November 12, 2007
You may have had mono (mononucleosis, also known as "the
kissing disease"). Even if you don't think that you have
had the disease, chances are that you know someone who has.
While it is a common belief for people think of mono as
something that makes people sick (and tired) for a period
of months, few understand that the majority of the adult
population has (at some point in their lives) had mono
(often without even knowing it).
"Mono, or mononucleosis, is spread through direct contact
with saliva. This includes sharing eating utensils or
drinks. Because it takes about 30 to 50 days for symptoms
to appear, a person who's infected can spread the virus
without even knowing it. ... If you've shared drinks with
or kissed someone who has mono, there's no way to tell
whether you will get it -- unless you know you've had mono
before. People who have already been infected with the
virus that causes mono -- Epstein-Barr virus or EBV -- will
develop immunity that protects them from further infection.
An estimated 95% of adults have been infected with EBV and
50% of children are infected before age 5. So you may very
well have already had mono and not known it."
Most people don't think of children as having mono. As
young children put things in their mouths and share food
and drinks with their siblings, parents, and friends, they
can often spread a disease that no one knew they had.
"Many children become infected with EBV [Epstein-Barr
virus], and these infections usually cause no symptoms or
are indistinguishable from the other mild, brief illnesses
of childhood. In the United States and in other developed
countries, many persons are not infected with EBV in their
childhood years. When infection with EBV occurs during
adolescence or young adulthood, it causes infectious
mononucleosis 35% to 50% of the time. ... Most individuals
exposed to people with infectious mononucleosis have
previously been infected with EBV and are not at risk for
infectious mononucleosis. ... Persons with infectious
mononucleosis may be able to spread the infection to others
for a period of weeks. However, no special precautions or
isolation procedures are recommended, since the virus is
also found frequently in the saliva of healthy people. In
fact, many healthy people can carry and spread the virus
intermittently for life."
Those who are exposed as young children often have the
disease run its course like any other mild, childhood
illness. It is those who do not get their first exposure to
the virus until later in life that often have more severe
It takes weeks for symptoms to appear once a person has
been exposed to the virus, and many who have had the virus
don't know that they have been exposed and had the
opportunity to develop immunity. For these reasons, it is
very difficult to know who might have the potential to
spread -- and who might have the potential to catch -- mono
at any given time.
"Once someone gets mono, the virus stays in that person's
body for life. But this doesn't mean that if you've had
mono you are always contagious. Over time, the virus
becomes less contagious. Eventually, it's very unlikely
that a person who had mono will transmit the virus to
someone else. People who have mono can be contagious from
the time they first become infected with the virus. But
they may not know that they have the virus in its early
stages. That's because it takes a while from the time a
person is infected to the time symptoms of mono show up --
about 4 to 7 weeks in fact. (This is called the incubation
period.) To make it even more confusing, some people can
carry the virus without having any symptoms of mono, so
they might not know they have the infection at all."
With all the confusion, it can be difficult to tell if a
person has mono, who has had mono, and who has the
potential to spread the disease.
"Symptoms of mono include: Fever, Sore throat, Swollen
lymph glands. Sometimes you may also have a swollen spleen.
Serious problems are rare. A blood test can show if you
have mono. Most people get better in two to four weeks.
However, you may feel tired for a few months afterward.
Treatment focuses on helping symptoms and includes
medicines for pain and fever, warm salt water gargles and
plenty of rest and fluids."
Serious problems are rare, but it is important to know what
to watch for.
"The main serious concern with mono is that the spleen will
enlarge and even rupture (tear open). The spleen is like a
large gland. It's located in the upper part of your abdomen
on the left side. It helps filter your blood. Although a
ruptured spleen is rare in people with mono, it's wise to
be aware of the signs and call your doctor right away if
you notice any of them. Signs of a ruptured spleen include
pain in the left upper part of your abdomen (under the left
chest), feeling lightheaded, feeling like your heart is
beating fast and hard, bleeding more easily than usual and
having trouble breathing. ... [If you have mono, you
should] avoid sports, activities or exercise of any kind
until your doctor tells you it's safe. Moving around too
much puts you at risk of rupturing your spleen. You need to
avoid physical activities for about 3 to 4 weeks after the
Questions of the Week:
What myths and misconceptions do you think surround mono
and how it is spread? What do you, your peers, and your
family members need to know about the disease? What should
you do if you think that you or someone you know might have
Please email me with any ideas or suggestions.
Note: Due to increasing amounts of SPAM sent to this account, please include "QOW" in the subject line when sending me email.
I look forward to reading what you have to say.
Health Community Coordinator
Access Excellence @ the National Health Museum