When Ashley came home with a headache and body aches and pains, she thought she had caught the flu. But by the next morning, Ashley's temperature had soared to 103 degrees Fahrenheit (39 degrees Celsius) and her throat felt like she'd swallowed hot coals. Even worse, she was so tired she could hardly lift her head off the pillow. Ashley had never felt this bad with any cold or flu. Ashley's mom took her to the doctor's office. A physical examination and a blood test revealed that Ashley had mononucleosis. What Is It? Infectious mononucleosis (pronounced: mah-no-noo-klee-o-sus), sometimes called "mono" or "the kissing disease," is an infection that is usually caused by the Epstein-Barr virus (EBV). EBV is very common, and most people have been exposed to the virus at some time in childhood. Not everyone who is exposed to the virus develops the symptoms of mono, though. As with many viruses, it is possible to be exposed to and infected with EBV without becoming sick. People who have been infected with EBV will carry the virus for the rest of their lives - even if they never have any signs or symptoms of mono. People who do show symptoms of having mono probably will not get sick, or have symptoms, again. Although EBV is the most common cause of mono, other viruses, such as cytomegalovirus (pronounced: sye-toe-meh-guh-low-vye-rus), can cause a similar illness. Like EBV, cytomegalovirus stays in the body for life and may not cause any symptoms. People often kid around about mono, but as Ashley discovered, it's no joke. A case of mono can keep you out of commission for weeks. How Do People Get Mono? One common way to "catch" mono is by kissing someone who has been infected, which is how the illness got its nickname. A quick smooch between friends probably won't do any harm. But if you have never been infected with EBV, intimate kissing with someone who is infected can put you at greater risk for getting the disease. But what if you haven't kissed anyone? You can also get mononucleosis through other types of direct contact with saliva (spit) from someone infected with the virus, such as by sharing a straw or an eating utensil. Some people who have the virus in their bodies never have any symptoms, but it is still possible to pick up the virus from them. Although experts believe that EBV can spread from people who have the virus but don't have symptoms of mono, people are most contagious while they have a fever. How Do I Know if I Have It? Symptoms usually begin to appear 4 to 7 weeks after infection with the virus. Signs that you may have mono include: constant fatigue fever sore throat loss of appetite swollen lymph nodes (also commonly known as glands, located in your neck, underarms, and groin) headaches sore muscles larger-than-normal liver and spleen skin rash abdominal pain People who have mono may have different combinations of these symptoms, and some people may have symptoms so mild that they hardly notice them. Other people may have no symptoms at all. Even if you have several of these symptoms, don't try to diagnose yourself. Always consult your doctor if you have a fever, sore throat, and swollen glands or are unusually tired for no apparent reason. Because these symptoms are so general and can be signs of other illnesses, it's possible to mistake mononucleosis for the flu or even strep throat. In fact, occasionally some teens may have mono and strep throat at the same time. When making a diagnosis, the doctor may want to take some blood tests to see if mono is causing your symptoms. But even if the blood tests indicate that you have mono, there isn't much the doctor can do other than advise you to drink lots of fluids and get lots of rest. How Can I Get Better? There is no cure for mononucleosis, but the good news is that even if you do nothing, the illness will go away by itself, usually in 3 to 4 weeks. Because mono is caused by a virus, antibiotics such as penicillin won't help unless you have an additional infection like strep throat. In fact, certain antibiotics can even cause a rash if you take them while you have mono. Although there's no magic pill for mono, you can do some things to feel better. The best treatment is to get plenty of rest, especially during the beginning stages of the illness when your symptoms are the worst. Put yourself to bed and pass on school, sports, and other activities. For the fever and aching muscles, try taking acetaminophen (such as Tylenol) or ibuprofen (such as Advil or Motrin). Steer clear of aspirin unless your doctor tells you to take it - it's been linked to a serious disease in kids and teens called Reye syndrome, which can lead to liver failure and death. If you have a sore throat, chew gum, drink tea with honey, or suck on hard candy or ice pops. Even if you're not hungry, try to eat a well-balanced diet and drink lots of water and juices to prevent dehydration. You can get some nutrition and soothe your throat with cold fruit smoothies or low-fat shakes. When you start feeling better, take it slowly. Although you can return to school once your fever disappears, you may still feel tired. Your