Mononucleosis, or 'mono', is an extremely common viral infection caused by the Epstein-Barr virus (EBV). Most people will be infected at some time in their lives. Mono can be spread through contact with saliva, including eating or drinking after an infected person, or through kissing. It is typically difficult to accurately determine when or from whom you caught mono. It generally takes 4–6 weeks for the first symptoms to appear, and once someone has mono, they are likely to remain contagious for several weeks; perhaps off and on for much of their life. Exposure in early childhood is often asymptomatic, or with mild symptoms which may go unnoticed at that age. Persons with early exposure are likely to have full or partial immunity to later mono illness, should they be exposed to the virus.
Typical Mononucleosis Symptoms (more severe in adolescents and young adults)
- Fever (typically 100.4 F / 38C or greater)
- Fatigue generally lasting 4–6 weeks. If > 3 months, schedule a follow up appointment at the IU Health Center
- Sore throat usually with swollen and coated tonsils
- Swollen lymph glands in front or sides of neck
- Loss of appetite
- Jaundice (yellowing of the skin)
You should contact the IU Health Center Medical Clinic if you experience any of these symptoms:
- Tonsil swelling that causes difficulty swallowing or breathing
- Pain in the upper right or left side of the abdomen
- Jaundice (yellowing of the skin or the white part of the eye)
- Chest pain
- Unusual weakness in arms or legs
- Severe headache
- Stiff neck
Mono is quite common amongst adolescents and young adults, especially when residing, studying and socializing in crowded settings, such as with the university lifestyle. The EB virus is most typically spread by saliva, thus the moniker of “kissing disease” has long been applied to mono. While that is certainly one way of contacting the illness, it is by no means the only path of contagion. Avoid cross contamination associated with eating or drinking from the same glasses, bowls and utensils of friends, strangers, and certainly those appear to have a viral illness. Wash your hands regularly, especially before putting food in your mouth.
Mono can usually be quickly diagnosed in the IU Health Center lab while you wait. A simple blood test is required. Occasionally, the test can be negative early in the illness even if symptoms are suspicious for mono, and a follow up test several days to a week later may be required to confirm the diagnosis of mono. The IU Health Center Medical Clinic will also sometimes perform a throat swab to rule out strep throat, as both strep and mono have symptoms that closely overlap, and some persons are co-infected.
Avoid Strenuous Activity
Expect to avoid sports, lifting, straining, or other physical exertion for about 4 weeks. That's because mono affects the spleen to some extent in about 50% of patients. An enlarged spleen is more vulnerable to rupture, and a ruptured spleen is a medical emergency. You should get medical clearance before you resume your regular activities.
Abstain From Alcohol
Mononucleosis often inflames the liver and alcohol makes this inflammation worse. Mono patients should not use alcohol for two months after the onset of symptoms.
Mono is a virus, so it has to run its course. Acute symptoms can last 7–10 days. Here's what you can do to feel better:
- Get plenty of rest to avoid prolonging or relapsing of your illness.
- Take acetaminophen (Tylenol) or ibuprofen (Advil, Motrin, etc.) for fever or pain. Acetaminophen (Tylenol) is broken down by the liver. Thus it is important to closely follow the dosing instructions or your Health Care Provider’s instructions to safely take this medication.
- Throat lozenges or spray containing benzocaine (such as Cepacol) may provide temporary relief from throat pain.
- Gargle with salt water for a sore throat (use 1/2 teaspoon of salt in 8 ounces of water).
- An OTC oral decongestant such as Sudafed (read medication restrictions/side effects) or sinus rinsing with a Neti Pot may relieve sinus pressure sometimes associated with mono.
- Feeling ill often causes a loss of appetite. This is normal, and usually improves as the infection improves. It is important, even if you have no appetite, to drink an adequate amount of fluids. You are drinking adequate fluids if your urine is a pale yellow color.
Even the common symptoms of mono are frequently severe enough to warrant medical examination, and at times require prescription medication for relief during the acute phase. If you have any concerns regarding the possibility of illness due to mono, feel free to schedule an appointment with an IU Health Center medical provider.