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Kissing disease. Glandular fever. Pfeiffer’s disease. All of these are names for the infectious mononucleosis syndrome, or mono, a viral illness typified by sore throat, fever and swollen glands. In the U.S., mono occurs mostly in adolescents, at a rate of roughly 45 in 100,000 people. What is it? • Mono is frequently caused by the Epstein-Barr virus (EBV), one of the most common human viruses, infecting approximately 95% of Americans by age 35. The majority of infections occur before the age of 5, when it is least likely to cause symptoms. • The virus is spread through saliva. Children can catch the virus from an infected playmate or family member. Teenagers may be exposed through sharing food, drinks and through kissing. Close contact of this kind, however, only occasionally results in an infection. • EBV has a one- to two-month incubation period before causing symptoms. Children under age 10 may appear only mildly sick, with a fever, decreased appetite and fussiness, or may have no symptoms at all. Between the ages of 10 and 30, the virus may cause flu-like symptoms, and can lead to mono about 40% of the time. Infection is rare over the age of 30, as most people this age have already been exposed. Symptoms: • Mono causes a severe sore throat, with white patches on the tonsils. Fever can rise as high as 104 degrees. The lymph nodes of the neck and armpits and groin can become swollen and tender. The spleen, located in the left upper area of the abdomen, can become enlarged. Muscle aches and extreme fatigue is very common with mono. • In the majority of cases, the infection goes away on its own within a few weeks. Fatigue and muscle aches sometime linger on, but most people recover fully in about two months. In rare cases, complications such as low numbers of platelets or red blood cells in the blood can occur. On occasion the tissue around the brain or liver is affected. Swelling of the throat can cause airway obstruction and, in about one in 1,000 cases, the spleen can rupture. • Seek immediate medical attention if symptoms last more than 10 days, or if you experience severe sore throat, headache with stiff neck, prolonged high fevers, yellow discoloration of eyes and skin, difficulty breathing, or sudden sharp stomach pain. • A number of different blood tests are available to diagnose mono. One can be done in the office with results in minutes. Another checks for the classic mononuclear white blood cells which appear in the blood during this infection, and for which this illness was named. The doctor will choose the most appropriate test depending on the situation, and may rule out other infections such as strep throat. • There is no cure for mono, but most people improve readily with fluids and rest. Ibuprofen (Motrin or Advil) or acetaminophen (Tylenol) may help the fever and aching. Throat sprays or lozenges may relieve the sore throat. Steroids may be used to reduce swelling of the throat. Antibiotics are not effective for mono. Avoid ampicillin and amoxicillin as they can cause a rash in someone with mono. Although prolonged bed rest is not necessary, avoid contact sports or strenuous activities for at least four weeks to prevent rupture of the spleen. • To prevent exposure to the virus, avoid kissing or sharing utensils with someone who has mono. People may be contagious while they have the infection and even for several months afterwards. There is no vaccine to protect against EBV. Fortunately, after an EBV infection, most people are immune for the rest of their lives. Dr. Richelle K. Marracino is a family practice physician at the UC Riverside Campus Health Center, 951.827.3031. DID YOU KNOW? In the U.S., mono occurs mostly in adolescents, at a rate of roughly 45 in 100,000 people. Infection is rare over the age of 30, as most people this age have already been exposed. People may be contagious while they have the infection and even for several months afterwards. |
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