Chronic Mono: Causes, Treatments, and More

By Craig Sorkin, DNP, APN
Medically reviewed checkmarkMedically reviewed
April 22, 2022

Infectious mononucleosis is also called mono or the kissing disease because it’s mainly shared through saliva.

Mono is an infection caused by the Epstein-Barr virus (EBV). Its symptoms include fever, fatigue, sore throat, body aches, and swollen lymph nodes in the neck.

The sickness typically lasts about four weeks.

However, the fatigue may last up to six months. In rare cases, the body may have trouble fighting the virus. In such a case, it turns into chronic mono.

Chronic mono is when your body cannot control the EBV infection.

Symptoms sometimes won’t go away; they may keep recurring (coming and going).

Read on to learn more about the chronic mono disease.

Learn what the symptoms, cause, and course of treatment is.

Lastly, learn who is at risk of getting chronic infectious mononucleosis and when it’s time to see a doctor. 

Mononucleosis

Mononucleosis is an infection caused by the Epstein-Barr virus.

The virus is very common, and most people by the age of 35 have it living in an inactive state in them. 

The infection, mono, caused by the Epstein-Barr virus, is typically seen in the adolescent and early adulthood years and is common among college students.

Symptoms

Mono can take four to six weeks for symptoms to appear after you were exposed to it.

This can make it difficult to know who you got sick from.

When you start feeling sick, you may experience:

Your symptoms could take a month or two to go away.

Sometimes the feelings of exhaustion can last about six months or longer.

Some less common symptoms include:

  • A swollen spleen
  • A swollen liver
  • A rash

Because your liver and spleen may swell, it’s best not to play any contact sports while you are sick. 

Causes 

The Epstein-Barr virus is responsible for a mono-infection.

It is a very common virus that 95% of people have in them by the time they are 35.

For most people, the virus goes undetected and simply lives in their bodies in an inactive state.

An active mono infection is typically seen in teens and college-age people.

You can get infectious mononucleosis from someone who may have no symptoms of having it themselves.

It is passed through body fluids, especially saliva.

Sharing a drinking glass or silverware could pass the virus on to you without you knowing it.

To try and avoid getting it, don’t share drinking glasses, silverware, toothbrushes, etc., with anyone else.

If someone is sick and has similar mono symptoms, keep a good distance from them and wash your hands if you touch any of their items.

Treatment

There is no medication or vaccine to prevent or get rid of mono.

When you are sick, treat your symptoms to help you feel more comfortable.

Here are some things you can do.

  • Take it easy and let your body have plenty of time to rest.
  • Keep yourself hydrated by drinking plenty of fluids.
  • Take over-the-counter medications like Tylenol or Ibuprofen to bring down your fever and decrease your body aches.

Don’t take antibiotics while you have mono because it might cause you to have rashes.

Because a virus and not a bacterium cause mono, the antibiotic would do nothing to help you recover anyway. 

Concerned about chronic mono? Chat with a medical provider using K Health.
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Chronic Active Epstein-Barr Virus

Chronic active Epstein-Barr virus (CAEBV) is a very rare complication of a mono-infection.

It happens when your immune system can’t fight the virus.

The virus stays active and keeps multiplying and spreading in your blood and organs.

Symptoms

The symptoms of CAEBV are the same as mono, such as fever, sore throat, body aches, and exhaustion, but they can be more severe and last longer.

It is defined as chronic because it lasts at least six months.

Some other rare symptoms that sometimes happen with CAEBV include:

  • Pneumonia
  • Nerve damage
  • Anemia
  • Liver failure
  • Decreased immune function 

Cause 

CAEBV is caused by the same virus that causes mono, the Epstein-Barr virus.

However, the reason why a person’s body cannot fight it and why the virus stays active in a small number of people is unknown.

Some researchers wonder if there is a possible genetic link because it is more common in Asian people and people from South America and Mexico but is very rare in people from the United States and Europe. 

Diagnosis 

Diagnosing CAEBV is based on your symptoms and lab tests.

First, you would have the typical monospot and EBV antibody lab tests to confirm the mono diagnosis.

If your symptoms are severe or lasting longer than normal, your medical provider may suspect CAEBV.

A lab test called a quantitative PCR test measures the amount of EBV DNA in your blood.

If it remains high for over three months, it means you have CAEBV. 

Treatment

Like mono, treatment for CAEBV is focused on relieving the symptoms to make you feel more comfortable.

  • Allow yourself to have plenty of rest; your body is working hard to fight this infection.
  • Keep yourself very well hydrated to help keep your immune system working at its best.
  • Take over-the-counter medication to keep your fever and body aches under control.

Several treatments have been experimented with, including anti-viral medications, but CAEBV has been resistant to those medications.

At this point, a bone marrow transplant (hematopoietic stem cell transplant) has been the only treatment found that cures CAEBV. 

Who’s At Risk?

Most people have inactive Epstein-Barr virus in them, and only a very small number of people ever get CAEBV.

Trends show it is more common in people from Asia, South and Central America, and Mexico.

This suggests that there could be a genetic link.

Concerned about chronic mono? Chat with a medical provider using K Health.
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When To See a Medical Provider

If you are experiencing the following symptoms call your medical health provider right away or call 911:

  • Trouble breathing or swallowing
  • Feeling dizzy or faint
  • Extreme weakness in your arms or legs
  • A high fever that will not go down
  • Severe headache
  • Sharp pain in your upper left abdomen

How K Health Can Help

Did you know you can get affordable primary care with the K Health app?

Download K to check your symptoms, explore conditions and treatments, and if needed text a doctor in minutes. K Health’s AI-powered app is HIPAA compliant and based on 20 years of clinical data.

Frequently Asked Questions

Can you get rid of chronic mono?
Yes, having a bone marrow transplant (hematopoietic stem cell transplant) has proven to cure chronic mono.
Is chronic mono contagious?
Yes, the virus that causes chronic mono is passed through body fluids like saliva. Do not share drinks or eating utensils that a sick person has used. If it is necessary to touch any of their items, wash your hands afterward.
Is chronic mono an STD?
No, chronic mono is passed to others through body fluids, typically saliva. It can include fluids passed through sex, but it is not considered an STD.
Can mono last for years?
A typical mono-infection usually lasts one to two months but can last up to six months. Chronic mono could potentially come and go for years.
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.

Craig Sorkin, DNP, APN

Craig Sorkin, DNP, APN is a board certified Family Nurse Practitioner with over 15 years experience. He received his Undergraduate and Graduate degrees from William Paterson University and his doctoral degree from Drexel University. He has spent his career working in the Emergency Room and Primary Care. The last 6 years of his career have been dedicated to the field of digital medicine. He has created departments geared towards this specialized practice as well as written blogs and a book about the topic.

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