Prevention & Recovery

Mononucleosis 101

Author: Canadian Living

Prevention & Recovery

Mononucleosis 101

This story was originally titled "Mononucleosis" in the September 2009 issue. Subscribe to Canadian Living today and never miss an issue!

This fall some postsecondary students will find themselves bedridden with a minor but unwelcome ailment – infectious mononucleosis (IM), or mono. However, students aren't the only ones at risk. About 50 per cent of children in Canada get the virus that causes mono, but it usually runs its course quickly and mildly, says Dr. Atul Humar, director of transplant and infectious diseases at the University of Alberta in Edmonton. Here's what you need to know.

1. Mono is caused by the Epstein-Barr virus (EBV).
EBV is a member of the herpes family. Once contracted, it is carried in the salivary glands and can spread through intimate contact, such as kissing or sharing utensils. About 95 per cent of adults have already had a previous EBV infection.

2. Not everyone who gets an EBV infection experiences mono symptoms.
When infected as children, most people have very mild or no symptoms. When they are infected as adolescents or adults, however, typical IM symptoms include fever, sore throat, tiredness, headache, loss of appetite, and muscle aches and pains. Enlarged lymph nodes, usually in the neck, can be seen in most patients. "Although some people experience a prolonged period of fatigue afterward, most recover over two to three weeks," says Humar. A fever lasts about 10 days but is at its worst during the first five days or so; a sore throat can last about four or five days, he says. A small percentage of people may experience jaundice or even encephalitis (brain inflammation), but this is rare.

3. Mono is often diagnosed based on symptoms and then confirmed with tests.
EBV causes an increase in a specific type of reactive white blood cells called atypical lymphocytes, and people with mono sometimes also have an overall higher white blood cell count. Mono tests check for these increases. An immunoglobulins test to detect EBV-fighting antibodies in the blood may be performed if your doctor suspects you or your child has mono, but it is not often necessary to confirm a diagnosis.

4. There is no need to stay at the hospital.
Most cases are mild. "I tell patients to do as much as they feel they are comfortable with," says Humar. However, sometimes a swollen spleen or liver may develop. An enlarged spleen is present in about 50 per cent of patients, says Humar, and can extend below the ribs, making it vulnerable to injury. Avoid contact sports, lifting or rigorous exercise until you are better.

5. Most people who get mono are immune from getting it again.
Although the symptoms of mono usually resolve themselves within a few weeks, EBV remains dormant in a few cells in the throat and blood for the rest of your life. The virus periodically becomes active in the saliva, which probably accounts for much of the spread of this illness, says Humar.

An ounce of prevention
Although antibiotics are not useful in treating mono because it is a virus, your body should be able to fight the infection on its own. Here are some tips for keeping your immune system in tip-top shape.
• Always wash your hands before touching food.
• Don't share a toothbrush or drink from someone else's cup.
• Eat healthily.
• Get plenty of fluids.
• Exercise regularly.
• Maintain regular sleeping habits.

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Prevention & Recovery

Mononucleosis 101