MONONUCLEOSIS  

Mononucleosis (mono) is a viral illness, caused by a virus called Epstein-Barr virus (EBV). The symptoms of mono in the acute phase include sore throat, swollen red tonsils with pus, swollen lymph nodes, especially in the neck area (commonly termed "swollen glands") and fever. The virus is transmitted via saliva, such as kissing, sharing water bottles or other drinking vessels or prolonged contact with coughing and sneezing. Mono is actually not as contagious as many other infectious diseases, such as strep. It is most contagious while a fever is present. There is still a small amount of virus carried in the saliva for up to six months. The above symptoms last for about a week. Following that, most children and adolescents have varying degrees of fatigue. Once the acute phase of the illness is over, your child can return to school as long as they are not too fatigued. Some children need to return to school for short periods at time at first.

Although mono occurs most commonly in people ages 15-25, it can occur at any age. We have been seeing children much younger than that with the illness. The diagnosis is made by a blood test. We either do a screening test by fingerstick in the office or send the child to the lab for more comprehensive testing.

The complications of mono are dehydration in the acute phase of the illness secondary to the pain and swelling of the tonsils and throat, and an enlarged spleen. The risk of having an enlarged spleen is important because when the spleen becomes enlarged, it is at risk of being injured or ruptured. We therefore have your child avoid contact sports, including skiing, snowboarding, biking, skateboarding and roller blading and other sports which could cause injury by being hit with a ball or bat or racket, until 3-4 weeks after the diagnosis is made. If there is left upper abdominal pain during any point in the illness, you should call us.

Because mono is a viral illness, there is no medication which treats the virus directly. The treatment is mostly symptomatic relief with acetaminophen or ibuprofen for pain and making sure your child is drinking enough fluids. Sometimes if we see that the tonsils are so enlarged and the patient is not drinking well, we will treat him or her with a short course of oral prednisone to decrease the swelling.

We then usually recheck the patient weekly until they are better.



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