body will tell you when it's time to rest - listen to it. By taking good care of yourself and resting as much as you need to, you will soon be back to normal, usually within a few weeks. Doctors also recommend avoiding sports for at least a month after the illness because the spleen (an organ in the body that sits under the left rib cage) is usually enlarged temporarily while you are ill. An enlarged spleen can rupture easily, causing bleeding, fever, and abdominal pain and requiring emergency surgery. Do not participate in contact sports, cheerleading, or even wrestling with your little siblings or your friends until your doctor gives you permission. As you recover, make sure you don't share the virus with your friends and family. Chances are they will not get the disease from casual contact with you, but you can take a few steps to help them stay germ free. Wash your hands often, cover your nose and mouth when you sneeze or cough, and keep your drinks and eating utensils to yourself. This is one time when your friends and family will thank you for being selfish. http://kidshealth.org/teen/infections/common/mononucleosis.html ---------------------------------------------------------------------------- **************************************************************************** Infectious mononucleosis (mono) or glandular fever is often called the kissing disease. The label is only partly true. Kissing can spread the virus that causes this disease, but more commonly coughing, sneezing, or sharing a glass or cup transmits mononucleosis. It's not highly contagious. Mononucleosis is caused by the Epstein-Barr virus, although similar signs and symptoms are sometimes caused by cytomegalovirus. Full-blown mono is most common in adolescents and young adults. Young children usually have minimal symptoms, and the infection often goes unrecognized. In lesser developed countries, mononucleosis is more frequently acquired at a young age, so classic mono signs and symptoms aren't as common as in developed nations. Mono usually isn't very serious, although the virus remains in your body for life. Most people have been exposed to the Epstein-Barr virus by the time they're 35 years old and have built up antibodies. They're immune and won't get mononucleosis again. Treatment mostly involves bed rest and getting adequate fluids. http://www.mayoclinic.com/health/mononucleosis/DS00352 ------ Signs and symptoms Signs and symptoms of mononucleosis may include: Fatigue Weakness Sore throat, perhaps a strep throat that doesn't get better with antibiotics Fever Swollen lymph nodes in the neck and armpits Swollen tonsils Headache Skin rash Loss of appetite Soft, swollen spleen In children between the ages of 4 and 15, the virus may cause a mild illness that resembles a common respiratory infection. In older adults, mono causes more severe signs and symptoms and lasts longer. The virus typically has an incubation period of four to six weeks, although in young children this period is shorter. Symptoms such as fever and sore throat usually lessen within a couple of weeks, although fatigue, enlarged lymph nodes and swollen spleen may last for a few weeks longer. http://www.mayoclinic.com/health/mononucleosis/DS00352/DSECTION=2& ------ When to seek medical advice If you've been feeling tired and weak; have had a persistent fever, headache, loss of appetite, rash and muscle aches; and have had swollen lymph nodes, tonsils and spleen — these are strong indications that you have mononucleosis. If rest and a healthy diet haven't resulted in easing your symptoms within a week or two or if your symptoms recur, see your doctor. http://www.mayoclinic.com/health/mononucleosis/DS00352/DSECTION=3& ------ Screening and diagnosis Your doctor may suspect mononucleosis based on your signs and symptoms and a physical examination. If there's a need for additional confirmation, a Monospot test is generally done to check your blood for antibodies to the Epstein-Barr virus. This is a screening test with a result within a day. But it may not detect the infection during the first week of the illness. Another antibody blood test requires a longer result time, but can detect the disease even within the first week of symptoms. Other blood tests that may be used look for elevated numbers of white blood cells (lymphocytes) or abnormal-looking lymphocytes. http://www.mayoclinic.com/health/mononucleosis/DS00352/DSECTION=4& ------ Complications Significant complications of mononucleosis include enlargement of the spleen. In extreme cases, the spleen may rupture, causing sharp, sudden pain in the left side of your upper abdomen. If such pain occurs, seek medical attention immediately — you may need to have surgery. Most people with mono have mild liver inflammation (hepatitis). Jaundice occurs occasionally, usually in people older than 35. About half of the people with mono have a low count of platelets, which are blood cells involved in clotting. Mononucleosis can also result in the following less common complications: Anemia, a decrease in red blood cells and hemoglobin Inflammation of the heart