Now that February is entering its final phase and Valentine chocolate boxes are lying empty, lets talk about the kissing disease that affects older children, young adults and college students. Here are some of the facts and frequently asked questions about mononucleosis.
It is commonly known as the kissing disease, but first described as glandular fever in 1889. The cause (the Epstein-Barr Virus) was discovered in 1968.
The disease will affect only 1 in 2000 people every year, but it is 100 times more frequently found in college students than in the general population.
Symptoms include high fever, a severe sore throat, large red tonsils covered with pus, and swollen lymph nodes in the neck, armpits and groin. They last about 1-2 weeks, and recovery time is 2-4 weeks even in most severe cases.
Because of the frequency and potential complications of mononucleosis when not taken seriously, I would like to address the most common questions and concerns here.
How does mono spread? The mono virus is spread by infected saliva through coughing, sneezing and, yes, kissing. Contrary to popular belief, mono is not very contagious and the sick person does not need to be isolated. Although the virus can be carried in the saliva for up to 6 months, mono is most contagious while the ill person still has a fever. It usually takes 4-7 weeks after exposure to the virus for symptoms to develop.
How is mono diagnosed? Most of the time the disease is diagnosed by its symptoms and can be confirmed by blood tests. One common test is called the Monospot test. This can be performed at your doctors office.
How is it treated? There is no specific drug treatment for mono. Because it is a viral illness, antibiotics are not helpful. For severe disease, your doctor may prescribe a short course of steroids or give you a stronger pain medicine to relieve the symptoms. The most important thing you can do is to drink plenty of fluids--like milkshakes, cold drinks or warm chicken brothand get plenty of rest. You may want to take Tylenol or Advil for the pain. For a sore throat, gargle with salt water or suck hard candy or frozen desserts. Avoid citrus fruits. Take a daily multivitamin pill until your appetite returns to normal, and you dont need to stay in bed; it wont shorten the course of the illness or reduce symptoms. However, slow down some until you no longer have a fever.
What are the complications of mono? Mono does usually resolve completely, but there are a few complications I would like to mention here. First, up to 80-90 percent of people will develop a rash when treated with penicillin. This usually starts 5 to 10 days after the drug is begun and does not represent an allergy to penicillin. The second important complication is rupture of the spleen. This is rare, but could be life-threatening. Considering the spleens abundant blood supply, rupture can cause significant bleeding in a short amount of time. Symptoms of rupture include abdominal pain on the left side, pallor, queasiness, or weakness.
How fast you can return to the physical activity? The timing to return to sports activities requires special considerations and will be determined by your doctor individually based on the illness severity, degree of spleen enlargement and the nature of the sport. As a general guideline, be ready to take it easy at least 3-4 weeks after the infection.
Dr. Marat Plotkin
(Dr. Marat Plotkin is at HealthPoint Pediatrics, 105 Greencastle Road, Tyrone, 770-631-1040.)