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Infectious Mononucleosis (Mono)

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.

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