Complications involving the nervous system (meningitis, encephalitis, seizures, Bell's palsy, Guillain-Barre syndrome) Swollen tonsils, leading to obstructed breathing The Epstein-Barr virus can cause much more serious illness in people who have impaired immune systems, such as people with HIV/AIDS or people taking drugs to suppress immunity following an organ transplant. Growing evidence suggests a possible link between mononucleosis and an increased risk of developing multiple sclerosis — a muscle-weakening disease of unknown cause. In one study of more than 60,000 women, researchers found that study participants who had multiple sclerosis had higher antibody levels to the Epstein-Barr virus in their blood compared with those without multiple sclerosis. Another even larger study found that people with the highest level of antibodies against the Epstein-Barr virus were more than 30 times more likely to develop multiple sclerosis later than those with the lowest level of antibodies. However, because so few people exposed to the Epstein-Barr virus ever develop multiple sclerosis, scientists point out that other factors must be involved in causing the disease. http://www.mayoclinic.com/health/mononucleosis/DS00352/DSECTION=5& ------ Prevention Mononucleosis is believed to spread through saliva. If you're infected, you can help prevent spreading the virus to others by not kissing them and by not sharing food, dishes, glasses and utensils until several days after your fever has subsided. If you've had mononucleosis, don't donate blood for at least six months after the onset of the illness. There's no vaccine to prevent mononucleosis. http://www.mayoclinic.com/health/mononucleosis/DS00352/DSECTION=7& *************************************************************************** ------------------------------------------------------------------------------ Mononucleosis is caused by the Epstein-Barr virus. Once a person has been infected, the virus stays in the body for the rest of his life and may reappear in the saliva from time to time. However, the person usually won't get the symptoms of mono - like being tired all the time, fever, and loss of appetite - again from this virus. If you have symptoms of mono - even if you've had it before - you need to see your doctor for a diagnosis. Other illnesses such as strep throat and the flu may cause similar symptoms. Your doctor can make an accurate diagnosis. http://www.nlm.nih.gov/medlineplus/infectiousmononucleosis.html --------------------------------------------------------------------------- Mono, short for mononucleosis, is caused by an infection with the Epstein-Barr virus (EBV), a virus in the herpes family of viruses. As with other herpes viruses, EBV stays in your body for the rest of your life. But this doesn't mean that if you've had mono you are always contagious. Read on to learn more about how people get mono. Mono is frequently referred to as the "kissing disease" because you can catch it from the saliva of someone who has the virus. But because it's transmitted through saliva, a person doesn't need to kiss someone to get mono: It can also be contracted by sharing a toothbrush, drinking straw, or eating utensil with someone who has the virus. After a person has been infected by the virus, he or she generally won't show any symptoms of mono for 4 to 6 weeks. (The time between when a person contracts the virus and when he or she has symptoms is what doctors call the incubation period.) When a person first notices symptoms, he or she may have 3-5 days of headache and feeling tired, followed by fever, sore muscles, headache, sore throat, and loss of appetite. Two indicators that someone may have something more than a cold or the flu are feeling tired all the time, and having swollen lymph nodes (glands) in the neck, under the arms, and around the groin. Some people also have an enlarged liver or spleen. Sometimes, though, people can carry the virus without having any symptoms of mono, so they don't necessarily know they have the infection. A blood test, known as the Monospot test, can help a doctor determine whether or not a person has mono. Mono can't be cured and needs to run its course naturally over about 2 to 4 weeks - and some people feel tired for several weeks longer. For information on taking care of yourself if you have mono, click on the More Articles Like This tab. Answering the big question about how long a person can be contagious is tricky because doctors and researchers aren't exactly sure. It's generally believed that a person can spread the infection for the entire time he or she has symptoms and even for several months after the symptoms are completely gone. But after that, it's very unlikely you'll give someone else mono. If you've had mono, it may be a good idea not to share that ice cream soda for about 6 months after you start feeling better. You also should avoid kissing, too - although a quick peck on the cheek shouldn't put anyone at risk! http://kidshealth.org/teen/infections/common/mono_contagious.html --------------------------------------------------------------------------- Pucker