Mononucleosis, often referred to as “mono”, is a very common viral illness often caused by the Epstein-Barr virus (EBV). About 90 percent of people over age 35 have antibodies to mono in their blood, which means that they have been infected with it, probably during early childhood. When mono strikes young children, the illness is usually so mild that it passes as a cold or the flu. When it occurs during adolescence or adulthood, however, the disease can cause much more serious problems. EBV is spread primarily through the exchange of saliva, which is why mono is sometimes called the “kissing disease.” However, coughing or other contact with infected saliva can also pass it from one person to another.
Mono comes on gradually. Once the EBV virus invades the body, it can take four to ten weeks for symptoms to develop. The early symptoms are typically flu-like – fever, headache, possibly severe sore throat, unusual fatigue, and muscle aches. The following additional symptoms may also appear: loss of appetite, a red rash usually forming on the chest, weight loss, joint aches, abdominal pain, chills, enlarged lymph nodes, enlarged spleen. Less often, one may also experience difficulty breathing, coughing, nausea, vomiting, jaundice (a yellow tinge to the skin and eyes), light sensitivity, or irregular heart rhythms.
The wide range of symptoms associated with mono can make diagnosing it difficult. A throat culture can be taken to rule out strep throat, and a blood sample may be taken to look for the presence of abnormal white blood cells. A monospot test, in which your blood is examined for special antibodies to mono, may also be done. These tests do not always give clear results, however, and additional ones may be needed. The reason is that it takes some time for the body to produce these antibodies. One might get an initial negative result only to get a positive one a week later.
Mononucleosis is usually a self-limiting illness and is not highly contagious. Most people recover on their own without any treatment within two to three weeks. Fatigue can linger for two months or longer. The primary recommendation is getting plenty of rest and drinking plenty of fluids, with a gradual return to normal activity. Because the spleen is often enlarged and, as a result, at a greater risk of rupture, strenuous activities and contact sports should be avoided for several weeks. Also, anyone with a diagnosed enlarged spleen should avoid lifting heavy objects. About 10 percent of those with mono develop a simultaneous bacterial throat infection that requires treatment with antibiotics. Ibuprofen or acetaminophen can be taken to fight fever and body aches while a steroid may be prescribed to reduce the size of swollen tonsils. Cold drinks, frozen desserts, and gargling with salt water can help to relieve minor pain. During the acute stage, avoid kissing as well as sharing food, drinks, or utensils with other people.
See a health care provider if you develop persistent fatigue or flu-like symptoms, or if you have a severe sore throat that does not go away after a few days.
Not everyone who comes in proximity to someone infected with mono comes down with the illness. A healthy immune system makes it possible to fight off the infection successfully.
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Sheera LaBelle can be contacted at [email protected].