“At first I was upset when they told me I had mono and a slight case of hepatitis;   I should just be resting in bed, not doing anything at all,” recalls Ashley, a 19-year-old college student. “I was scared because I really didn’t know what mono was. I knew a few friends in high school who had it and they were out of school for months.”

What is Mono?

 Most people know mono as the “kissing disease” that makes you tired. Mono or infectious mononucleosis is a common, acute infectious viral disease, usually caused by the Epstein Bar Virus (EBV) or less commonly, the cytomegalovirus (CMV).

Mono is extremely common among people between the ages of 10 and 30. According to Margaret Venzke, Instructor at George Mason University in Fairfax, Virginia, mono is fairly common, especially with the busy lifestyle of young adults. “Typically, they tend to burn the candle at both ends with exams, studying, sporting events and socializing. Adequate rest and eating a healthy diet are low on the priority list.” 

Ashley remembers, “I would go without sleep a lot and drink lots of coffee, which couldn’t have been too good for me. I was also stressed out when I had a bad day at work or an enormous amount of homework to do.”   

There’s no need to panic if your child’s roommate or friend announces he or she has mono, says Ms. Venzke. “While mono is contagious, it is not as contagious as the common cold. Your child may have had a mild case during childhood and not know it. Since he had the disease, he developed antibodies and is immune.” So, don’t panic. Encourage common sense and good lifestyle and hygiene practices.

HOW DO YOU CATCH MONO?

            Mono is a virus that is passed from one person to another through saliva. This is why it has been called the “kissing disease.” However, intimate kissing with someone

who is infected is not the only way it is caught. Sharing eating utensils, toothbrushes, cups, straws and even coughing can spread mono. Practicing good hand washing and hygiene habits is critical. EBV has an incubation period of four to eight weeks after being infected before symptoms develop. Some people carry the virus in their bodies and never have any symptoms, but can still transmit the virus. However, people are most contagious while they have a fever and are presenting acute symptoms.

WHAT ARE THE SYMPTOMS OF MONO?

            “I remember coming down with an awful headache that persisted for a few weeks,” recalls Ashley. “Thinking it was my contacts or allergies, I ignored it but it never fully went away. My body was craving sleep, but with my odd schedule, carrying a 17-credit class load and working 30-35 hours a week, I just figured this was normal. My symptoms progressively grew worse until I couldn’t do my regular activities, so I finally went to the doctor.

Your child can have any combination of symptoms, from severe to mild, or none at all. Regardless, if they have a fever, sore throat and swollen glands or unexplained fatigue, a visit to the doctor is called for. “The symptoms of mono mimic those of other diseases and proper diagnosis is very important,” stresses Ms. Venzke.

HOW IS MONO DIAGNOSED?

            Since the symptoms of mono are similar to those of other diseases, many people only visit the doctor because of the extreme, lingering fatigue. Therefore, the monospot test is usually done. Ms. Venzke explains, “A drop of blood is tested right in the office and within a few minutes we have the results. This is the test most routinely done at colleges. However, occasionally it can show a false negative and if the person is still presenting with symptoms, blood will be drawn and sent to a lab to check for the Epstein Barr virus.”

WHAT IS THE TREATMENT?

            Mono is caused by a virus, so antibiotics are not helpful. Since approximately 8%

of mono patients also develop strep throat, the doctor will do a throat culture and prescribe antibiotics for the infection.

            There is no treatment for mono, so it’s important to be monitored by a doctor who will advise your child to:

-         Get 10-12 hours of sleep a day, particularly in the early stages of the disease. However, one study found patients recuperated faster if they resumed normal activity as they felt able rather than being confined to bed rest until all symptoms were gone.

-         Avoid contact sports, cheerleading, even playful wrestling with younger siblings until the doctor clears them. As the spleen may be enlarged, these

-         activities can cause rupture, a rare but potentially serious complication requiring surgery.

-         Avoid alcohol while symptoms are present and for about a month after they resolve to allow liver function to return to normal.

-         Drink plenty of fluids and avoid caffeine (coffee, tea, sodas). Dehydration is the most common complication because of severe sore throat pain, which can lead to inadequate fluid intake.

-         Limit activities to sleeping, eating, studying and going to classes. Especially during the early phase of the virus when symptoms are worse, it is important to get as much rest as possible. The acute phase usually lasts one to two weeks, after which 90% of normal stamina is usually regained. Full

recovery may take one to two months or even longer. Encourage them to be patient with themselves and to listen to their bodies.

-         Stay home if fever develops since this is the most contagious period.

-         Eat a well balanced, healthy diet. You want to strengthen their immune system so it can fight this virus off. Limit sugar which has been shown to depress the immune system and nourish them with fresh, whole foods: fruits, vegetables, protein and whole grains.

In some severe cases Ms. Venzke will prescribe a steroid. “Some people’s tonsils enlarge so much and the back of their throats swell so severely that there is concern for their airway. Steroids reduce swelling and make the person more comfortable.”

The Good News

            Once they’ve had a case of mono, they won’t ever get it again. One episode confers life long immunity.

            Good hygiene habits (hand washing, covering their mouth when sneezing or coughing, not sharing eating utensils), and being sensitive to their body’s needs for rest and nutritious food will help their immune system to function effectively, which will keep them healthy and full of energy.

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What are the Symptoms?

            Extreme, lingering fatigue and exhaustion;

            Sore throat – most doctors will also check for strep since the symptoms overlap;

            Swollen glands in neck, armpits and groin, particularly lymph nodes in the back of the neck;

            Fever;

            Muscle aches;

            Skin rash;

            Loss of appetite;

            Headaches;

            Abdominal pain;

            Enlarged liver and spleen.

What Can I Do?

While there is no medication or cure per se for mono, there are things you can do to make your child more comfortable, especially during the acute phase:

            -If they experience fever or aching muscles, they can use acetaminophen (Tylenol) or ibuprofin (Motrin, Nuprin or Advil).

- Aspirin has been linked to Reye Syndrome in children and teens, which can lead to liver failure and death, so it should be avoided.

            -A sore throat can be very uncomfortable and cause dehydration. To soothe it, have them try chewing gum, sucking on hard candies, lozenges or popsicles, drinking herbal tea with honey and gargling with saltwater. 

-Cold fruit smoothies or low fat shakes can do double duty by providing fluids and nutrition while soothing a sore throat.