What to Ask About Mononucleosis
Confronting a new diagnosis can be frightening, and because research changes so often, confusing. Here are some questions you may not think to ask your doctor, along with notes on why they re important.
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Infectious mononucleosis, or mono, occurs when an individual is infected with the Epstein-Barr virus, a type of human herpes virus. But not everyone who is infected develops mono. Another herpes virus, known as cytomegalovirus, can also cause mono-like symptoms.
Yes. Mono is spread through direct contact with saliva. As a result, it is commonly referred to as the kissing disease. The virus can also be spread when a person who has not been infected shares a glass or utensil with someone who is either sick or about to become sick. It can also be contracted by coughing, sneezing or even a handshake if saliva is present.
Mono is usually thought of as an illness that affects adolescents and young adults, but very young children also commonly contract the virus. Children usually have a more mild illness and do not typically experience the more classic symptoms of mono that are often found in teenagers. Adults very rarely contract the virus, because they were usually infected with Epstein-Barr virus at an earlier age.
How long does the infection last?
Mono typically lasts about a month, but in more some cases it can take up to six months to fully resolve.
If I catch mono, will I get sick right away?
No. There is an incubation period. If you contract the virus, it will take about four to six weeks to develop any signs of the infection. Common symptoms include fatigue, fevers, a sore throat and swollen lymph glands. Sometimes the spleen or liver may become enlarged.
How long is a person with mono contagious?
The symptoms caused by an acute mono infection will dissipate after about a month, but the herpes virus that caused the illness remains dormant inside the cells for life. Individuals with mono tend to be most contagious during the incubation period the four to six weeks before they get sick and during the acute phases of their illness. Some people may even shed Epstein-Barr virus when they are no longer sick.
Your physician will start by taking a complete medical history, and will then perform a physical exam to see if there are any signs of infection. If mono is suspected, the doctor will order a blood test, known as a heterophil or monospot test, to confirm the diagnosis.
Are blood tests always definitive?
The monospot test is not perfect. When used too early or in very young children it can be inaccurate. If you receive a negative result, your physician may retest you after about a week. The doctor may also order a more specific test known as the EBV antibody test, or do a workup for cytomegaloviarus, or CMV, another herpes virus that can cause symptoms resembling mono.
There is no vaccine or drug to cure or treat mono. If you have mono, the best thing you can do is get plenty of rest and drink lots of fluids. But there are some drugs that can help ease the symptoms. Throat lozenges and over-the-counter painkillers like Tylenol can help reduce fevers and soreness. Corticosteroids may also be prescribed for patients with severe swelling in the throat, tonsils or spleen.
No. Unless there is a secondary infection, antibiotics are not used to treat mono. Sometimes individuals with mono may also develop strep throat, an infection that requires antibiotics.
When can I go back to school or work?
There is no set time. You should always refrain from normal activities if you have a fever. Depending on the severity of your symptoms, you may also want to wait until your glands and spleen return to a normal size and you feel less fatigued.
When can I resume strenuous activities or contact sports?
It is important that you refrain from contact sports and heavy lifting when you have mono. If your spleen is enlarged, the impact could cause it to rupture and may require surgery. Consult with your doctor before resuming any strenuous activities.
If I ve had mono once, can I get it again?
Because the Epstein-Barr virus resides in the body for life, it can reactivate, but in most cases it won t cause symptoms unless the immune system becomes severely compromised. For example, if you had mono when you were 20 and then at 40 you have a bone marrow transplant to treat cancer, you may reactivate the virus and develop symptoms.