Mono and Epstein Barr Virus: What You Need to Know
Sue Hubbard, M.D.
Most cases of mono occur among teens, big fans of kissing and sharing water bottles, glasses, food, even lipstick
I've received several questions via our iPhone App regarding mononucleosis, commonly called "the kissing disease," as the virus is passed in saliva. I think it's because many people were watching the recent "Glee" episode where Finn and Quinn had mono.
Mono is most frequently caused by the Epstein Barr virus, but other viruses may mimic the symptoms of mono. Many of us have been exposed to Epstein Barr virus (EBV) and may not even realized it, while others will develop a viral illness which typically causes sore throat, fever, congestion, swollen lymph nodes and fatigue. Obviously, these symptoms mimic many illnesses.
In my experience, the most classic cases occur among teens, who can often be found kissing one another, as well as sharing glasses, water bottles, food, and even lipstick, which may transmit the virus via contamination with saliva. In most cases, a patient has no idea where they contracted the virus, often because it takes 4 to 10 weeks after exposure to develop the symptoms of mono.
A teen will often come into the office complaining of a very bad sore throat, with or without fever, and swollen lymph nodes in the neck. They usually think they have strep throat, but their throat culture comes back negative for strep. In this case, they're assumed to have a viral pharyngitis.
A typical viral sore throat usually improves over a few days, but with mono, the patient usually feels worse rather than better after 4 to 7 days. Their throat becomes more painful, with more swelling of the tonsils, and the tonsils are often covered with white patches, called exudates.
In some cases, there may be swelling of the upper eyelids (periorbital edema) and a skin rash may develop, especially if the patient had previously been put on a penicillin-related antibiotic for presumed strep. It's interesting that younger children who contract mono often don't have as many of the symptoms as a teen, and indeed they have a shorter illness, so many youngsters with mono are never "officially" diagnosed with the EBV virus, but are now immune to the virus, too.
The easiest way to diagnose mono is with a blood test called a monospot that picks up the EBV antibodies in the bloodstream. It usually takes about a week after symptoms begin to have a positive monospot. Other antibody tests may be run to determine if a patient currently has mono, or has ever had mono, but these are more expensive and take a longer period of time to get results.
The acute symptoms of mono last anywhere from 7 to14 days, but the fatigue may last longer. Because mono is a viral illness, it is not treated with antibiotics. Treatment, like with so many other illnesses, is simply symptomatic: fluids, rest, pain relievers like acetaminophen or ibuprofen (do not use aspirin products in children) and tincture of time.
I also recommend that patients take several weeks off of sports due to the possibility of their spleen (which is lymph tissue, too) becoming swollen. The issue with splenic swelling is the risk of rupture if the spleen is hit, bumped or fallen on during an activity.
Once the patient is feeling better, has been examined again, and their spleen has returned to normal, they may return to their sports. It's also wise to limit a teen's activity so they may get sufficient rest. This basically means that once they're feeling well enough, they can return to school, but other activities are put on hold until their energy returns
As one teenage mono patient aptly put it, "It's like I was grounded, but I didn't even get into trouble." The reason for a slow return to full activity with extra rest is to ensure that within 3-4 weeks of diagnosis the patient is fully recovered.
I've found if you don't tell teens specifics about activities, once their acute symptoms have passed they fail to rest, and the fatigue lasts longer. Sufficient rest and nutrition are essential to recovery. The good news: You only get EBV once!
Available at Amazon.com:
- Mono and Epstein Barr Virus: What You Need to Know
- Don't Forget Skincare and Sun Protection in Winter
- When to Worry About Stuttering
- Healthy Foods That Make Teeth Rot
- Make Sledding Safety a Priority
- New Research Offers Hope For Eczema Patients
- Why Sarah Palin Is Wrong About Michelle Obama's Weight Gain Fight
- New Iron Recommendations Issued For Children
- Get Smart About Antibiotics
- 8 Ways to Soothe a Sick Kid
- Is It Really That Icky?
