Overview
Infectious mononucleosis (mono) is often called the kissing disease. The virus that causes mono (Epstein-Barr virus) is spread through saliva. You can get it through kissing, but you can also be exposed by sharing a glass or food utensils with someone who has mono. However, mononucleosis isn't as contagious as some infections, such as the common cold.
You're most likely to get mononucleosis with all the signs and symptoms if you're a teen or young adult. Young children usually have few symptoms, and the infection often goes undiagnosed.
If you have mononucleosis, it's important to be careful of certain complications such as an enlarged spleen. Rest and enough fluids are keys to recovery.
Symptoms
Signs and symptoms of mononucleosis may include:
- Fatigue
- Sore throat, perhaps misdiagnosed as strep throat, that doesn't get better after treatment with antibiotics
- Fever
- Swollen lymph nodes in your neck and armpits
- Swollen tonsils
- Headache
- Skin rash
- Soft, swollen spleen
The virus has an incubation period of about four to six weeks, although in young children this period may be shorter. The incubation period refers to how long before your symptoms appear after being exposed to the virus. Signs and symptoms such as a fever and sore throat usually lessen within a couple of weeks. But fatigue, enlarged lymph nodes and a swollen spleen may last for a few weeks longer.
When to see a doctor
If you've been experiencing the above symptoms, you may have mononucleosis.
If your symptoms don't get better on their own in a week or two, see your doctor.
Causes
The most common cause of mononucleosis is the Epstein-Barr virus, but other viruses also can cause similar symptoms. This virus is spread through saliva, and you may catch it from kissing or from sharing food or drinks.
Although the symptoms of mononucleosis are uncomfortable, the infection resolves on its own without long-term effects. Most adults have been exposed to the Epstein-Barr virus and have built up antibodies. This means they're immune and won't get mononucleosis.
Complications
Complications of mononucleosis can sometimes be serious.
Enlargement of the spleen
Mononucleosis may cause enlargement of the spleen. In extreme cases, your 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 surgery.
Enlarged spleen
The spleen is a small organ usually about the size of your fist. But a number of conditions, including liver disease and some cancers, can cause your spleen to become enlarged.
Liver issues
Problems with your liver also may occur:
- Hepatitis. You may experience mild liver inflammation (hepatitis).
- Jaundice. A yellowing of your skin and the whites of your eyes (jaundice) also occurs occasionally.
Less common complications
Mononucleosis can also result in less common complications, including:
- Anemia — a decrease in red blood cells and in hemoglobin, an iron-rich protein in red blood cells
- Thrombocytopenia — a low count of platelets, which are blood cells involved in clotting
- Heart problems — an inflammation of the heart muscle (myocarditis)
- Complications involving the nervous system — meningitis, encephalitis and Guillain-Barre syndrome
- Swollen tonsils — which can block breathing
The Epstein-Barr virus can cause much more serious illness in people who have impaired immune systems. People with weakened immune systems may include people with HIV/AIDS or people taking drugs to suppress immunity after an organ transplant.
Prevention
Mononucleosis is 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 improved — and even longer, if possible. And remember to wash your hands regularly to prevent spread of the virus.
The Epstein-Barr virus may persist in your saliva for months after the infection. No vaccine exists to prevent mononucleosis.