Infectious Mononucleosis

Overview

Infectious mononucleosis, also known as “kissing disease”, is a viral disease characterised by symptoms such as fever, sore throat, swollen lymph glands, and excessive exhaustion. Symptoms of the condition can take up to six weeks and typically do not last longer than four months. Mouth-to-mouth contact with infected saliva is the most common method of transmission. Because the virus can be carried in saliva, it is impossible to prevent transmission.

Key Facts

1. Sprunt and Evans published their findings on infectious mononucleosis for the first time in the Bulletin of the Johns Hopkins Hospital in 1920.
2. Epstein-Barr virus (EBV), commonly known as human herpes virus 4, is a type of herpes virus that consists of double-stranded DNA and is widely spread. It is the infectious mononucleosis virus that is responsible for causing the disease (“mono” or “glandular fever”).
3. The time that passes after an individual becomes infected with the virus before they exhibit symptoms is called the incubation period. It can continue anywhere from four to six weeks. Meanwhile, the signs and symptoms associated with mononucleosis usually range from one to two months. 
4. Young people between the ages of 15-30, medical personnel, students, and caregivers, are at higher risk of contracting infectious mononucleosis.
5. Infectious mononucleosis is often called the “kissing disease” as it can be transmitted by kissing infected individuals.
6. EBV persists life-long in more than 95% of adults, but only a relatively few people develop EBV-associated diseases.
7. Complications of infectious mononucleosis can include; anaemia, hepatitis, enlargement of the spleen, swollen tonsils, thrombocytopenia & inflammation of the heart muscles.
8. There is no current cure or effective medication for infectious mononucleosis. Still, painkillers and corticosteroids may help you relieve the associated pain.

Symptoms

Some possible signs and symptoms of mononucleosis include:

• Fatigue
• Throat pain: This is sometimes misinterpreted as strep throat and does not improve even with antibiotic treatment.
• Fever
• Painful, swollen lymph nodes in your neck and armpits
• Swollen tonsils
• Headache
• Rashes on the skin 
• Soft, swollen spleen

Diagnosis

According to the Mayo Clinic, the possible diagnoses for infectious mononucleosis are:

• Physical exams: Your doctor may suspect you have mononucleosis based on the signs and symptoms you’ve been experiencing, the length of time they’ve been present, and a physical exam. As you describe your symptoms, they will look for further signs, such as swollen lymph nodes, tonsils, liver, or spleen.
• Antibody test: If more confirmation is required, a monospot test may be performed to screen your blood for Epstein-Barr virus antibodies. It might not detect the infection during the initial week of illness.
• White blood cell count: Your healthcare provider may perform further blood tests to look for an abnormally increased number of white blood cells (lymphocytes) or lymphocytes with an abnormal appearance. These blood tests will not confirm mononucleosis, but they may indicate the likelihood of the disease.

Causes

The  Epstein-Barr virus (EBV), a type of herpes virus, is the primary cause of infectious mononucleosis.  You may catch the virus by coming into close contact with saliva or other bodily fluids, such as blood, produced by an infected individual. Additionally, it can be transmitted through sexual activities and the transplantation of organs.

If you kiss someone with mononucleosis, share food or drinks with them, or stay around them when they cough or sneeze, you could potentially catch the virus. After becoming infected, it can take up to eight weeks for symptoms to appear. The infection may not develop symptoms in teens and adults. The virus almost always does not present symptoms; hence the condition is often misdiagnosed as something else.

Another type of herpes virus, human cytomegalovirus (CMV), is responsible for approximately five percent to seven percent of infectious mononucleosis cases. This virus is found in body fluids such as tears, saliva, urine, and blood. It can also be transmitted through feces. CMV can infect a person who comes into close touch with contaminated bodily fluids of another person who is already infected. 

Kissing and intimate sexual contact are cytomegalovirus’s most typical transmission modes. Additionally, an infected mother can pass the infection on to her unborn child. Because the signs and symptoms of this virus are frequently not felt by the affected person, it is sometimes called a “silent” virus.

Prevention

There is currently no vaccination available for the prevention of infectious mononucleosis. You can help protect yourself from the disease by avoiding kissing those infected and sharing drinks, food, or personal things like toothbrushes.

Typical Treatments

There is no established cure or medication that is effective against infectious mononucleosis. However, to lessen the swelling in your throat and tonsils, your physician may recommend that you take corticosteroid medicine. The symptoms usually leave on their own within one to two months.

If your symptoms worsen or you experience severe stomach discomfort, you should make an appointment with your primary care physician.

Additional home treatments that may help alleviate symptoms include the following:

• Getting a good amount of sleep
• Maintaining adequate hydration, ideally by drinking uncontaminated water
• Consuming steaming bowls of soup
• Enhancing your immune system by consuming foods that are anti-inflammatory and high in antioxidants, such as leafy green vegetables, apples, brown rice, and salmon; making use of over-the-counter pain medications, such as acetaminophen and Tylenol.

NOTE: Never give aspirin to a child under 18, as doing so puts them at risk of contracting Reye’s syndrome, a rare condition that can harm both the brain and the liver.

Conclusion

Mononucleosis can linger for weeks, requiring you to stay at home while you heal. Handle your body with care as it battles the virus.

Mononucleosis will cause some missed activities for young people, such as classes, team practices, and parties. You will, without a doubt, need to rest for a time. Students must notify their schools that they are recovering from mononucleosis and may require additional accommodations to complete their assignments.

You do not have to be isolated if you have mononucleosis. Because of childhood exposure, many people are already resistant to the Epstein-Barr virus. However, you should skip some activities until you feel better.