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Tip of the Week:

The Facts on Mononucleosis

Mononucleosis (Mono) is a generally benign viral illness. Mono is caused by the Epstein-Barr virus which is a member of the herpes virus family. It is spread via saliva and an infected person can spread the virus for approximately three to six months. Once a person has had Mononucleosis, it is thought they are protected from further infection with the Epstein-Barr virus. The incubation period is 20 to 50 days.

Mono may begin with a general feeling of tiredness followed a few days later by fever, sore throat and swollen, tender glands in the neck. Other symptoms include headache, swollen eye lids and occasionally a rash. The symptoms may present in varying degrees at different times in the illness. Enlargement of the spleen may occur and occasionally there may be liver enlargement.

The diagnosis of infectious Mononucleosis is based on the clinical symptoms and confirmed by the Monospot test. The test, which confirms the presence of antibodies, is performed with a simple fingertip blood sample. The Monospot can sometimes be negative early in the course of the illness because the amounts of antibodies in the blood have not reached detectable levels. In these cases, the person may be retested in a week. In approximately 3 to 30 percent of individuals, the illness can be accompanied by a streptococcal throat infection. Throat cultures are often performed at the time of diagnosis.

There is no specific treatment plan for Mono. Antibiotics are not helpful because the illness is caused by a virus, however, they would be necessary if there was a secondary strep throat infection. Most uncomplicated cases of Mono need only symptomatic therapy including pain medication such as acetaminophen (Tylenol) or ibuprofen (Advil) and warm saltwater gargles. When someone with Mono experiences more severe symptoms, such as enlarged obstructive tonsils or an enlarged spleen, a short course of corticosteroids may be prescribed.

Generally, the acute phase of the illness lasts about two weeks. During this time rest and a healthy diet are important. Most students are able to return to classes after the fever resolves. It may take several more weeks before there is full resolution of the fatigue.

When the spleen is enlarged it is more susceptible to rupture. Avoiding contact sports, strenuous activity and heavy lifting for at least one month or until the spleen is no longer enlarged is advised. Follow-up physician visits every one to two weeks are recommended.

Students need to plan a realistic schedule of rest with modification of class/work responsibilities. These responsibilities can cause stress as students try to balance the commitments of their coursework and the need for increased rest for recovery, but most students are able to cope without leaving school. There is no need for isolation of a person with Mono. To prevent the spread of the illness good hand- washing is recommended and avoiding sharing eating or drinking utensils. Alcohol consumption should be avoided for at least one month as it is toxic to the liver.