Mononucleosis

The ‘kissing disease’ can lay you low, and it mostly affects young adults

Symptoms of Mono

• Fever
• Sore throat
• Weakness
• Swollen tonsils
• Swollen lymph nodes in neck and armpits
• Headache
• Skin rash
• Loss of appetite

She’s out and about again

Elana Katz is fully recovered from her bout with mononucleosis, as evidenced by photos from a trip to Israel this spring.

When 23-year-old Elana Katz developed a persistent sore throat and swollen lymph nodes last December, she assumed she was coming down with a minor “bug.” With final exams approaching, she put it out of her mind.

By the end of her last exam, Katz’s tonsils had swollen so much she couldn’t swallow or eat—and she felt drained. “That’s when I decided to take it seriously,” says Katz, a medical student. Doctors at her college infirmary confirmed what she’d begun to suspect: she had mononucleosis.

“Mono” is caused by Epstein-Barr virus, a type of herpes. It’s often called the kissing disease because it’s spread through saliva. Sharing a smooch with a carrier can lead to infection, but so can sharing a glass or standing within range of a virus-laden cough or sneeze.

The good news is that—just as with colds and flu—not everyone who’s exposed gets sick, says family medicine physician Lisa Medina, M.D., of Lehigh Valley Hospital and Health Network. Full-blown mono is most common in adolescents and young adults (ages 10-30). Younger children also get it, but usually have minor symptoms, and most people over age 30 have built up immunity.

Symptoms (see right) usually begin four to six weeks after exposure, often starting with a fever and intense sore throat. Fatigue and a swollen spleen (an organ that’s part of the immune and lymph systems) may persist for several months afterward. “It’s not the worst disease,” Medina says, “but it can really put you to bed for awhile.”

Although there’s no cure for mono (antibiotics don’t fight viral infections), there are ways to feel better. Get plenty of rest and drink lots of fluids to prevent dehydration and relieve sore throat. Over-the-counter painkillers and gargling with salt water also ease throat pain.

Most of Katz’s symptoms disappeared after a regimen of bed rest and soothing ice cream at home in Allentown with her parents. In January she returned to school, but didn’t regain her full strength for another two months. “After classes and working at the hospital every day, I was pretty tired by 5 o’clock,” she says.

Fortunately, mono has few lasting effects and recurrence is very unlikely. Researchers recently found a possible link between mono and multiple sclerosis, but results aren’t conclusive. It is important to avoid contact sports for up to three months after mono, because an enlarged spleen is more easily ruptured and that can be life-threatening.

Prevent mono as you would any contagious infection, Medina says—“wash your hands and try not to be around people who are coughing and sneezing.”

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