Mono health facts
- Mononucleosis, or mono, is a common illness most often caused by the Epstein-Barr virus. One catches mono after coming in contact with the saliva of a person infected with mono, which is why it is often called “the kissing disease.”
- The disease most often occurs in teens and young adults, causing flu-like symptoms such as fatigue, fever and sore throat. Children can also get mono but are less likely to experience symptoms.
- Though not a serious illness, people who suspect they have mononucleosis should see their primary care provider for an accurate diagnosis, to learn steps to getting over it, and to rule out other causes of the symptoms.
- Mono symptoms usually last 2 to 4 weeks, though fatigue and tiredness can linger for longer, even months.
- Treatments generally involve rest, staying hydrated and over-the-counter medications for symptom management.
What is mononucleosis, which is also called the kissing disease?
Mononucleosis, or mono, is a common illness most often caused by the Epstein-Barr virus (EBV). It is also called the “kissing disease” because it is usually caused by coming in contact with the saliva of an infected person. This can also happen by drinking after, sharing food with, or being sneezed on by an infected person. Coming in contact with other bodily fluids can also spread the condition.
Mono most often occurs in teens and young adults, though children can also get it. The disease does not often occur in adults over age 35. It causes flu-like symptoms such as fatigue, fever and sore throat.
Though not a serious illness, people who suspect they have mononucleosis should see their primary care provider for an accurate diagnosis. This is important in order to:
- Begin recovery by ceasing physical activity for 4-6 weeks.
- Rule out other causes of symptoms, the most important being infection by HIV (human immunodeficiency virus).
- Begin treating symptoms.
- Understand the need for a follow-up to be cleared to resume normal activity.
Why is mononucleosis called the kissing disease?
The Epstein-Barr virus that causes it is usually spread by contact with the saliva of an infected person, which is most likely to happen during kissing. But it can be caused by drinking after, or being sneezed on by, an infected person.
Who is most likely to get it?
Younger people aged 15-24, people working in the medical field or as caregivers, and students or anyone in contact with large groups of people.
What are the symptoms?
Sore throat, fatigue, swollen lymph glands, head and body aches, and fever. Sometimes adults and teens don’t have any symptoms, and most children have no symptoms.
When should someone with mono see a primary care provider?
If a person suspects his or her symptoms are mononucleosis, they should see a doctor for a definitive diagnosis to start managing the condition. One should also seek medical care when symptoms get worse or new symptoms develop.
What are mono treatments?
There’s no treatment to cure the disease, only to lessen the symptoms. Fever and sore throat can be helped by over-the-counter medications. Home help includes:
- Getting lots of rest, and ceasing physical activity for 4 to 6 weeks.
- Gargling with salt water.
- Staying hydrated.
How long does mono last?
Most people recover within two to four weeks. Sometimes symptoms can linger for more than four months.
How can people prevent getting the kissing disease?
It’s almost not possible to prevent getting mono, though the risk of getting it can be reduced by avoiding contact with people who have it. This includes kissing, sharing food and other personal items.
What causes mono and who is likely to get it?
According to the American Academy of Family Physicians (AAFP), about 95% of people at some time get Epstein-Barr virus. EBV is a herpes virus that becomes clinically infectious mononucleosis in 5 out of 1,000 people and causes 90% of mono cases. In medical practices that see a high population of young adults, as we do at HealthFit Family Medicine, incidence of the disease increases to anywhere from 9 to 48 people per 1,000.
Most people are infected before adolescence and people aged 15 to 24 are most likely to develop symptoms, which are more often severe in this age group. Why teens are more likely to have symptoms is not clear.
Younger children also get mono but usually have mild symptoms or no symptoms. Parents can often mistake mono symptoms in their child for a cold or flu. Only 1 in 1,000 children under age 10 get infectious mono.
Mononucleosis is uncommon in adults because the prevalence of EBV in the population means they most likely have been previously exposed to the virus.
In the United States, symptomatic mono is 30 times more likely to occur in whites than blacks. This may be due to earlier and more frequent exposure to EBV in blacks.
What are mono symptoms?
Mono symptoms vary considerably among different age groups. Children often have no symptoms, while teens and young adults most often have symptoms and they are more severe than for other age groups. The condition is often mistaken for the flu due to similarity of symptoms.
Classic symptoms include
- Fatigue and being very tired.
- Sore throat.
- Swollen and tender glands in the neck and underarms.
- Enlarged spleen.
- Swollen liver.
Mononucleosis symptoms usually go away in 2-4 weeks. But some people can experience fatigue and tiredness for months.
Most of the time, the virus causing the mono infection remains dormant in the body. The virus can reactivate in some people, though this usually does not occur. People with weak immune systems are more likely to experience symptoms if the virus does become active again after the initial case.
Our healthcare providers are likely to suspect infectious mono in people 10 to 30 years old who have sore throat, fatigue, fever and swollen lymph node glands. We will first talk to the patient about symptoms and do a physical evaluation of the symptoms. A blood test for a certain kind of white blood cell count can support a diagnosis of mononucleosis.
To reach a definitive diagnosis for mono infection, we will perform a monospot test to see if heterophile antibodies are present. The immune system produces these antibodies as a response to EBV infection. The AAFP says the heterophile antibody test is 71% – 90% effective in diagnosing mononucleosis, though a 25% rate of false-negative results occurs in the first week of the illness.
However, a negative monospot test does not always mean a patient does not have mono. So if we still suspect the disease as the cause of symptoms, we may need to conduct further blood testing.
No specific treatment can cure mononucleosis, and treatments are aimed at reducing the symptoms. In general, patients should take care of themselves by resting, eating a healthy diet and drinking plenty of fluids. Antibiotics don’t work against viral infections like mononucleosis, though sometimes strep throat can accompany the condition and we may use antibiotics to treat that.
HealthFit providers base treatment on several patient-specific factors. These include the severity of symptoms, how long we think they will continue and the patient’s age, overall health, tolerance for medications and therapies, and personal preferences.
- Rest, which gives the immune system time to kill the virus.
- Stopping physical activity for 4 to 6 weeks, which can reduce the risk of complications.
- Over-the-counter medications to address symptoms like fever and sore throat.
- Always staying hydrated.
- When necessary, we may use corticosteroids initially to reduce swelling of the tonsils and throat.
The majority of patients with mononucleosis recover just fine. Recovery in 2 to 4 weeks is common. But symptoms may be present for several weeks and prevent a person from being able to perform normal activities. If new symptoms present or current ones get worse, call our office.
Complications from mononucleosis
Fortunately, people usually do not experience complications from a case of this infectious disease. Those that may occur include:
- Kidney inflammation.
- A rupture of the spleen.
- Upper airway obstruction.
- Anemia due to abnormal breakdown of red blood cells.
- Problems with the nervous system such as meningitis and others.
- Heart muscle inflammation.
- Problems with heart rhythm.
When seeing a patient for mono, we explain the signs of these complications. Patients experiencing any of the above, or who suspect any of the above, should check back with our providers. Sometimes they should go to a hospital if they feel their complications are dire.