Mononucleosis
After dragging her out of bed, Ashley's mom took her to the doctor's office. A physical examination and a blood test revealed the verdict: mononucleosis. Ashley had heard other kids talk about "the kissing disease," but she'd never paid much attention. Now that she had it, she wanted answers. What was it? What could she do to get well? And, most importantly, when could she get back to school, soccer, and life in general?
What Is It?
Infectious mononucleosis (pronounced: mon-oh-new-klee-oh-sis), sometimes called "mono" or "the kissing disease," is an infection that is usually caused by the Epstein-Barr virus (EBV). A similar illness can be caused by other viruses, such as cytomegalovirus (pronounced: sy-tow-meh-gah-low-vy-rus).
EBV is very common. Most people become infected with it at some point during their lives, but not everyone develops mono when they get infected. Most of the people who do get the illness are between the ages of 15 and 25; children usually don't have symptoms of mono when they become infected with EBV.
EBV is classified as one of several herpes viruses, but it is not one of the viruses that cause cold sores or genital herpes. Like other herpes viruses, once you've been infected with EBV, it stays in your body for the rest of your life. It may reappear in your saliva from time to time, but you usually won't get the symptoms of mono again from this virus.
Teens often kid around about mono, but as Ashley discovered, it's no joke. A case of mono can keep you out of commission for weeks.
How Do People Get Mono?
One common way to "catch" mono is by kissing someone who has been infected, which is how the illness got its nickname. Although a quick smooch between friends probably won't do any harm, intimate kissing with someone who's infected can put you at greater risk for getting the disease if you have never been infected with EBV.
But you may wonder, "How did I get this kissing disease when I haven't kissed anyone?" You can also get mononucleosis through other types of direct contact with saliva from someone infected with the virus, such as by sharing a straw or an eating utensil. Some people who have the virus in their bodies never have any symptoms, but you may still pick up the virus from them. In fact, experts believe that EBV often spreads from people who have it but don't have mono. Someone who does have mono is most contagious while he or she has a fever.
How Do I Know Whether I Have It?
Symptoms usually begin to appear 4 to 7 weeks after you've been infected with the virus. Signs that you may have mono include:
*being tired all the time
*fever
*sore throat
*loss of appetite
*swollen lymph nodes (also commonly known as
glands, located in your neck, underarms, and groin)
*headaches
*sore muscles
*larger-than-normal liver and spleen
*skin rash
*abdominal pain
People who have mono may have different combinations of these symptoms, and some people may have symptoms so mild that they hardly notice them. Other people may have no symptoms at all.
Even if you have several of these symptoms, don't try to diagnose yourself. Always consult your doctor if you have a fever, sore throat, and swollen glands or are unusually tired for no apparent reason.
Because these symptoms are so general and can be symptoms of other illnesses, a doctor may mistake mononucleosis for the flu or even strep throat. In fact, occasionally some teens may have mono and strep throat at the same time. To help make a diagnosis, the doctor may want to take some blood tests to determine if mono is causing your symptoms. But even if the blood tests indicate that you have mono, there isn't much the doctor can do other than advise you to drink lots of fluids and get lots of rest.
How Can I Get Better?
There is no cure for mononucleosis, but the good news is that even if you do nothing, the illness will go away by itself, usually in 3 to 4 weeks. Because mono is caused by a virus, antibiotics such as penicillin won't help unless you have a secondary infection like strep throat. In fact, certain antibiotics can even cause a rash if you take them while you have mono.
Although there's no magic pill for mono, you can do some things to feel better. The best treatment is to get plenty of rest, especially during the beginning stages of the illness when your symptoms are the worst. Put yourself to bed and pass on school, sports, and that party you wanted to go to.
For the fever and aching muscles, try acetaminophen (such as Tylenol) or ibuprofen (such as Advil or Motrin). (Steer clear of aspirin unless your doctor tells you to take it - it's been linked to a serious disease in kids and teens called Reye syndrome, which can lead to liver failure and death.) If you have a sore throat, chew gum, drink tea with honey, or suck on hard candy or Popsicles. Even if you're not hungry, try to eat a well-balanced diet and drink lots of water and juices to prevent dehydration. You can get some nutrition and soothe your throat with cold fruit smoothies or low-fat shakes.
When you start feeling better, take it slowly. Although you can return to school once your fever disappears, you may still feel tired. Your body will tell you when it's time to rest - listen to it. By taking good care of yourself and resting as much as you need to, you will soon be back to normal, usually within a few weeks.
Doctors also recommend avoiding sports for at least a month after the illness because the spleen is usually enlarged temporarily while you are ill. An enlarged spleen can rupture easily, causing bleeding, fever, and abdominal pain and requiring emergency surgery. Do not participate in contact sports, cheerleading, or even wrestling with your little siblings or your friends until your doctor gives you permission.
As you recover, make sure you don't share the virus with your friends and family. Chances are they will not get the disease from casual contact with you, but you can take a few steps to help them stay germfree. Wash your hands often, cover your nose and mouth when you sneeze or cough, and keep your drinks and eating utensils to yourself. This is one time when your friends and family will thank you for being selfish.
Updated and reviewed by: Elana Pearl Ben-Joseph, MD
Date reviewed: September 2003
Originally reviewed by: Catherine Lamprecht, MD
