TrustCare Kids: Identifying and Treating Mono

To many young people, one of the “best” diseases to get is mono, a viral infection that is also referred to as the “kissing disease.” One of the reasons this disease is so relatively welcome is that the symptoms tend to be mild and usually require staying home from school and sleeping a lot. Yet even though mono is thought of as a condition associated with being a teenager, both young kids and adults can still get an infection.

What is Mono?

Short for infectious mononucleosis, mono is the colloquial name for an infection that is most often caused by the Epstein-Barr virus (EBV). Although Epstein-Barr can be behind a number of other, somewhat rare diseases associated with the lymph nodes, it is thought to be responsible for upwards of 90% of mono infections. In fact, EBV is one of the most common viruses in the world; it is estimated that nearly 95% of people in the world will be exposed to it by the time they reach 40 years old, though most will not actually become infected. Though rare, mono can also be caused by another virus called cytomegalovirus (CMV).

Also sometimes known as glandular fever, mono is most commonly a condition that affects teenagers and young people between the ages of 15 and 30. The CDC (Centers for Disease Control and Prevention) estimates that about a quarter of young people exposed to the virus will actually develop mono. It is possible and somewhat common for prepubescent children to be exposed to the virus and develop the infection, though in these cases the children usually don’t have symptoms; if they do have symptoms, they are likely to be mild, flu-like symptoms.

Symptoms of Mono

The good news for younger people is that a mono infection only very rarely produces any symptoms. In infants and young children especially, an EBV infection will likely cause, at worst, a series of mild symptoms such as fever, sore throat, fatigue, and swollen lymph nodes. For most children who have become infected, however, neither they nor their parents will even realize it ever happened. In teenagers and young adults, though, some common symptoms of mononucleosis can be expected:

• tiredness
• fever
• chills
• sore throat
• visible white patches at the back of the throat
• swollen lymph nodes
• headache
• body aches
• reduced appetite
• puffy eyelids
• anemia
• sensitivity to light
• enlargement of the liver or spleen

Is Mono Contagious?

Like many other infectious diseases, the Epstein-Barr virus that causes mono can be easily passed from one person to another through bodily fluids. One of the ways mono differs from a disease like influenza or the common cold, however, is that it isn’t as easily spread through aerosolized droplets. It typically requires direct or indirect contact between the mucus membranes of different people. This includes coming into contact with another person’s saliva through kissing (hence the kissing disease name) or through sharing items like toothbrushes, eating utensils, and drinking glasses.

It is also possible to become infected by EBV through sexual contact or blood transfusions, but this way of contracting the virus is more rare. In most cases a person will need to come in contact with another person’s saliva to actually become infected. Yet because the incubation period for the virus is abnormally long, it can take 4-6 weeks for symptoms to appear after the initial infection. What this also means is that the period of time when a person is contagious is very long, often from six months to well over a year. And, once infected, a person is a carrier for life; it has even been known to lie dormant for a long time and then cause a person to become contagious again.

Mono Diagnosis and Treatment

The diagnosis for infectious mononucleosis is typically accomplished by evaluating the various symptoms that are present; however, this can be challenging since the symptoms are often mild and can potentially be associated with other conditions. Beyond consideration of symptoms, diagnosis involves a physical examination to look for swollen glands or an enlarged liver or spleen. In some rare cases the doctor may order blood tests to determine abnormal white blood cell counts, lower platelet counts, or abnormal liver function.

There is no cure for mono, nor is there a vaccine that can prevent infection. Because of this, treatment is largely characterized by lessening or relieving the symptoms. In most cases, symptoms will last 2-4 weeks until the immune system begins to produce relevant antibodies. Also, since mono is a viral infection, medications like antibiotics won’t have any effect on the progression of the disease. Below are some common treatment methods for relieving the symptoms:

• stay hydrated by drinking plenty of fluids
• plenty of rest
• pain relief medication like acetaminophen or ibuprofen
• no aspirin for children (can cause Reye syndrome)
• avoid heavy lifting or contact sports in case of enlarged spleen

Given how widespread the Epstein-Barr virus is around the world, completely preventing infection can be a tall order. Yet preventing mono involves utilizing practices that are also helpful for preventing other communicable viral infections. For young children, prevention primarily involves teaching good hygiene practices and instilling the idea of not sharing any utensil or item that is exposed to saliva. Being mindful of the spread of saliva through coughing and sneezing is an equally valuable practice for avoiding the spread of COVID-19, for example.

When to See a Pediatrician

The great news for parents of young kids is that mono is rarely a cause for concern. Even if your child is exposed to the virus, there’s a very good chance he or she won’t even experience any symptoms. Even teenagers, who are much more likely to develop symptoms from an infection, are not in danger of serious illness. Nevertheless, the principles behind the avoidance of the virus—making sure to not share objects that may have someone else’s saliva on it—are beneficial for all people at all times.

While the development of infectious mononucleosis isn’t a cause for concern, there are some rare complications that occasionally crop up. You should reach out to a pediatrician if your child is experiencing sharp abdominal pains, has trouble breathing, is extremely fatigued, or is showing signs of dehydration. At TrustCare Kids, we offer both appointments with a pediatrician and walk-in only access to our kids urgent care clinic. Our staff is dedicated to providing excellent, convenient healthcare for kids so that parents can have peace of mind.

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This post has been medically reviewed by Dr. Catherine Phillippi, pediatrician at TrustCare Kids. She earned her medical degree from the University of Mississippi School of Medicine in 1999 and completed her pediatric training at the University of Arkansas for Medical Sciences/Arkansas Children’s Hospital.