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Infectious mononucleosis, commonly known as mono or the kissing disease, is primarily transmitted through the Epstein-Barr virus (EBV) which is primarily spread through saliva. While kissing is a common mode of transmission, sharing utensils or glasses with an infected person can also spread the virus. However, mono is less contagious compared to some other infections like the common cold.
Symptoms of mononucleosis are most commonly experienced by teenagers and young adults, while young children often show few symptoms, and the infection may go unnoticed.
For those diagnosed with mono, it’s vital to be cautious of potential complications such as an enlarged spleen. Rest and staying hydrated are crucial for a successful recovery.
Symptoms
Signs and symptoms of mononucleosis may manifest as follows:
- Fever
- Fatigue
- Headache
- Sore throat, potentially initially mistaken for strep throat and not improving with antibiotic treatment
- Enlarged lymph nodes in the neck and armpits
- Swollen tonsils
- Soft, swollen spleen
- Skin rash
The Epstein-Barr virus typically has an incubation period of about four to six weeks, although it might be shorter in young children. The incubation period represents the time between exposure to the virus and the onset of symptoms. While symptoms like fever and sore throat often subside within a couple of weeks, fatigue, swollen lymph nodes, and an enlarged spleen may persist for several more weeks.
If you’re experiencing these symptoms and they don’t improve within a week or two, it’s recommended to seek advice from your doctor.
Causes
Mononucleosis is most frequently caused by the Epstein-Barr virus, although other viruses can produce comparable symptoms. The transmission of this virus occurs through saliva, making it possible to contract through kissing or sharing food and drinks.
While the symptoms of mononucleosis can be uncomfortable, the infection typically resolves on its own without causing long-term effects. In most cases, adults have already been exposed to the Epstein-Barr virus, developing antibodies that confer immunity and protect them from contracting mononucleosis.
Risk factors
There are two notable periods during which individuals contract Epstein-Barr virus (EBV): in early school-age children and again during adolescence/young adulthood. Young children frequently exhibit no symptoms, while teenagers and individuals in their 20s are more susceptible to developing mononucleosis. Approximately 1 in 4 individuals within this age range who contract EBV experience mono, although it can affect anyone, regardless of their age.
Diagnosis
Physical assessment
Based on the signs and symptoms you present, their duration, and a physical examination, your doctor may suspect mononucleosis. They will look for indications such as swollen lymph nodes, tonsils, liver, or spleen, and evaluate how these signs correlate with the symptoms you describe.
Blood tests
- Antibody tests: If further confirmation is necessary, a monospot test may be conducted to examine your blood for antibodies specific to the Epstein-Barr virus. This rapid screening test provides results within a day. However, it may not identify the infection during the initial week of the illness. An alternative antibody test, although requiring a longer result time, can detect the disease even within the first week of symptoms.
- White blood cell count: Additional blood tests may be employed by your doctor to assess for an increased number of white blood cells (lymphocytes). While these blood tests do not conclusively confirm mononucleosis, they may indicate it as a potential diagnosis.
Treatment
No specific therapy exists for treating infectious mononucleosis, as antibiotics are ineffective against viral infections like mono. The main strategy for managing the condition involves self-care, including getting enough rest, maintaining a nutritious diet, and staying hydrated. Over-the-counter pain relievers can be used to alleviate symptoms such as fever or a sore throat.
Medications
- Treating secondary infections and complications: The sore throat associated with mononucleosis may be accompanied by a streptococcal (strep) infection. You could also potentially experience a sinus infection or infection of your tonsils, known as tonsillitis. You could also potentially experience a sinus infection or inflammation of your tonsils, known as tonsillitis. Antibiotic treatment may be necessary for these additional bacterial infections. In cases of severe airway narrowing, corticosteroids may be employed.
- Risk of rash with certain medications: Individuals with mononucleosis are advised against using antibiotics like amoxicillin and those derived from penicillin due to the potential development of a rash. While the appearance of a rash doesn’t necessarily indicate an allergy to the antibiotic, alternative antibiotics with a lower likelihood of causing a rash are available to address infections associated with mononucleosis.
