What Is Mononucleosis? - Mono Symptoms, Causes, Treatment, and Prevention - Prevention.com
Mononucleosis (Mono) is one of those illnesses most people are vaguely aware exists but may not know all that much about. Mono causes symptoms that can be confused with a bad cold, the flu, or even COVID-19, making it yet another illness that should be on your radar right now.
But what is mono, exactly, and what are the signs that you might have this over any of the other illnesses floating around out there right now? Here's what you need to know.
What is mono?
Infectious mononucleosis, usually referred to as just "mono," is a contagious disease that's usually caused by the Epstein-Barr virus, according to the Centers for Disease Control and Prevention (CDC). Mono, which is also called "the kissing disease," is usually spread through bodily fluids, with saliva being the most common, the CDC says. Still, it's possible to spread the virus through blood and semen during sexual contact, blood transfusions, and organ transplants.
Mono is most common in teens and college students, with at least one in four teens and young adults who get infected with Epstein-Barr virus developing infectious mononucleosis, per the CDC.
For what it's worth: Mono isn't a seasonal illness. "There is no clear seasonality to infectious mononucleosis caused by Epstein Barr virus," says Amesh A. Adalja, M.D., a senior scholar at the Johns Hopkins Center for Health Security.
What are the symptoms of mono?
It can take anywhere from four to six weeks to develop symptoms of mono once you've been infected, the CDC says. And yes, it's easy to confuse the symptoms of mono with those of a bad cold, the flu, or COVID-19, says William Schaffner, M.D., an infectious-disease specialist and professor at the Vanderbilt University School of Medicine. "It all gets pretty fuzzy with these viruses," he says.
John Sellick, D.O., an infectious disease expert and professor of medicine at the University at Buffalo/SUNY, agrees. "Could this be COVID or mono? It's sometimes hard to tell," he says.
These are the most common symptoms of mono, per the CDC:
- extreme fatigue
- fever
- sore throat
- head and body aches
- swollen lymph nodes in the neck and armpits
- swollen liver or spleen or both
- rash
The swollen lymph nodes in the neck and armpits, along with a bad sore throat, are usually one of the biggest differentiators between mono and other illnesses, Dr. Schaffner says.
Most people recover from mono in two to four weeks, but Dr. Schaffner says that "some people have waxing and waning symptoms, where they feel better for a bit and then worse—that can be frustrating."
How is mono diagnosed?
Your doctor will usually suspect that you have mono based on your symptoms and by looking at things like your swollen lymph nodes, tonsils, liver, or spleen (which they can feel by pressing on your abdomen, Dr. Sellick says).
Your doctor may also order a monospot test to check your blood for antibodies to the Epstein-Barr virus, along with a white blood cell count to see if yours are elevated, the Mayo Clinic says.
How is mono treated?
There isn't one medication that's designed to treat mono, Dr. Schaffner says. Instead, your doctor may recommend that you do things like drink plenty of fluids, get lots of rest, and take over-the-counter medications to minimize pain and fever, if you have those symptoms.
One thing to keep in mind, too, is that you may need to take it easy for a little while. Many people with mono have an enlarged spleen, so doctors generally recommend that you take a pass on contact sports for a certain period of time to avoid the risk of getting hit in the abdomen and rupturing your spleen. That amount of time can vary, Dr. Sellick says, adding, "I usually recommend waiting until they're feeling better and I can no longer [feel] an enlarged spleen."
You'll also want to just listen to your body. "Everything depends on how well you feel," Dr. Schaffner says. "It can be a very frustrating illness because some people can feel weak for quite some time."
Do you need to stay home when you have mono?
Not necessarily. "Our usual recommendation is that you can go back to school or work when you feel OK," Dr. Sellick says. "Most of the time, people with acute mono feel pretty miserable." Aline M. Holmes, D.N.P., R.N., a clinical associate professor at Rutgers University School of Nursing, agrees, noting that you're less infectious after your symptoms start to get better. "Just take it easy for a while," she says. "Mono does cause you to be very tired."
Dr. Sellick just recommends being mindful of not sharing utensils and practicing good hand hygiene when you do venture out to avoid infecting anyone else. By the way, if you have a partner, you can probably start kissing them again as soon as you feel better. "If you've been kissing up to the point that you felt sick, they probably were already exposed," Holmes says.
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