Mononucleosis

Mononucleosis

Mononucleosis, also called mono or the “kissing disease”, is a syndrome, or set of symptoms, most often caused by infection with Epstein Barr Virus (EBV). Mono is most common in people ages 15 to 35. Like the common cold, mono is spread by exchange of saliva, either by kissing or sharing utensils, drinks and food. The classic presentation of mono includes terrible sore throat lasting 7-10 days (unless treated), and accompanied by lymph node enlargement in the neck, followed by 2-4 weeks of fatigue, which can be quite dense initially. Some people’s fatigue can last even longer. People are most contagious when they are most sick, but may remain contagious for over a year. Some people have so few symptoms that they aren’t sick enough to get diagnosed with mono. For these reasons, it is probably most often spread by people who don’t realize they are contagious. It is rare to get mono more than once. Studies have shown that upwards of 80% of college graduates will have been exposed to EBV.

Most people with mono develop inflammation of both the liver and spleen. Because of liver inflammation, avoidance of alcohol for at least 30 days is advisable. Because of spleen inflammation, and potential risk of rupture, vigorous physical activities, especially strenuous lifting and contact sports, should be avoided for the first 30 days of illness.

Prevention

  • Wash your hands often
  • Limit the number of people with whom you share saliva. This can also decrease the likelihood of your getting other viral infections such as colds, flu and gastroenteritis.
  • Get plenty of sleep, maintain a good diet and exercise regularly to keep your immune system strong

Treatment

Home care   Home Care

  • If you have a terrible sore throat or fever or fatigue or other symptoms, you should make an appointment with a medical provider for evaluation.
  • If you have been exposed to someone with mono, but don’t have symptoms, you probably don’t require testing or treatment. There is no vaccine to prevent or specific treatment to cure EBV infection or mono. The treatment is “supportive”, which is to say focused on managing symptoms. If you don’t have symptoms, you don’t require treatment.
  • There are a variety of treatment strategies that can be effective to relieve your symptoms. Because mono is caused by a virus, not a bacteria, antibiotics will not help mono.
  • Rest and drink plenty of fluids
  • Take Ibuprofen or Naprosyn to relieve fevers and body aches
  • Avoid sports or other vigorous physical activity until you are evaluated and results of testing reviewed.

Professional care   Professional Care

Seek medical attention if:

  • If you have symptoms of mono, seek professional care
    • Mono can be diagnosed by history and physical exam
    • These findings are often confirmed by one of several tests, some of which may be done in the office while you wait.
  • If you experience left upper abdominal pain, seek immediate medical attention as this may represent rupture of your spleen