Mononucleosis, also known as “the kissing disease,” is a viral illness, with the Epstein-Barr virus (EBV) infecting over 90% of people worldwide. Yet, not everyone who contracts EBV will develop visible symptoms of mononucleosis.
This contagious illness leaves you feeling tired and achy for weeks. Most children and young adults are exposed to EBV at some point while growing up.
Understanding this condition is important because, while it's usually a mild illness, it can lead to complications and long-term discomfort. Read this blog to learn more about mononucleosis, how it affects children, its symptoms, causes, prevention, and more.
What is Mononucleosis(Mono)?
Mononucleosis, in short, “Mono,” is a viral illness caused by an EBV virus. It commonly affects children and young adults. It's known for its characteristic symptoms, including extreme fatigue, fever, and a sore throat.
Mono spreads primarily through bodily fluids such as saliva. That's why it's popularly called “the kissing disease.”
Epstein-Barr virus (EBV) is an omnipresent virus that is responsible for causing infection Mononucleosis. Most Americans are infected with it by age 35. Interestingly, not everyone has developed mono symptoms – Some people only carry the virus.
What Causes Mono?
Mononucleosis is primarily caused by the Epstein-Barr virus (EBV). EBV is a member of the herpesvirus family, specifically herpesvirus type 4. This virus is highly prevalent, with roughly 90% of adults worldwide having been infected with EBV at some point in their lives.
As stated by the Centers for Disease Control and Prevention (CDCP), mononucleosis occurs 25% of the time when a teenager is infected with EBV.
Mono is highly contagious and spreads through the exchange of bodily fluids, such as saliva. Common modes of transmission are:
- Kissing an infected person
- Sharing personal items like spoons, toothbrushes, and utensils with an infected person
- Touching toys and other objects that children have drooled on.
- Sharing drinks with an infected or disinfected person
EBV can also spread through blood and semen using sexual contact as well as blood transfusion.
ii) Incubation period:
After initial exposure to EBV, there is an incubation period before the mono symptoms start to appear. The incubation period means how long before your symptoms become noticeable after you get exposed to the virus.
This incubation period usually lasts for four to six weeks. The virus enters the body and replicates during this phase, but the person may not develop any visible symptoms.
iii) Active infection:
Once activated, the virus may live inside the body for months or even years. That means it stays in a lethargic or inactive state.
During this time, an infected person may spread the illness to others even if they do not show any symptoms themselves. The mono virus primarily attacks B lymphocytes, a type of WBC, and can cause the symptoms of mononucleosis.
Signs and Symptoms of Mono
The symptoms of mono usually last for about one to two months. The most common signs and symptoms of mono include:
- Persistent high fever (Temperature >100.4°F)
- Extreme tiredness and weakness
- Sore throat with swollen tonsils
- Enlarged lymph nodes or swollen glands in your neck and armpits
- Skin rash
- Sore muscles and stiffness
- Enlarged liver or spleen
- Loss of appetite
- Upper respiratory symptoms
An enlarged spleen is a less common sign but can be too risky. For some individuals, their spleen may remain enlarged even after their fatigue ends.
The symptoms are similar to the flu or common cold. That's why it's difficult to differentiate from other common viruses. As a result, if the symptoms don't improve after one or two weeks, speak to your doctor.
How Long Does Mono Last?
The duration of infectious mono can vary from person to person. Most people begin to experience symptoms about four to six weeks after being infected with the EBV. While some people recover within a few weeks, others may have symptoms that persist for several months.
Fatigue is often the most typical symptom and may linger for several weeks, even after other symptoms have resolved. In some cases, it may take up to six months for a person to fully regain their energy levels.
Additionally, symptoms such as fever and sore throat usually reduce within two weeks. But swollen spleen and enlarged lymph nodes may last around four to six weeks or longer.
How is Mono Diagnosed?
Diagnosing mono can be quite difficult since the symptoms are similar to other illnesses like flu. The doctors usually diagnose mono based on a person's symptoms.
They may conduct a physical examination to check for common symptoms such as swollen lymph nodes, tonsils, and an enlarged spleen.
After evaluating symptoms, they may also review the patient's medical history, including any recent exposure to individuals who might be infected with EBV, activities that could lead to transmission, and the duration of symptoms.
Medical tests are not usually needed to diagnose infectious mononucleosis. However, specific lab tests can be done to discover the cause of mono illness.
Some of the laboratory tests could include:
i). Complete Blood Count (CBC) – Sometimes, doctors request a complete blood count test. This blood smear test shows if you have increased lymphocytes (normal WBC) and atypical lymphocytes (unusual-looking WBC) present, which might indicate you have developed infectious mononucleosis.
ii). White Blood Cell count – A mononucleosis usually causes your body to produce more white blood cells (WBC) as it tries to defend itself. A high WBC count shows a strong possibility of infection with EBV.
iii). Monospot Test – This is one of the most reliable techniques to diagnose mononucleosis. This test targets antibodies in the blood. However, it doesn't specifically look for EBV antibodies.
Rather, it detects other antibodies your body will likely produce when you are infected with EBV (Heterophile antibodies)
iv). EBV antibody test – The EBV antibody test is done if your mono spot test shows negative. Here, the doctor will look for proteins that your immune system develops in response to EBV, i.e., EBV-specific antibodies.
If EBV antibodies are found, it means you were infected lately. If other types of antibodies are found, it signifies you were infected in the past.
It’s interesting to know that about 9 out of 10 adults worldwide have antibodies that show that they have a current or past EBV infection.
There is no particular way to treat infectious mononucleosis. It goes away in two to four weeks on its own. However, some doctors may prescribe an anti-inflammatory medication to lower throat and tonsil swelling.
