Infectious mononucleosis or mono also known as glandular fever, is an infection usually caused by the Epstein–Barr virus (EBV). Mono, or infectious mononucleosis, refers to a group of symptoms usually caused by the Epstein-Barr virus. It typically occurs in teenagers, but you can get it at any age. The virus is spread through saliva, which is why some people refer to it as “the kissing disease.

The virus infects the majority of people when they are children, when the sickness has few or no symptoms. Fever, sore throat, swollen lymph nodes in the neck, and exhaustion are common symptoms in young adults. The majority of people recover in two to four weeks, but fatigue might continue for months. Swelling of the liver or spleen is also possible, with splenic rupture occurring in less than 1% of cases.

Transmission

While Epstein–Barr virus, commonly known as human herpesvirus 4, is the most common cause, the disease can also be caused by a few other viruses. It is most commonly transmitted through saliva, but it can also be transmitted through sperm or blood. Objects like as drinking cups and toothbrushes, as well as coughing and sneezing, can spread the virus. Spread may occur by objects such as drinking glasses or toothbrushes or through a cough or sneeze. Those who are infected can spread the disease weeks before symptoms develop. Mono is primarily diagnosed based on the symptoms and can be confirmed with blood tests for specific antibodies. Another typical finding is increased blood lymphocytes of which more than 10% are atypical.

Causes

Epstein–Barr virus

About 90% of cases of infectious mononucleosis are caused by the Epstein–Barr virus, a member of the Herpesviridae family of DNA viruses. It is one of the most commonly found viruses throughout the world. Contrary to common belief, the Epstein–Barr virus is not highly contagious. It can only be contracted through direct contact with an infected person's saliva, such as through kissing or sharing toothbrushes. About 95% of the population has been exposed to this virus by the age of 40, but only 15–20% of teenagers and about 40% of exposed adults actually become infected.

Cytomegalovirus

About 5% to 7% of cases of infectious mononucleosis are caused by human cytomegalovirus, another type of herpes virus. This virus is found in body fluids including saliva, urine, blood, and tears. A person becomes infected with this virus by direct contact with infected body fluids. It can also be transferred from an infected mother to her unborn child. This virus is often "silent" because the signs and symptoms cannot be felt by the person infected. However, it can cause life-threatening illness in infants, people with HIV, transplant recipients, and those with weak immune systems. For those with weak immune systems, cytomegalovirus can cause more serious illnesses such as pneumonia and inflammations of the retina, esophagus, liver, large intestine, and brain.

Symptoms

People with mono often have a high fever, swollen lymph glands in the neck and armpits, and a sore throat. Most cases of mono are mild and resolve easily with minimal treatment. The infection is typically not serious and usually goes away on its own in 1 to 2 months.

Other symptoms may include:

• a headache
• fatigue
• muscle weakness
• a rash consisting of flat pink or purple spots on your skin or in your mouth
• swollen tonsils
• night sweats

Mono is hard to distinguish from other common viruses such as the flu. If your symptoms don’t improve after 1 or 2 weeks of home treatment such as resting, getting enough fluids, and eating healthy foods, consult a doctor.

Treatment

Infectious mononucleosis is generally self-limiting, so only symptomatic or supportive treatments are used. The need for rest and return to usual activities after the acute phase of the infection may reasonably be based on the person's general energy levels. Nevertheless, in an effort to decrease the risk of splenic rupture experts advise avoidance of contact sports and other heavy physical activity, especially when involving increased abdominal pressure for at least the first 3–4 weeks of illness or until enlargement of the spleen has resolved, as determined by a treating physician.

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