The "kissing disease" lingers on.
Here's what you should know about it.
By Jenny Ewen, BA, NREMT
We all remember “the kissing disease” from adolescence, which is known as infectious mononucleosis, or mono. Since the virus spreads through saliva, it can be shared from kissing, but also from an uncovered cough or sneeze, or sharing food and drinks with someone who is infected.
It’s also considered a disease of the youth since mainly adolescents and young adults will present with all the symptoms; whereas young children who get infected may have very few symptoms so the disease may go unnoticed.
Causes of Mono
Epstein-Barr Virus (EBV) is the main cause of mono, and one in four young adults who get infected with EBV will develop mono. EBV is a member of the herpes virus family, and is considered to be one of the most common human viruses since most people will get infected at some point in their lives.
EBV is spread through bodily fluids (mainly saliva), and once infected, the virus may stay in your body for months after acute symptoms resolve.
Since so many adults are exposed to EBV and may already be infected, they may have already built up antibodies, so they won’t get mono. This is why it’s mainly younger people who get infected with EBV and develop mono.
Signs and Symptoms
Once infected with mono, there is an incubation period of four to six weeks, after which time symptoms may begin to appear.
Typically fever and sore throat symptoms will decrease within two weeks, but fatigue, enlarged lymph nodes, and swelling in the spleen could last for another few weeks.
The main signs and symptoms of mono are:
- Appetite loss
- Sore throat (that will not improve with antibiotics)
- Swollen tonsils (which can cause problems with breathing) and swollen lymph nodes in the neck and armpits
- Rash on the skin
- Enlargement of the spleen
Although the symptoms can last a few weeks, typically the infection will clear on its own without any long-term issues when there aren’t any complications.
Some examples of complications from mono include swelling of the spleen that results in rupture (but only in extreme cases), liver inflammation or jaundice, anemia, low count of platelets (thrombocytopenia), or inflammation of the heart muscle (myocarditis). Contracting EBV causes more serious problems in anyone with an impaired immune system.
Diagnosis and Treatment
Anyone experiencing the symptoms of mono should go to their doctor to get checked and diagnosed. A doctor will perform a physical exam to assess signs and symptoms, and ask questions to find out how long the symptoms have persisted.
Typically, mono is treated based on symptoms; however, lab tests can be used when it’s not presenting as a typical case. Blood tests can check for antibodies to EBV (a monospot test), and white blood cell count can suggest mono as a possibility based on an elevated number of white blood cells.
There isn’t a cure for mono since the virus will eventually go away on its own. Symptoms last about a month, so the focus of treatment is relieving the symptoms with rest (it may take months to resume exercise), fluids, and over-the-counter pain relievers for fever, headache, and sore throat.
Antibiotics are not prescribed for mono because they are not effective in treating mono since it’s a viral infection, not bacterial.
There is no vaccine against EBV or mono, so the best prevention is to avoid sharing any food/drink and close contact with anyone who is infected.
If you’re infected, you should be careful to not spread your saliva/bodily fluids until several weeks after your symptoms have completely subsided.
Sources and More Information
Centers for Disease Control and Prevention, “Epstein-Barr Virus and Infectious Mononucleosis”https://www.cdc.gov/epstein-barr/about-mono.html
CDC, “About Epstein-Barr Virus (EBV)” https://www.cdc.gov/epstein-barr/about-ebv.html
Familydoctor.org (American Academy of Family Physicians), “Mononucleosis (Mono)”https://familydoctor.org/condition/mononucleosis/?adfree=true
Mayo Clinic, “Mononucleosis” https://www.mayoclinic.org/diseases-conditions/mononucleosis/symptoms-causes/syc-20350328
NIH U.S. Library of Medicine, Medline Plus, “Infectious Mononucleosis”https://medlineplus.gov/infectiousmononucleosis.html
More from The Allied Times
One Punch An ER visit with the reasons why one punch is really all it takes.By Marven Ewen, MDMedical DirectorIn Hollywood movies, during fight scenes, the characters often take multiple blows to the face and yet continue fighting with minimal apparent injury. This is not true in real life. I recall the first time…
Maximizing Protein Intake for Optimal Health and Vitality How much protein do we really need?By Mariah Xzena Briones, RMTCertification SpecialistProtein is a crucial macronutrient that plays a vital role in our overall health and well-being. While protein has long been recognized as an essential component of our diet, emerging evidence suggests that the recommended protein…
A Less Common Indication for High-Flow Oxygen A look back at an ER visit for an ongoing painful headache.By Marven Ewen, MDMedical DirectorLate one evening, a 36-year-old man presented to the ER with a severe stabbing right sided headache. As he rocked back and forth holding his head he told me that he had been…
POEMS SyndromeThe rare blood disorder named for its symptoms.By Jenny Ewen, BA, NREMTEditor-In-ChiefPOEMS syndrome is a rare blood disorder suspected to affect up to 5000 people in the USA, primarily men who are in later adulthood (around age 50). This syndrome damages the nerves and organs due to an increased number of abnormal plasma cells with…
Meet AMT: Dr. Ewen We interview our staff members for details on their EMS journey.When/why did you first become interested in becoming a doctor/working in the medical field? At the time I started to think about going to medical school I was an undergraduate with a major in psychology. I was interested in a career…
Meet AMT: Shannon Z. We interview our staff members for details on their EMS journey.When/why did you first become interested in becoming an EMT/working in EMS? Throughout my entire career spanning 30+ years, I have had many positions that required a safety background including OSHA, Workers Comp, Safety Committee Chair, Accident Investigations, etc. Being involved…