Infectious Mononucleosis, often referred to as Mono or Glandular Fever, is a contagious viral disease. Often caused by the Epstein-Barr virus (EBV), mono is a common disease affecting adolescents and young adults. According to the CDC, at least 25% of young adults who get infected with EBV will contract contagious mononucleosis.
Causes and Symptoms
The most common cause of mono is through infection with the Epstein-Barr virus. Other viruses can also cause the mono. As EBV is transmitted through saliva, people are often infected through kissing, but you can also contract it through a cough or sneeze, or by sharing silverware with an infected person.
It’s estimated that 95% of adults worldwide carry the virus. With its global reach, there’s little you can do to avoid infection, but most adults have built up antibodies so won’t contract mononucleosis. While many people present no symptoms when infected with EBV, a study by the Cincinnati Children’s Hospital found that EBV infection can lead to an increased risk of developing seven other major diseases, including celiac disease and type I diabetes.
Symptoms of mono generally appear four to six weeks after becoming infected with EBV. Symptoms vary greatly by individual, and they may develop slowly and not all occur at the same time. Common symptoms include:
- Fever
- Extreme fatigue
- Sore throat, often with swollen tonsils
- Loss of appetite
- Rashes
- Head and body aches
- Swollen lymph nodes, most often in the neck and armpits
Other less common symptoms include:
- Swollen liver, spleen, or both
- Shortness of breath
- Chest pain
- Cough
- Nosebleeds
- Rapid heart rate
- Sensitivity to light
Whilst enlarged spleen and swollen liver are the less common symptoms, they can pose a serious risk to your health. If you experience these symptoms, seek immediate medical advice.
How Long Is It Contagious?
How long does mono last and how long is it contagious are two common questions asked about this disease. Due to the long incubation period, you may not even realize you’re infected until well after the exposure. Researchers are still unsure how long you remain contagious, but some experts suggest there may be the potential for infection for up to 18 months.
Symptoms typically appear four to six weeks after infection and generally last two to four weeks. For some people, fatigue may linger for many more weeks and occasionally the symptoms of mononucleosis can last six months or more.
Who’s at Risk?
While anyone can become infected with the Epstein-Barr virus, the infection often causes mono in young people and those with weakened immune systems. Most people infected with mononucleosis will only have it once – rarely do the symptoms return months or years later.
What Can Go Wrong?
Serious complications can occasionally arise from mononucleosis. These include:
- Enlargement of the spleen – the spleen can swell to two to three times its normal size in people with mono.
- Liver issues, including hepatitis (inflammation) and jaundice.
- Anemia – a decrease in hemoglobin and red blood cells.
- Thrombocytopenia – abnormally low platelet count affecting blood clotting.
- Heart problems, such as myocarditis, or an inflammation of the heart muscle
- Nervous system complications – including meningitis and encephalitis
- Swollen tonsils or tonsillitis, which can also restrict breathing.
These complications are most likely in people with impaired immune systems.
How Is Mono Diagnosed?
Although the symptoms of mono can be broad, it’s important to seek medical advice if you feel like you may have contracted the disease. To diagnose mononucleosis, your doctor will perform a physical exam to look for:
- Swollen lymph nodes or tonsils
- Swollen liver or spleen
- Skin rash
They may then also perform some blood tests. These include:
- Mononucleosis tests including the monospot test and EBV antibody test
- White blood cell count
- Antibody titer test to differentiate between current and past infections
Treatment
Usually, no treatment for mono is needed. There’s no specific therapy or vaccine available and antibiotics don’t work on viral infections like mononucleosis. Much like the common cold, many doctors recommend staying hydrated, eating nutritious food and get plenty of bed rest.
If you’re suffering through the symptoms of mono and need relief, try out the following treatments:
- Over-the-counter anti-inflammatory drugs like ibuprofen can help reduce pain and fever
- Medicated lozenges and sprays can bring relief to a burning throat.
- Make a salt gargle – add one teaspoon of salt to warm water (not boiling) and gargle. This helps remove pus from the tonsils and throat and makes swallowing easier.
- Apply a heat bag to help reduce swelling to neck the glands.
Above all else, the best way to treat mono is with rest and hydration. Without adequate rest time and fluids, the body takes longer to recover. It’s also recommended to avoid contact sports for at least two weeks but up to six months depending on the severity of your illness. As mono can cause your spleen to swell, the danger of spleen rupture is higher for mono sufferers and care should be taken to avoid injury.
Prevention
As EBV is one of the most widespread viruses in the world, avoiding infection can be near impossible. But if you’ve never had mono before, there are steps you can take to minimize your chances of contracting the disease:
- Avoid close contact with anyone who has the disease.
- Avoid kissing anyone who’s been infected with EBV in the past.
- Don’t share drinking glasses or cutlery.
- Wash your hands regularly.
Final Word
While mononucleosis is a debilitating disease affecting a huge portion of the world’s population, the prognosis for most is good. Many people who contract the disease recover quickly and build up a life-long immunity.
If you start feeling symptoms of mono, ensure you take it easy and get plenty of rest. If your symptoms don’t improve within a few days, make an appointment with your health care professional. If left unchecked, mono could result in serious complications but can be ruled out with some simple blood tests.
References:
https://en.wikipedia.org/wiki/Infectious_mononucleosis
https://www.cdc.gov/epstein-barr/about-mono.html
https://www.aafp.org/afp/2015/0315/p372.html
https://www.rchsd.org/health-articles/i-had-mono-5-years-ago-am-i-still-contagious/
https://medlineplus.gov/ency/article/000591.htm
https://www.mayoclinic.org/diseases-conditions/mononucleosis/expert-answers/mononucleosis/faq-20058564
https://medlineplus.gov/ency/article/003454.htm
https://www.ncbi.nlm.nih.gov/pubmed/21853428
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