Mononucleosis: Avoiding and Treating Mono

The kissing disease: you'd know exactly what that meant even if you hadn't read the title of this article. Mononucleosis, or mono, is a common disease that usually occurs during the teen and young adult years. Most people are exposed to the virus that causes mono at some point in their lives, and many carry this virus without even knowing that they have it. Despite being ubiquitous, however, mono is subject to a great deal of confusing misinformation.

The Spread of Mono

Mononucleosis is an infectious disease typically caused by the Epstein-Barr Virus, also known as human herpesvirus 4 (HHV-4). And although that name conjures up distressing images of sexually transmitted diseases, there's no reason to be afraid -- EBV is one of the most common viruses in all humankind.

That's not hyperbole. Here are the facts about mono and EBV:

• Mono typically occurs in 10-35 year olds, with the highest incidence rates in 15-17 year olds.
• Nearly half of all children are infected with EBV by age 5, but mono symptoms typically don't develop at this age.
• By age 40, 85-90% of Americans have EBV antibodies, rendering them immune to mono.

As a disease, mono does not spread easily, due to growing in the nose and throat and depending on infected fluids to transmit. Its long incubation period and permanency, however, makes its spread almost inevitable:

• EBV will always remain in your body, and may have occasional reactivation periods; virus particles can appear later on and be transmitted, long after having mono.
• Mono's incubation period is 4 to 6 weeks; symptoms may not appear until the end of this period, but the person is still infectious.
• Mono can be spread to others for a year after the initial infection.
• The most likely groups to contract mono are college students, nurses, and people in the military.

That last fact suggests a pattern: any place where younger people are made to cohabitate, like college dorms or military barracks, is susceptible to outbreaks of mono.

Symptoms of Mono

Mono is marked by a number of symptoms that are frustrating and uncomfortable, but mostly minor:

• Fever and chills.
• Headache or body ache.
• Lack of energy and fatigue.
• Loss of appetite.
• Sore throat, often accompanied by swollen tonsils with white patches.
• Swollen lymph nodes and glands, especially the lymph nodes in the neck.

In addition, rashes can occur, especially in patients prescribed with the antibiotics ampicillin or amoxicillin.

The most potentially concerning mono symptom is enlargement of the spleen, which may be indicated by pain in the upper left abdomen. Nearly 50% of mono patients suffer from an enlarged spleen, which may see their spleen swell to 2-3 times average size. Be careful if this happens! An enlarged spleen is vulnerable to rupture, which can be deadly. Mono patients are highly discouraged from playing sports for 3-4 weeks during and after the infection.

Diagnosing Mono

The symptoms listed above will aid a diagnosis of mono, as well as the presence of mono patients in your life, but the easiest way to confirm it and to rule out other illnesses or complications is a blood test. These tests may include:

• Mononucleosis tests (monospot test and EBV antibody test): the monospot has a potential for false negatives if early in the infection.
• Complete Blood Count (CBC test): this helps to rule out other infections or complications.
• Liver tests: in the risk the liver is inflamed or functioning poorly.
• Further blood tests: cytomegalovirus can cause an illness similar to mono, and must be ruled out if a mono test is negative.

Avoiding Mono

This is easier said than done, considering the prevalence of EBV. If you're a nervous parent or young person, you probably don't have anything to worry about. Due to the high rate of immunity, mono patients aren't quarantined. But if there's an outbreak in your school and you're worried, here are some things to avoid:

• Kissing: you probably knew this one already.
• Sharing food, drinks, or utensils.
• People sneezing or coughing.

If you have mono, you may want to wear a protective face mask to help prevent spreading the disease to others.

Treating Mono

This is easier than avoiding mono, because in the absence of complications, you're just going to let the virus run its course. This will usually take a few weeks, although fatigue may occur for months afterward. Here are some tips to help you deal with the main period of illness:

• Rest: nothing else comes close. You're going to need it, and trust us, your body will let you know that.
• Liquids: this is sounding like classic cold advice, but liquids will help reduce your fever and restore energy.
• Avoid Physical Activity: you don't want to take the chance of a ruptured spleen. Don't lift anything heavy or do anything strenuous. You'll need the energy, anyway.
• Avoid Alcohol Consumption: statistically you're probably too young for it anyway. But mono can affect the liver,
• Check Your Medications: if you're taking something already, check with your doctor, as some medicines can also affect your liver.
• Common Medications: pain relievers and fever reducers like acetaminophen or ibuprofen. Do not take aspirin! It's linked to Reye's syndrome, which affects young patients recovering from a virus.
• Special Medications: your doctor may prescribe corticosteroids to control swelling in the throat and tonsils, or lessen the length or severity of the mono. If a bacterial infection is also present, you'll be prescribed antibiotics.