- Are Germ-killing Products Harming Your Health?
- Is Cord Blood Banking Worth It?
- Child Born With Hip Dysplasia May Not Need Future Hip Replacement
- Why Vitamin D Is Important For Your Kids
- Safeguard Your Child's Digestive Health
- Goal of Treatment for Alpers' Disease is to Ease Symptoms
- Confusion Reigns Over Cough and Cold Medicines
- Children Can Have Migraine Headaches
- First They Came for My Twinkie ...
- Keeping Lunch Boxes Interesting and Healthy
- Kids Should Drink Milk, Even If It Is Chocolate
- Protect Your Child From Iron Deficiency
- Rare Muscle and Skin Disorder Can Be Difficult to Treat
- The Kid's Doctor: Kids and Choking Dangers
- Pertussis Cases Continue to Rise
- Alternative Treatments To Fight a Cold
- Contact Lenses Appropriate For Kids Old Enough to Handle the Responsibility
- Adverse Effects of Scoliosis Depend on Magnitude of the Curvature
- How to Make Sure Your Kids Eat Enough Vegetables
- Four Loko: Boozy Up-and-Down Makes This Loko Loco
- The Kid's Doctor: Young Athletes and Overuse Injuries
- The Kid's Doctor: Wart Treatments Vary
- Colic -- Although Stressful -- is Temporary
- Healthy Eating Guide to Cereal
- Supplements for High School Athletes: How to Make Smart Choices
- Why Sniffles Hit Hardest at Night
- Child With High Body Mass Index at Increased Risk of Health Problems
- Normal Weight Obesity - A Growing Concern
- Child's Height at Age 2 May Predict Adult Height
- A Parent's Guide to Coughs
- Team up With Schools to Fight Flu Season
- The Dangers of Diagnosing Online
- Family Dinners Help Fight Obesity
- Don't Take Hollywood's Advice on Treating Kids With Head Lice
- Determine Cause of Child's Lack of Growth Before Considering Hormones
- Teach Your Kids to Stress Less
- Common Food Allergies in Kids
- Healthy Lunches Your Kids Will Love Recipe
- Teens' Chronic Headaches Often Fade With Time
- Anxiety Before New School Year is Common for Many Children
- Childhood Obesity From a Holistic Perspective
- Whooping Cough Continues to Affect People of All Ages
- Keep Your Athletes Hydrated On and Off the Field
- Drink Up! Avoiding Dehydration
- How to Stop Your Baby's Wheezing and Prevent Asthma
- Fighting Drugs With the Power of Sleep
- Milk: When the First Food May Be the Best Food
- Introducing New Foods to Your Child
- Coping With Altitude Sickness
- Protecting the Future Health of Our Boys
- The Power of Persuasion: Food Marketing Really Does Work
- Fighting Childhood Obesity From a Holistic Perspective
- Congress Must Act Now to Alleviate Child Hunger
- Exercise for Kids: 5 Tips for Parents
- Too Much Screen Time for Kids Means Poorer Health
- Nutrition May Be Key to Helping Control ADHD
- Foods to Reduce Allergy and Asthma Symptoms in Kids
- Toddler With Recurring Ear Infections May Benefit From Tubes
- Prevent and Treat Summer Rashes
- Enjoy Breakfast as a Family
- Sick Day TLC
- When to Call the Doctor
- Sunscreen Facts You Need to Know
- Asthma and Allergies Can Run in Families
- Salivary Gland Stones Rare But Not Unheard of in Children
- How Much Vitamin D is Enough
- Tick-Borne Disease Risk Peaks in Spring and Summer
- Are Carbonated Drinks Bad for Bones?
- The Threat of Childhood Obesity
- Secrets to Breathing Better With Allergies
- What's the Right Amount of Vitamin C
- Get the Lead Out: The Less Exposure to This Toxic Metal the Better
- Everything You Ever Wanted to Know About Sugar
Copyright © 2011 KIDSDR.COM DISTRIBUTED BY TRIBUNE MEDIA SERVICES, INC.