Infectious Mononucleosis

Infectious mononucleosis (mono) is a common acute infectious disease usually found in individuals between the ages of 5 and 30.  It is caused by the Epstein-Barr virus.

SIGNS
Early signs or symptoms of mono can be vague, such as headache, chills, easy fatigability, fever and sore throat.  As the disease advances, its manifestations become more obvious; fever; feeling of extreme exhaustion; tender, enlarged lymph nodes in the neck, armpits and groin.  Symptoms of nausea, vomiting, decreased appetite and abdominal pain may appear. There may be yellowing of the skin or whites of the eyes (jaundice).  You may have any or all of the above signs or symptoms.

DIAGNOSIS
Diagnosis is confirmed by a blood test.  These tests may not be positive until several weeks after the symptoms arise and, rarely, may remain negative throughout the course of the disease.

TREATMENT
Since the disease is viral, there is no medication that can cure mono.  Treatment is symptomatic and supportive, but medical supervision is absolutely necessary. Patients are instructed to:

  1. Obtain 10-12 hours of sleep a day.

  2. Avoid contact sports.

  3. Avoid alcohol.

  4. Push fluids; avoid caffeine.

  5. Avoid social activities; limit activities to sleeping, eating, and studying and, if able, classes.

  6. Remain at home if fever develops.

  7. Eat a well-balanced diet.

RECOVERY
Time of recovery varies from individual to individual, depending on the early recognition of symptoms and severity of the course of the disease.  Recovery may occur in several weeks or take several months.  Patience is needed during the recovery stages.  The acute phase generally lasts 1-2 weeks; at the end of that time, normal stamina is regained to about 90%.  Full recovery may not occur 1-2 months, possibly longer.

Bed rest, while recommended for those suffering from the disease, has been found to lose its efficacy if prolonged excessively.  In one study, a group of students allowed normal activity as soon as they felt like it appeared to recuperate faster than a group confined to bed until all signs of the illness were gone.

COMPLICATIONS
An enlarged spleen or liver may be a complication of "mono," and may cause upper abdominal pain.  Contact sports, as well as "rough-housing," are to be avoided - because a blow to the abdomen could cause damage to either of these organs.

Nausea, vomiting, decreased appetite and jaundice may indicate liver involvement.  Seek medical attention if severe abdominal pain, excessive vomiting, decreased mental status and/or confusion, dizziness upon standing or dark urine develop.

CONTAGION
Mono is passed directly from person to person by contact with saliva.  Although it is not highly contagious, it can be transmitted from an infected patient from several weeks to one year from time of infection.  Many patients (estimated at 60-80% of all college students) have had mono in childhood, but may not have been specifically diagnosed.  This is because they may not have had the typically severe mono symptoms.  If they had unrecognized mono in childhood, they are immune, because having the disease usually confers immunity.

Do not share eating or drinking utensils or toothbrush.  Practice good handwashing before food preparation, eating and after bathroom use.