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
Ectopic Pregnancy The facts behind this life-threatening condition.By Marven Ewen, MDMedical DirectorIt was another busy night in the ER. The patient was a 32-year-old woman who was brought to the emergency room complaining of severe abdominal pain and vaginal bleeding. Her blood pressure was still normal but she was tachycardic and appeared pale. Her…
Early Indicators of Thyroid Problems Identifying early signs and symptoms of thyroid disorders.By Mariah Xzena Briones, RMTCertification SpecialistHormones control our bodily functions—body temperature, menstrual cycle, regulation of metabolism, muscle strength and more. A balance of hormones is necessary for regular function. Any variation from the optimal balance can result in health issues – the thyroid…
An Unusual Cause of Dyspnea The reasons behind difficulty breathing can be surprising.By Marven Ewen, MDMedical DirectorA stoic 73-year-old man was brought to the ED with dyspnea. He had a history of COPD and was administered albuterol en route to the hospital with no change in dyspnea. I noticed his shoes were not tied.…
Raynaud’s PhenomenonThe vascular condition where cold fingers and toes aren’t just from winter weather.By Jenny Ewen, BA, NREMTEditor-In-ChiefOverviewAs the winter season settles upon us, feeling cold is a pretty common occurrence. Blood vessels near the surface of the skin will constrict when exposed to cold in order to push blood deeper in the body and…
Stress Eating: An Emotional Blackhole Stress and overeating can go hand in hand, but prevention is possible.By Mariah Xzena Briones, RMTCertification SpecialistAre your cravings immensely increasing when you’re bombarded with never-ending tasks at work? Have you noticed your study table being more occupied with snacks than books especially during exam week? Food cravings and increased…
A Trip to Africa The threat of malaria must be considered when traveling.By Marven Ewen, MDMedical DirectorOne evening an aspiring 40 year old nature photographer was brought to the ER. He was feeling ill with intermittent fever for several days. He had malaise, arthralgias, a headache, and episodes of delirium. No one else in the…