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Mono — The Kissing Disease

The fall is upon us and that means germs are running rampant throughout the halls. One of the viruses that can be prevalent this time of year is infectious mononucleosis, more commonly known as mono. Some of you may know it as the "kissing disease." Is it really caused by kissing? What are the symptoms? Do I need to be checked for it? Read on find the answers to these questions and many more.

What causes mono?
Mono is caused by Epstein-Barr virus (EBV). Most adults have been exposed to mono at some point and have a mild illness associated with this. After exposure to EBV, immunity occurs in most individuals. This means that once you have mono you should not be able to contract it a second time. It is spread most commonly by saliva. This means it can be spread by coughing, sneezing, kissing or sharing drinks and eating utensils.

What are the symptoms?
The most common symptoms are fever, fatigue, sore throat, headache and enlarged lymph nodes in the cervical (neck) region. Also, enlargement of the spleen and/or liver may occur along with this. Enlargement of these organs may cause some generalized abdominal pain and occasional vomiting.

There are often abnormal laboratory results associated with this disorder as well. Blood tests confirm the presence of acute Epstein-Barr virus. Sometimes the blood test for EBV is not positive right away so you may have to have it rechecked if your symptoms persist. Often, liver function tests are elevated with this virus. They do decrease with time and return to normal but you may have to return to your medical provider's office to have serial blood tests to confirm this.

What else could it be?
Other viruses such as cytomegalovirus (CMV) often mimic EBV and have similar symptoms. The only way to differentiate these is to have blood tests drawn to confirm the dose. Treatment does not change based on which virus is causing the symptoms. Other possibilities are strep throat, viral tonsillitis, mumps, or acute viral hepatitis. Only your medical provider can differentiate between all of these possibilities and give an accurate diagnosis for your symptoms.

How is it treated?
Treatment for infectious mononucleosis is mostly supportive cares. Tylenol and ibuprofen for pain and fever, rest, and good fluid intake are first line treatments. Antiviral medications have not been proven effective and generally are not recommended. Occasionally steroids such as prednisone can give some relief of symptoms but do not always shorten the course of the disease. Antibiotics are not helpful unless there is strep throat associated with the EBV. As there is often association of enlarged liver and spleen, it is important to take it easy and avoid contact sports while having an acute EBV reaction. When these organs are enlarged, aggressive contact to these areas of the body can cause rupture of the organs (especially the spleen) which can be life-threatening. It is recommended you sit out of contact sports until cleared by your medical provider.

If you feel that you have some (or all) of the symptoms of EBV, please contact your medical provider today for an appointment. It is important to see your physician or physician extender if you have any of the symptoms associated with EBV for greater than 48 hours. Also, make sure that you get your flu shot soon to prevent any other unwanted illnesses this fall and winter.

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