up! Have you ever heard of the "kissing disease"? If you said that it's mono, you're absolutely correct. But you don't get mono only from kissing. Infectious mononucleosis (say: mah-no-noo-klee-o-sus), called mono for short, is caused by the Epstein-Barr virus (EBV), which is a type of herpes (say: hur-peez) virus. Other viruses in the herpes family cause cold sores and illnesses like chickenpox. How Do I Get Mono? Most people who get mono are between the ages of 10 and 25. The mono virus affects your lymph nodes, throat, salivary glands, liver, spleen, and blood, and it can make you lose your appetite and feel tired and achy all over. Salivary glands are located inside of your mouth - on the inside of your cheeks and under your tongue - and produce saliva, or spit. Your spleen is located on the left side of your abdomen, just under the rib cage, and it helps cleanse your blood of bacteria and viruses. Mono is contagious, which means you can easily spread the virus to other people who haven't had mono before. Even though you can get mono from kissing someone infected with EBV, there are also other ways you can get it, but they all involve contact with saliva. Coughing (while not covering your mouth) on someone or sharing pillows, straws, toothbrushes, or food from the same plate also spread mono. If you get mono, you can infect other people for up to 6 months afterward. At first, people usually don't feel sick after getting infected with the EBV virus. So someone could have mono - and be spreading it - and not even know it. That's why it's important not to share things like forks, straws, or lip gloss at school. How Do I Know I Have It? Mono almost always causes you to feel really, really tired, but you may have other symptoms, too. These include: fever sore throat swollen lymph glands (the infection-fighting glands in your neck, underarms, groin, and elsewhere throughout your body) headaches sore muscles enlarged liver or spleen (an organ located on the left side of your belly, right under your ribs, that filters blood and helps fight infections) Sometimes, it may seem like you have the flu or maybe strep throat because the symptoms are so much alike. The only way to tell for sure if you have mono is to go to a doctor, who will examine you and draw blood for tests (one test is called the Monospot) to see if you have mono. If You Have Mono Usually with mono you will need plenty of rest, which means no school for awhile, no sports, and no running outside playing with friends or even wrestling with your little brother. While you're resting, it's a good idea to drink plenty of water and other fluids. You can ask your mom or dad to give you a fever or pain reliever if you have a fever or if your muscles are sore. Don't take any aspirin, though, because that can put you at risk for a condition called Reye syndrome, which can be dangerous. If you play contact sports, such as football and basketball, you will probably need to avoid them while you're sick and for about a month after you get better - especially if your spleen is enlarged. Your doctor will let you know when it's safe for you to get back in the game. While you have mono, you might get a little constipated, which means that you have trouble having bowel movements (pooping). Talk to your mom or dad if you can't poop or your bowel movements are hard instead of soft. Eating plenty of veggies, fruits, and grains and drinking plenty of water can help get things moving. You'll probably be happy to hear that mono usually goes away after a few weeks, even though you'll have to take it easy for awhile. Make sure you wash your hands after you cough or sneeze. Keep your straws, forks, and toothbrushes to yourself, and . . . no kissing for a few months! http://kidshealth.org/kid/talk/qa/mono.html ------------------------------------------------------------------------------- Epstein-Barr virus, frequently referred to as EBV, is a member of the herpesvirus family and one of the most common human viruses. The virus occurs worldwide, and most people become infected with EBV sometime during their lives. In the United States, as many as 95% of adults between 35 and 40 years of age have been infected. Infants become susceptible to EBV as soon as maternal antibody protection (present at birth) disappears. Many children become infected with EBV, 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. Symptoms of infectious mononucleosis are fever, sore throat, and swollen lymph glands. Sometimes, a swollen spleen or liver involvement may develop. Heart problems or involvement of the central nervous system occurs only rarely, and infectious mononucleosis is almost never fatal. There are no known associations between active EBV infection and problems during pregnancy, such as miscarriages or birth defects. Although the symptoms of infectious mononucleosis usually resolve in 1 or 2 months, EBV remains dormant or latent in a few cells in the throat and blood for the rest of the person's life. Periodically, the virus can reactivate and is commonly found in the saliva of infected persons. This reactivation