Question of the Week

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 cases.

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 infection starts."

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 mono?

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

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