Kissing disease demistified

Commonly referred to as “mono,” is an infection caused by the Epstein-Barr virus (EBV). Like any virus, it can be spread from person to person. However, it is usually less contagious than the common cold, since the virus is mainly present in saliva; hence its nickname, “the kissing disease.”

As many as 95 percent of adults in the U.S. have been exposed to the EBV at some time in their lives. Commonly, this occurs in childhood and is manifest as a brief, mild viral illness. When exposure occurs in adolescence or early adulthood, 35 percent to 50 percent of the time it causes infectious mononucleosis. This acute illness is most commonly seen in individuals 15 to 35 years old.     

Once exposed to the virus, individuals generally will develop symptoms in four to seven weeks. The most common signs and symptoms include fever, sore throat with white patches on the throat and swollen lymph glands. Other symptoms include body aches, fatigue, headache and lack of appetite.

Because the infected individual’s immune system is revved up to produce infection fighting cells, the spleen can get enlarged. Rarely, it can rupture or tear. In addition, the liver can become inflamed (hepatitis) causing jaundice (yellowing of the skin), nausea and vomiting.

The signs and symptoms of mono are very similar to that of strep throat and other viral infections. Therefore, it is often difficult to distinguish between these causes. Your doctor may order a Monospot blood test to determine if mono is the cause and/or a rapid strep test or throat culture to see if strep is present. Other blood tests may be necessary as well.
A blood count usually shows an elevation in monocytes, one of the infection fighting cells of the body. These cells have a single nucleus and their increased presence in the disease gives us the name mononucleosis.

Since infectious mononucleosis is a viral infection, it cannot be cured with antibiotics. The body’s natural defenses will eventually stifle the illness. Symptoms can last up to four weeks or more, particularly the symptom of fatigue.

Treatment consists of plenty of rest and fluids. Medicines to treat symptoms may be advised, such as acetaminophen (Tylenol) or ibuprofen to take care of fever or pain. Aspirin should be avoided in mono due to a risk of Reye’s syndrome in children. Exercise, sports and vigorous activities should be avoided until your doctor tells you it’s safe. This is because of the risk of spleen rupture.

Most individuals exposed to people with infectious mononucleosis have previously been infected with EBV and are not at risk for the disease. In fact, many healthy people can carry and spread the virus intermittently for life. These people are usually the primary reservoir for person-to-person transmission. For this reason, transmission of the virus is difficult to prevent.

Always practice good handwashing and get adequate rest, exercise and a healthy diet to stay well.

The content in this column is for information purposes only and is not intended to be used for diagnostic or treatment purposes. Consult your physician for appropriate individual treatment. Dr. Reynolds practices Family Medicine in Chesterfield.

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