Infectious mononucleosis, also called mono, is a common and contagious illness spread by the virus, Epstein-Barr.
You can catch mono through the saliva of a person that is infected with mono (even if they have no symptoms).
When you are sick with mono, treatment is focused on helping you feel more comfortable as there is no medication or vaccine to get rid of the infection.
Typically, people recover with no long-term effects, although a full recovery may take a few months.
Read on to learn more about mono, its symptoms, and its cause.
We will then discuss if it’s possible to get mono twice and what can cause this to happen.
Lastly, we will discuss things you can do to prevent mono from coming back (recurring).
What is Mono?
Mono has been given the nickname the “kissing disease” because it is usually transferred from person to person through saliva.
It can, however, be passed through other body fluids as well.
The incubation period (the time from exposure to the time of symptoms) is four to eight weeks.
This means you won’t feel symptoms for one to two months after being exposed, making it tricky to know who you got sick from.
When you do start feeling sick from mono, you may start to feel:
- Very tired
- A sore throat
- A fever
- Swollen lymph nodes in your neck
- Body aches
You may get a rash on rare occasions, or your liver or spleen may swell.
Because of the possibility of swelling, it’s best to avoid contact sports while you are sick.
There is no treatment for mono, but you can do things that help you feel more comfortable such as:
- Getting plenty of rest so your body can heal
- Drink plenty of fluids to stay hydrated
- Take over-the-counter medications to relieve your fever and body aches
It can take a few weeks or up to six months to get better from mono.
Be patient and let your body do the work to get you better.
Typically, the Epstein-Barr virus is the culprit of the infection.
However, other viruses can cause the infection as well.
Epstein-Barr is part of the herpes family of viruses and is found in nearly 95% of adults.
This means almost everyone is exposed to it at some point in their life; however, most never get an infection from it. It is most common in adolescents and college students.
If you experience any of the symptoms mentioned above, please seek medical care, and your provider will examine you and order some lab tests to see if you have the Epstein-Barr antibodies in your blood.
To keep yourself from getting sick with mono, avoid sharing drinks, toothbrushes, and eating utensils with other people.
Can You Get Mono Twice?
The answer to this is yes, and no.
Once you’ve encountered the virus, it will remain in your body in an inactive state for the rest of your life.
Typically, the body can prevent the virus from reactivating and causing a second infection; however, it can reactivate if your immune system is in a weak state.
So yes, the virus can reactivate in your body, making you not feel well.
Although this is very rare, it’s not a new re-infection.
Symptoms to watch for
Symptoms of a recurrence of mono would be the same as the original infection:
- Sore throat
- Swollen lymph nodes
- Body aches
These symptoms are very similar to other illnesses.
However, what may seem like a recurrence of mono, could actually be a different illness.
For example, strep throat may have some symptoms in common with mono.
However, strep is caused by bacteria and needs antibiotics for treatment.
Your healthcare provider will be able to determine this.
If you are feeling unwell again, it’s best to let your medical provider know so you can have the proper testing.
What causes mono relapse?
The following are known circumstances that weaken your immune system and, in rare cases, could allow the virus to reactivate:
- Psychological stress
- A variety of cancers
- Autoimmune diseases
- Chronic fatigue syndrome/ Myalgic encephalomyelitis
- Being a patient in an intensive care unit
Is mono worse the second time?
A recurrence of mono should not be worse the second time.
In most cases, there are no symptoms in reactivated mono.
But, it is also possible to have similar symptoms as during the first infection.
In rare cases, mono becomes chronic mono. In this case, the symptoms can be progressively worse.
How to Reduce Your Risk of Mono
To prevent getting mono, please be sure to follow good hygiene practices.
Don’t share drinking glasses or eating utensils with anyone.
If someone appears to be sick, make sure to keep your distance and wash your hands if you need to touch their items.
To reduce your risk of recurrence, learn to manage stress in your life to keep your stress level lower.
Also, learn ways to boost your immune system to keep it at its strongest.
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Frequently Asked Questions
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.
K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.
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Infectious Mononucleosis. (2016).
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Kerr, J. Epstein-Barr Virus (EBV) Reactivation and Therapeutic Inhibitors. (2019)
Mohseni, H. et al. Mononucleosis. (2021).
Mononucleosis (Mono). (n.d.)