Where to find it
Q. My 17-year-old niece was recently diagnosed with mononucleosis. What is this? Is it contagious? Are there complications?
A. Mononucleosis, also called infectious mononucleosis or simply "mono," is a contagious disease most often caused by the Epstein-Barr virus (EBV), although other viruses may be implicated. It is nicknamed "the kissing disease" because it is transmitted through saliva. Coughing, sneezing and the sharing of utensils by someone with mono can also spread the virus, which may persist for several months in saliva. Less frequently, it can spread via blood, sexual contact or organ transplantation.
Mono can occur at any age, but most commonly affects people in their teens or early 20s. At least 25 percent of people in this age group who become infected with EBV develop mononucleosis. Because EBV is widespread in the population, many are exposed and even infected as young children when the virus typically causes no or few symptoms. Exposure to the virus in adolescents is more likely to result in a full-blown syndrome that may include fatigue, fever, sore throat, swollen neck or armpit lymph nodes, enlarged tonsils, rash and swollen spleen. Symptoms start four to six weeks after infection, may not occur simultaneously, and tend to last two to four weeks. The fatigue and swollen spleen can last for several months. Infection generally results in lifelong immunity.
While symptoms of mononucleosis can be difficult to distinguish from those of flu or the common cold, the condition is often suspected in adolescents with prolonged symptoms. The monospot blood test usually confirms the diagnosis, and other blood tests show an elevated number of mononuclear white blood cells, hence the name "mononucleosis."
Treatment of mono consists of rest, hydration and good nutrition. Over-the-counter medications used to treat mild pain and fever (e.g. acetaminophen or ibuprofen) can be helpful. Warm salt water gargling may alleviate a sore throat. Antiviral drugs provide little or no benefit. Antibiotics are not effective against mono since it is a viral infection. However, they may be prescribed if there is an accompanying bacterial infection of the tonsils. A medical practitioner should be consulted if symptoms worsen or persist for more than 10 days.
Most cases of mono are mild and self-limiting, but some complications of the disease can be potentially serious. A swollen spleen is at risk for rupture — a medical emergency heralded by sharp, sudden, severe abdominal pain. Therefore, anyone recovering from mono should avoid contact sports until cleared by their doctor. Other possible complications include liver inflammation, jaundice, anemia, low platelets, inflammation of the heart muscle and central nervous system inflammation. These conditions can be life-threatening in individuals with compromised immune systems such as transplant patients or those with HIV/AIDS.
Sue Smith volunteers with the Grillo Center, which offers free, confidential research to assist in health understanding and decisions. To use this service, contact us at grillocenterhealth.org, 720-854-7293 or 4715 Arapahoe Ave., Boulder. No research or assistance should be interpreted as medical advice. We encourage informed consultation with your health care provider.