Cause
Mono is caused most often by the Epstein-Barr virus (EBV). A much less common monolike illness is caused by a different virus called cytomegalovirus (CMV).
How mono is spread
Epstein-Barr virus (EBV) can be found in saliva and mucus (and sometimes tears). EBV is not easily spread. People can live in the same house with a person who has mono and never become infected with the virus. However, a family member who has a weakened immune system may be at higher risk for infectious mono. Mono can continue to be spread by those who previously had mono but no longer have symptoms.
- EBV lives and grows in the nose and throat. Any fluid that comes from these parts of the body, including saliva, tears, or mucus, can be infected with the virus.
- The virus (EBV) is spread when people come in contact with infected fluids. EBV can be spread through intimate contact or sharing of saliva. A brief kiss on the lips is not likely to spread EBV. The virus is spread when a person gets someone's infected saliva in his or her mouth.
- You can get EBV if you share a drinking glass or eating utensils with an infected person (through sharing saliva).
- People can become infected when they receive blood from someone who is infected with EBV; however, this is rare.
- Some people carry EBV in their bodies throughout their lives but never get mono symptoms. From time to time the virus can become active and be spread to others. Lifetime carriers of EBV are the most common source of EBV infection.
Contagious and incubation period
- A person can pass the Epstein-Barr virus (EBV) on to others as long as the virus can be found in his or her throat. This period can be from several months to many years.
- Not all people who become infected with EBV get symptoms of mono. However, they can still spread the virus to others.
- There is a small risk of spreading EBV through blood products. If you know you have mono, you should not donate blood.
- It takes 4 to 6 weeks for infection to develop once a person comes in contact with EBV. This is called the incubation period.
Symptoms
It is common for people who become infected with the virus that causes mono (Epstein-Barr virus, or EBV) to have no symptoms. This is especially true in young children, who may have a fever but no other symptoms. Young adults between the ages of 15 and 24 are more likely to have obvious symptoms.
The most common symptoms of mono are:
- Fever, which may range from 101°F (38.33°C) up to 104°F (40°C), and chills.
- Sore throat, often with white patches on the tonsils (which may resemble strep throat).
- Swollen lymph nodes all over the body, especially the lymph nodes located in the neck.
- Swollen tonsils.
- Headache or body aches.
- A lack of energy and fatigue.
- Loss of appetite.
- Pain in the upper left part of the abdomen, which may indicate that the spleen has become enlarged.
- A rash with raised, red bumps or patches can occur and is frequent in those who have been prescribed ampicillin, amoxicillin, or penicillin for symptoms of mono that are similar to other infections (such as strep throat).
- Mono may cause a person's spleen to swell to 2 or 3 times its normal size; an enlarged spleen occurs in up to 50% of those with mono. A blow to the abdomen could cause the spleen to break open (rupture). In rare cases, the spleen ruptures on its own.
What happens
- Mono is usually a mild illness that goes away without treatment after several weeks. During this time symptoms may come and go. It is common for the course of mono to occur as follows:
- Sore throat is at its worst during the first 3 to 5 days and gradually improves over the next 7 to 10 days.
- Fever may last 10 to 14 days but is usually mild during the last 5 to 7 days. If you have a fever, you should stay home from work or school until the fever goes away. You can then go back to your normal activities if you feel up to it.
- Swollen glands may last up to 4 weeks.
- It may take several weeks (even months) for your energy level to return to normal. Don't try to rush this process. Pushing yourself too hard could cause other symptoms to return. Give your body the rest it needs.
- Mono can cause your spleen to enlarge, making it prone to injury. You should avoid heavy lifting and contact sports for 3 to 4 weeks after you become ill with mono (or until a health professional gives you the go-ahead) to reduce the risk of injuring your spleen.
- It is not known how long a person is able to pass the Epstein-Barr virus (EBV) on to other people. You can spread EBV even if you never have symptoms of mono.
- If you know you have mono, you should not donate blood. EBV can be spread through blood products, although this is uncommon.
- EBV can live in a person's throat for more than a year. Eventually it becomes inactive (latent), although it will stay in the person's body for the rest of his or her life and can become active from time to time without causing symptoms. When the virus is active, it can be spread to others.
Home treatment
Self-care is usually all that is needed if you have mono. Unless you have a serious complication of mono (which rarely happens), there is no medication or treatment that will speed your recovery. More than 95% of people with mono recover without problems. There are many steps you can take to ease the symptoms until you are back to normal.
- Listen to your body. Don't push yourself when you have mono. If you feel tired, it is important to rest and give your body a chance to heal.
- Rest in bed. You probably won't feel like working or going to school anyway, and rest is very important.
- Avoid contact sports and heavy lifting for 3 to 4 weeks after you become ill with mono (or until a health professional gives you the go-ahead) to reduce the risk of injuring your spleen.
- Take acetaminophen (such as Tylenol) or ibuprofen (such as Advil) to reduce fever and relieve headache and sore throat. Do not give aspirin to anyone under the age of 20, because its use has been linked with Reye's syndrome.
- Soothe your sore throat with cool liquids and saltwater gargles [1tsp (5 g) of salt in 8 fl oz (236.59 mL) of water]. Hard candies or throat lozenges might help, too.
- Drink plenty of fluids, especially if you have a fever. This will help prevent dehydration.
- Your symptoms will gradually improve over 2 to 3 weeks. You should be able to return to your normal activities within about a month. Let your symptoms be your guide. You may need to adjust your school and/or work schedule to take advantage of times when you feel more energetic. If you feel better, try to get back to your routine sooner, but remember not to push yourself.
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