
Transmission
- Saliva-based.
- Kissing with saliva exchange-(quick cheek smooch usually is safe)
- May be spread by sharing eating utensils, straws, or toothbrushes with an infected person.
- Thought to occasionally spread through sneezing or coughing, which spread tiny saliva droplets.
- May be spread by people who have the virus without having symptoms.
- Thought to be more contagious when the infected person has a fever.
- EBV remains inactive in a few cells in the throat and blood for the rest of the person’s life, and may reactivate periodically. This reactivation usually happens with no symptoms of illness, but the virus is capable of infecting others during this time.
Signs & Symptoms
Symptoms of mono usually appear sometime within 4-7 weeks of infection with the virus:
- Fever, chills
- Sore throat-may be extreme
- Tender, enlarged lymph glands in the neck, underarm, and groin
- Headache
- Sore, aching muscles and/or joints
- Skin rash
- Loss of appetite
- Nausea, vomiting
- Abdominal pain (from swollen liver or spleen)
- Yellowing of the skin or whites of the eye (related to liver involvement)
Symptoms of mono usually clear up in about 1-2 months, although fatigue may linger for several weeks to months longer.
Complications
Complications are rare. They occur in 1-5% of cases.
- Central nervous system infections, including meningitis or encephalitis
- Breathing problems from swollen tonsils
- Rupture of the spleen
- Heart problems
- EBV may play a role in the development of two rare cancers not normally found in the US —Burkitt’s lymphoma and nasopharyngeal carcinoma.
Pregnancy:
- There are no known associations between active EBV infection and problems during pregnancy.
Diagnosis
A clinical diagnosis is usually made on the basis of the three hallmark signs of fever, sore throat, and swollen glands lasting 1-4 weeks.
- Positive ‘”Monospot” blood test.
- Increased numbers of white blood cells
Treatment
- Since the disease is viral, there is no medication to cure it.
- Treatment aimed at reducing discomfort and symptoms.
- Avoid alcohol
- Increase fluids
- Corticosteroids to reduce throat swelling
Prevention
- There is no vaccine against this virus.
- Do not share anything that an infected person’s saliva has contacted.
- Practice good hand washing.