Mononucleosis, commonly known as mono or glandular fever, is a viral infection caused by the Epstein-Barr virus (EBV). It is a very common virus, and most people are infected with EBV at some point in their lives. Children often experience mild symptoms, but teenagers and adults can become more severely ill. Once you have had mononucleosis, you typically develop immunity and cannot get it again.
Causes
Mononucleosis is caused by the Epstein-Barr virus (EBV), which is spread primarily through saliva. This is why it is often referred to as the “kissing disease.” The virus can also be transmitted through sharing drinks, utensils, or other personal items. The incubation period, the time between infection and the onset of symptoms, is typically four to six weeks.
Symptoms
Children infected with EBV often have mild, cold-like symptoms. However, teenagers and adults may experience more pronounced symptoms, which can resemble strep throat but are often more severe. Common symptoms of mononucleosis in adolescents and adults include sore throat, difficulty swallowing, fatigue, headache, loss of appetite, fever, body aches, and swollen lymph nodes in the neck, armpits, and groin. The tonsils may also be enlarged and covered with a grayish-white coating. Less common symptoms include swelling around the eyes, skin rash, and nausea.
The liver and spleen can also become temporarily swollen during mononucleosis. Liver swelling is often asymptomatic, but some individuals may develop jaundice, characterized by yellowing of the skin and whites of the eyes. Spleen enlargement is usually painless, but there is a small risk of splenic rupture, especially if the area is subjected to trauma. Symptoms of splenic rupture include sudden abdominal pain, fatigue, paleness, and heart palpitations.
Fatigue is a hallmark symptom of mononucleosis and can persist for weeks or even months after other symptoms have resolved.
Diagnosis
A doctor will typically examine the throat, looking for swollen tonsils with a grayish-white coating. They will also palpate the lymph nodes in the neck, armpits, and groin to check for swelling and tenderness. The abdomen may be examined to assess the size of the liver and spleen. Blood tests can help confirm the diagnosis of mononucleosis. These tests can detect the presence of antibodies to EBV and may also reveal elevated levels of white blood cells and liver enzymes. A throat swab may be taken to rule out strep throat, as the symptoms of the two conditions can be similar.
Treatment Options
Mononucleosis is a viral infection, so antibiotics are ineffective. Treatment focuses on relieving symptoms and supporting the body’s natural healing process. Rest is essential, especially during the acute phase of the illness. Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can help alleviate fever, sore throat, and body aches. Gargling with warm salt water may also provide relief for a sore throat.
In rare cases, severe symptoms may require hospitalization. For example, individuals with difficulty swallowing may need intravenous fluids to prevent dehydration.
Self-Care
There are several self-care measures that can help alleviate symptoms of mononucleosis. These include getting plenty of rest, staying hydrated, eating soft foods that are easy to swallow, and avoiding alcohol. Because the liver is often affected, it is important to abstain from alcohol until fully recovered, typically for at least four weeks.
It is also crucial to avoid strenuous activity for at least one month after the onset of symptoms to prevent splenic rupture. Walking and light activities are generally safe, but contact sports and heavy lifting should be avoided.
Prevention
Mononucleosis is highly contagious, so it is important to take precautions to prevent its spread. These include avoiding close contact with infected individuals, not sharing drinks or utensils, and practicing good hygiene, such as frequent handwashing.
Takeaway
Mononucleosis is a common viral infection that can cause significant fatigue and discomfort. While there is no specific cure, rest, supportive care, and avoiding strenuous activity can help alleviate symptoms and promote recovery. Most people recover fully within a few weeks, although fatigue may persist for several months.