In the case of mono treatment, you should aim to ease the symptoms while your immune system contains the EBV. Also, no antiviral drugs are known to treat infectious mononucleosis effectively.
Home Remedies To Treat Mono
There are a few home remedies to relieve your symptoms caused by EBV. They include:
- You can use over-the-counter (OTC) drugs to reduce your fever or throat pain. For example, acetaminophen and ibuprofen.
- Gargling salt water, taking lozenges, and sucking on ice cubes to relieve sore throat.
- Stay hydrated by drinking lots of water and juices (Ideally 8 glasses).
- Get plenty of sleep and rest to recover.
- Avoid going out often to prevent transmitting the virus to others.
- Sip warm chicken soup to soothe your throat pain.
- If you have a high fever, cool down with a wet towel and compress.
- Eat healthy foods that are rich in antioxidants to boost your immune system. For example, vegetables, brown rice, olive oil, and salmon.
- Take supplements to improve your immune and gut health. For example, omega-3 fatty acids, probiotics, and vitamin supplements.
- Do not get involved in strenuous activities like sports or weight lifting, as it can further complicate your enlarged spleen.
How can I prevent mononucleosis (mono)?
There is no vaccine developed to protect against EBV infection or mono. The best and only way to prevent mono is to stay away from infected people.
If you’re infected, stop sharing dishes, food, drinks, and utensils until the fever has improved, and even longer if possible. Be cautious in crowded or close-contact settings.
Also, avoid kissing anyone, as the virus is associated with saliva. Remember to wash your hands with soap often to prevent the spread of the virus.
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Mononucleosis Complications & Long-term Effects
While mononucleosis is usually a self-limiting illness, it can lead to serious complications in some cases, including:
One of the major concerns with mono is the enlargement of the spleen. The spleen is an organ in the left upper abdomen and part of the immune system. It's responsible for filtering blood and fighting infection.
When a person becomes infected with EBV, the spleen becomes enlarged. In some cases, the spleen can enlarge to a dangerous size, which increases the risk of splenic rupture. If your spleen tears, it can bleed into your abdomen (hemorrhage).
Internal bleeding due to splenic rupture could be life-threatening and requires immediate surgery. Therefore, if someone with mono experiences sharp abdominal pain, they must consult a healthcare professional right away.
That's why people with mono are advised to avoid strenuous physical activities or sports until their spleen returns to its normal size or symptoms are gone.
Mono infection can lead to swelling of the tonsils. They block your airway, making it difficult to breathe or swallow through your mouth. It may also cause discomfort or sore throat.
Liver inflammation, such as hepatitis, can occur in mono, resulting in high liver enzymes and potentially leading to liver dysfunction. Symptoms may include abdominal pain, dark urine, and jaundice.
Infectious mono may affect blood cell counts, leading to serious conditions like anemia or thrombocytopenia, where there's a reduced number of red blood cells or platelets in the blood. These conditions can result in fatigue, weakness, and an increased risk of bleeding.
Nervous system problems:
In extremely rare cases, mononucleosis can lead to neurological complications, affecting your nervous system. This includes brain inflammation, seizures, or meningitis.
Although very uncommon, some people with mono may experience heart problems, such as inflammation of the heart muscle (myocarditis) or an irregular heart rhythm (arrhythmia). These conditions can lead to chest pain, shortness of breath, and palpitations.
Chronic fatigue syndrome:
A small percentage of people with mono experience lingering fatigue that lasts for several (6-8) months, leading to a condition known as chronic fatigue syndrome.
When to Call the Doctor?
Many kids and young adults who suffer from mononucleosis recover soon without long-term complications. Only in rare circumstances, the above complications can happen. If any of the below signs occur, take your child to the doctor right away.
- Intense and sharp pain in the upper left abdomen could indicate a serious problem with the spleen.
- Shortness of breath
- Difficulty eating and swallowing food items
- Dehydration or unusual urine output
- Feel drowsy and restless more often
To sum it up, mononucleosis is an infectious disease caused by the Epstein-Barr virus (EBV). It is spread through the saliva of an infected person. Mono is contagious even if you don't get any symptoms.
Understanding its symptoms and adopting preventive measures are crucial for managing the disease effectively.
Rest and OTC medications are usually the best ways to ease mono symptoms. Most people with mono usually recover within two to four weeks.
If your symptoms don't get better in two weeks or you experience extreme pain in your belly, contact your doctor and seek treatment accordingly.
1. What are the causes of mononucleosis?
Ans: The most common cause of infectious mononucleosis is Epstein-Barr virus (EBV). But other viruses can also cause this illness. When someone comes in contact with the saliva of an infected person, they get transmitted by EBV.
2. What does mono affect the most?
Ans: Mono mainly triggers the spleen, making it swell for a longer period. In extreme cases, the enlarged spleen may rupture, causing sudden pain and bleeding inside the belly, which can be fatal.
3. Is mono very serious?
Ans: No. Mononucleosis is not a very serious illness. However, it can increase the spleen's size for a long period. This will result in the rupturing of the spleen, which further causes internal bleeding in the stomach.
4. How long does mono last?
Ans: Mono illness typically lasts for about four to six months after getting infected. However, in children, the duration might be shorter.
5. Can you catch mono from someone?
Ans: Yes. The virus that causes mono is usually transmitted through a person's saliva. Hence, casual contact with an infected person does not increase the risk. But it can be done by kissing, sharing spoons and toothbrushes, and even oral sex with the infected person.
6. Does mono go away on its own?
Ans: Mono symptoms are common and usually go away on their own after one to two weeks. Only if you get plenty of rest, drink water and juices, and eat healthy foods.