usually occurs without symptoms of illness. EBV also establishes a lifelong dormant infection in some cells of the body's immune system. A late event in a very few carriers of this virus is the emergence of Burkitt's lymphoma and nasopharyngeal carcinoma, two rare cancers that are not normally found in the United States. EBV appears to play an important role in these malignancies, but is probably not the sole cause of disease. Most individuals exposed to people with infectious mononucleosis have previously been infected with EBV and are not at risk for infectious mononucleosis. In addition, transmission of EBV requires intimate contact with the saliva (found in the mouth) of an infected person. Transmission of this virus through the air or blood does not normally occur. The incubation period, or the time from infection to appearance of symptoms, ranges from 4 to 6 weeks. 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. These people are usually the primary reservoir for person-to-person transmission. For this reason, transmission of the virus is almost impossible to prevent. The clinical diagnosis of infectious mononucleosis is suggested on the basis of the symptoms of fever, sore throat, swollen lymph glands, and the age of the patient. Usually, laboratory tests are needed for confirmation. Serologic results for persons with infectious mononucleosis include an elevated white blood cell count, an increased percentage of certain atypical white blood cells, and a positive reaction to a "mono spot" test. There is no specific treatment for infectious mononucleosis, other than treating the symptoms. No antiviral drugs or vaccines are available. Some physicians have prescribed a 5-day course of steroids to control the swelling of the throat and tonsils. The use of steroids has also been reported to decrease the overall length and severity of illness, but these reports have not been published. It is important to note that symptoms related to infectious mononucleosis caused by EBV infection seldom last for more than 4 months. When such an illness lasts more than 6 months, it is frequently called chronic EBV infection. However, valid laboratory evidence for continued active EBV infection is seldom found in these patients. The illness should be investigated further to determine if it meets the criteria for chronic fatigue syndrome, or CFS. This process includes ruling out other causes of chronic illness or fatigue. DIAGNOSIS OF EBV INFECTIONS In most cases of infectious mononucleosis, the clinical diagnosis can be made from the characteristic triad of fever, pharyngitis, and lymphadenopathy lasting for 1 to 4 weeks. Serologic test results include a normal to moderately elevated white blood cell count, an increased total number of lymphocytes, greater than 10% atypical lymphocytes, and a positive reaction to a "mono spot" test. In patients with symptoms compatible with infectious mononucleosis, a positive Paul-Bunnell heterophile antibody test result is diagnostic, and no further testing is necessary. Moderate-to-high levels of heterophile antibodies are seen during the first month of illness and decrease rapidly after week 4. False-positive results may be found in a small number of patients, and false-negative results may be obtained in 10% to 15% of patients, primarily in children younger than 10 years of age. True outbreaks of infectious mononucleosis are extremely rare. A substantial number of pseudo-outbreaks have been linked to laboratory error, as reported in CDC's Morbidity and Mortality Weekly Report, vol. 40, no. 32, on August 16, 1991. When "mono spot" or heterophile test results are negative, additional laboratory testing may be needed to differentiate EBV infections from a mononucleosis-like illness induced by cytomegalovirus, adenovirus, or Toxoplasma gondii. Direct detection of EBV in blood or lymphoid tissues is a research tool and is not available for routine diagnosis. Instead, serologic testing is the method of choice for diagnosing primary infection. EBV-Specific Laboratory Tests Laboratory tests are not always foolproof. For various reasons, false-positive and false-negative results can occur for any test. However, the laboratory tests for EBV are for the most part accurate and specific. Because the antibody response in primary EBV infection appears to be quite rapid, in most cases testing paired acute- and convalescent-phase serum samples will not demonstrate a significant change in antibody level. Effective laboratory diagnosis can be made on a single acute-phase serum sample by testing for antibodies to several EBV-associated antigens simultaneously. In most cases, a distinction can be made as to whether a person is susceptible to EBV, has had a recent infection, has had infection in the past, or has a reactivated EBV infection. Antibodies to several antigen complexes may be measured. These antigens are the viral capsid antigen, the early antigen, and the EBV nuclear antigen (EBNA). In addition, differentiation of immunoglobulin G and M subclasses to the viral capsid antigen can often be helpful for confirmation. When the "mono spot" test is negative, the optimal combination of EBV serologic testing consists of the antibody titration of four markers: IgM and IgG to the viral capsid antigen, IgM to the early antigen, and antibody to EBNA. IgM to the viral capsid antigen appears early in infection and disappears within 4 to 6 weeks. IgG to the viral capsid antigen appears in the acute phase, peaks at 2 to 4 weeks after onset, declines slightly, and then persists for life. IgG to the early antigen appears in the acute phase and generally falls to undetectable levels after 3 to 6 months. In many people, detection of antibody to the early antigen is a sign of active infection, but 20% of healthy people may have this antibody for years. Antibody to EBNA determined by the standard immunofluorescent test is not seen in the acute phase, but slowly appears 2 to 4 months after onset, and persists for life. This is not true for some EBNA enzyme immunoassays, which detect antibody within a few weeks of onset. Finally, even when EBV antibody tests, such as the early antigen test, suggest that reactivated infection is present, this result does not necessarily indicate that a patient's current medical condition is caused by EBV infection. A number of healthy people with no symptoms have antibodies to the EBV early antigen for years after their initial EBV infection. Therefore, interpretation of laboratory results is somewhat complex and should be left to physicians who are familiar with EBV testing and who have access to the entire clinical picture of a person. To determine if EBV infection is associated with a current illness, consult with an experienced physician. Additional Information about EBV Antibody Tests and Interpretation Antibody tests for EBV can measure the presence and/or the concentration of at least six specific EBV antibodies. By evaluating the results of these different tests, the stage of EBV infection can be determined. However, these tests are expensive and not usually needed for the diagnosis of infectious mononucleosis. It is not appropriate for CDC to interpret test results or to handle counseling for the public. We suggest that questions be directed to a local physician who is familiar with the patient's history and laboratory test results. In addition, CDC cannot recommend specific physicians for referral. Our general recommendation is for patients to consult with an infectious disease specialist or their local or state public health department. SUMMARY OF INTERPRETATION The diagnosis of EBV infection is summarized as follows: Susceptibility If antibodies to the viral capsid antigen are not detected, the patient is susceptible to EBV infection. Primary Infection Primary EBV infection is indicated if IgM antibody to the viral capsid antigen is present and antibody to EBV nuclear antigen, or EBNA, is absent. A rising or high IgG antibody to the viral capsid antigen and negative antibody to EBNA after at least 4 weeks of illness is also strongly suggestive of primary infection. In addition, 80% of patients with active EBV infection produce antibody to early antigen. Past Infection If antibodies to both the viral capsid antigen and EBNA are present, then past infection (from 4 to 6 months to years earlier) is indicated. Since 95% of adults have been infected with EBV, most adults will show antibodies to EBV from infection years earlier. High or elevated antibody levels may be present for years and are not diagnostic of recent infection. Reactivation In the presence of antibodies to EBNA, an elevation of antibodies to early antigen suggests reactivation. However, when EBV antibody to the early antigen test is present, this result does not automatically indicate that a patient's current medical condition is caused by EBV. A number of healthy people with no symptoms have antibodies to the EBV early antigen for years after their initial EBV infection. Many times reactivation occurs subclinically. Chronic EBV Infection Reliable laboratory evidence for continued active EBV infection is very seldom found in patients who have been ill for more than 4 months. When the illness lasts more than 6 months, it should be investigated to see if other causes of chronic illness or CFS are present. http://www.cdc.gov/ncidod/diseases/ebv.htm ------------------------------------------------------------------------------------- Swelling of the lymph nodes is also common and is the origin of another alternate name for the disease, glandular fever. Less often, a rash, eyelid swelling, or muscle soreness, as well as the more serious and even less common onset of pneumonia, meningitis, hepatitis, or peripheral neuritis, may occur. In some cases, the spleen may become enlarged, and rupture of the organ is the primary cause of the rare instances of death associated with mononucleosis. Currently there is no cure for infectious mononucleosis, treatment typically taking the form of bed rest, ingestion of fluids, and painkillers. Aspirin is usually avoided, however, because the pharmaceutical has been associated with Reye syndrome when used to treat children with viral diseases. Usually