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Mono: The signs, symptoms and care

“You’ve got mono,” is the last thing a teenager – or their parent – wants to hear at a visit to their clinic provider.

Whether your teen is busy with a part-time job, a sports team, theater production, or an-extra challenging academic workload at college, any illness that slows them down is a blow to their health as well as their aspirations to achieve great things. 

Infectious mononucleosis, also called mono, is a contagious viral illness commonly seen among teenagers and young adults. It is usually caused by the Epstein-Barr virus (EBV), although there are other viruses that can also cause mono.

At least one out of four teenager or young adults who get infected with EBV will develop infectious mononucleosis.

Mono is primarily transmitted through the passage of saliva, which is why it is sometimes referred to as the “kissing disease.” However, you can also be exposed through a cough or sneeze or by sharing utensils or a glass with someone who has mono, or through other bodily fluids.

Typical symptoms of mono usually appear 4-6 weeks after infection with EBV. Symptoms can include extreme fatigue, sore throat, enlarged tonsils, fever, headache, body aches, rash, swollen lymph nodes in the neck and armpits and swollen liver and/or spleen.

Enlarged spleen and liver are less common symptoms, however can potentially be life threatening. In rare cases, the spleen may rupture, which may require surgery to remove it.

Since mono often affects teenagers and young adults, for those who participate in competitive sports and other types of exercise, activity and sports participation is usually off limits for a period of time due to the risk of splenic rupture.

It is very important for people with EBV to follow the instructions of their provider and only return to sports/contact activities when the provider feels it is safe and they are no longer at risk for splenic rupture. Splenic rupture after the fourth week of symptoms is rare; it is generally recommended that athletes can return to noncontact sports after 3 weeks of onset of symptoms and to wait 4 weeks to return to strenuous contact sports.

Clinically, mono is suspected based on symptoms and usually confirmed with a blood test.

The mainstay of treatment for mono is supportive care. Acetaminophen and NSAIDs, such as ibuprofen and naproxen, are recommended for headache, sore throat and body aches. It is important to drink fluids to stay hydrated and get plenty of rest.

There is no vaccine to prevent mononucleosis infection.

You can help protect yourself by not kissing or sharing food, drinks and personal items with someone infected with mononucleosis.

And, because it is nearly impossible to know someone is infected with EBV until weeks after they have acquired the virus, avoiding the above listed personal contact with anyone will lessen your chance of unknowingly catching mono.