within a month, the body successfully recuperates from an infection of mononucleosis on its own, but some individuals may continue to feel unusually tired and weak for several months. Even after symptoms of mononucleosis subside, the virus may be exuded in saliva so that the patient is actually contagious for several months. Once exposed to the virus, there is an incubation period of 10 to 60 days, though one to two weeks before the onset of symptoms is most common for youths. The Epstein-Barr virus that causes infectious mononucleosis is one of the most widespread human viruses in the world. It is estimated that 95 percent of the 35- to 40-year-old adult population in the United States has been infected. However, a significantly smaller percentage of individuals have ever experienced mononucleosis. This is because when humans are exposed to the disease at a very young age, they typically do not experience any symptoms of illness, but develop immunity to mononucleosis. If infection with the virus does not occur, however, until adolescence or young adulthood, then an individual has approximately a 50 percent chance of developing the disease. The only fluid of the body known to carry infectious Epstein-Barr virus is saliva, but the specialized white blood cells known as B lymphocytes may also contain the virus in a state of incomplete replication. When B lymphocytes do become infected, they are altered permanently, assuming some of the atypical growth characteristics of cancerous lymphocytes. The vast majority of individuals that experience mononucleosis experience a full recovery with no complications. However, in rare instances, serious problems related to the disease may transpire. For instance, a patient may develop hemolytic anemia or other disorders of the blood if the bone marrow fails to produce enough red and white blood cells or if the body begins destroying either of these cell types as a result of infection. The Epstein-Barr virus that causes mononucleosis also can occasionally lead to a condition known as BellÕs palsy, in which the facial muscles on one side of the body may become unusually weak or even temporarily paralyzed, or to Guillain-BarrŽ syndrome, which is characterized by a more general paralysis of the muscles. Other possible complications include inflammation or other involvement of the heart, spleen, and central nervous system. http://www.microscopyu.com/galleries/pathology/mononucleosis.html ----------------------------------------------------------------------------- What is mononucleosis? Mononucleosis (often called "mono") is an infection caused by the Epstein-Barr virus. Signs of mono include fever, sore throat, headaches, white patches on the back of your throat, swollen glands in your neck, feeling tired and not feeling hungry. How is mono passed? Mono is not spread as easily as some other viruses, such as the common cold. The mono virus is found in saliva and mucus. It is usually passed from one person to another through kissing, although it may rarely be passed in other ways, such as coughing. Signs of mono usually develop 4 to 7 weeks after you're exposed to the virus. Generally, people only get mono once. It's most common among people 15 to 35 years old. How is mono diagnosed? Your doctor will probably first ask you some questions about your symptoms and then may do blood tests to confirm the diagnosis. One common test used to diagnose mono is called the Monospot test. Sometimes other blood tests are needed if the results of the Monospot test aren't clear. Does mono have any complications? Sometimes. 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 has functions that relate to 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. Can mono be cured? No. But mono will go away on its own. Symptoms usually last about 4 weeks. How is mono treated? The main point of treatment is to relieve your symptoms. The following list includes tips on treatment. ¥ Rest. ¥ Drink plenty of fluids. ¥ If you have a sore throat, gargle with salt water, or suck on throat lozenges, hard candy or flavored frozen desserts (such as Popsicles). ¥ You may want to take acetaminophen (one brand name: Tylenol) or ibuprofen (some brand names: Advil, Motrin, Nuprin) to relieve pain and fever. Do not give aspirin to children. Aspirin should be avoided because it has been associated with a disease called Reye's syndrome in children. Reye's syndrome is a serious illness that can lead to death. Do I need an antibiotic? Antibiotics like penicillin are of no help in mono. Mono is caused by a virus, and antibiotics don't work against viruses. If you have a bacterial infection in addition to having mono, your doctor may give you an antibiotic. What about sports and exercise? 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 infection starts. What is mononucleosis? Mononucleosis (often called "mono") is an infection caused by the Epstein-Barr virus. Signs of mono include fever, sore throat, headaches, white patches on the back of your throat, swollen glands in your neck, feeling tired and not feeling hungry. http://www.familydoctor.org/077.xml