Mono or Mononucleosis is a group of symptoms that affect some people, most commonly after infection with the Epstein-Barr virus (EBV).
Mono is also known as glandular fever.
Many people experience an infection with EBV at some point in their lives. Many do not develop symptoms of mono, but they become carriers.
There is so much to know about mono and EBV, such as ways to lessen symptoms, shorten the duration of the illness, and prevent its recurrence. This article will cover all of these topics.
What Is Mono?
Mononucleosis or mono is an illness that commonly affects teenagers and young adults but can affect children as well.
Viruses, most commonly Epstein-Barr Virus (EBV), and certain infections cause the illness.
Mono is sometimes called “the kissing disease” because it spreads easily through bodily fluids like saliva.
You can also get it by sharing eating utensils with or drinking from the same glass as someone infected with the virus.
Many people are exposed to EBV at some point during childhood, although they may not realize it at the time.
For adolescents and young adults who were not infected as a child, exposure often results from contact with an infected person’s saliva.
After a person has been exposed, the virus can remain in their body for months or even years, meaning they could spread the infection to others without realizing they are infected and contagious.
In addition, it may also be possible to spread the virus through other bodily fluids, such as semen or vaginal secretions.
People with mono often have a high fever, swollen lymph glands in the neck and armpits, and a sore throat.
Most cases of mono are mild and resolve with minimal treatment.
The incubation period for mono is around six weeks, and a person is contagious during this period.
Other symptoms of mono may include:
- Muscle weakness
- Rash consisting of flat pink or purple spots on your skin or in your mouth
- Swollen tonsils
- Night sweats
In rare cases, mono can also cause:
- Blood problems such as anemia or low platelet counts
- Inflammation of the heart muscle
- Inflammation of the brain and spinal cord membranes, known as meningitis
- Encephalitis, or inflammation of the brain
- Guillain-Barre syndrome
- Breathing problems due to swollen tonsils
Young children and older adults may have only a fever and muscle aches.
There are many different types of viruses that can cause a mono-like illness.
The most common cause of mononucleosis is the Epstein-Barr virus (EBV), which is a member of the herpes family of viruses.
The EBV is transmitted through contact with saliva.
Many people are infected with EBV but never experience symptoms of mono, or the symptoms are very mild and similar to those of another common illness, such as a cold or flu.
While EBV is the most common cause of mono, other viruses can also cause the infection, including:
- Cytomegalovirus (CMV)
- Rubella, or German measles
- Hepatitis A, B, or C
Is mono a sexually transmitted infection?
The virus EBV or Epstein-Barr is a type of herpes virus.
It’s different from the herpes simplex virus (HSV), which causes genital and oral herpes.
Both viruses can be sexually transmitted.
This means that if you’re having sex without a condom, the virus could be transmitted from one person to another.
The virus is also most commonly transmitted through saliva, via kissing, sharing food or drinks, and sharing utensils.
How long does mono last?
People aged 15–24 years are most likely to develop the classic symptoms of mono.
The incubation period for mono is around six weeks.
During this period, a person is contagious from the time of infection until symptoms appear.
They appear healthy, but they can spread mono to others.
When symptoms emerge, they may be severe for a few days, then gradually get milder.
Most people feel better after 2–4 weeks, but the fatigue can last for several weeks or months.
Treatment For Mono
In most cases, doctors or healthcare providers are able to diagnose mono based on medical history and physical examination.
Your doctor or healthcare provider will check for swelling in the lymph nodes in your neck and armpits and look for other signs of mono, such as inflamed tonsils, fever, a swollen liver or spleen, and possibly a pink measles-like rash on your body.
They will also likely ask if you’re experiencing severe fatigue, sore throat, muscle aches, or other symptoms.
Suppose your doctor determines that your symptoms are not typical of mono or decides that more information is needed to make a diagnosis.
In that case, they may turn to lab tests such as these to rule out other infections or illnesses:
- Monospot Test: The monospot test is also called the heterophile test. It is a blood test that checks for antibodies (proteins that form to attack the foreign virus or bacteria cells) to EBV. It’s fast, inexpensive, and easy, but it may not detect EBV until the second week of infection and has been shown to produce both false-positive and false-negative results.
- EBV Antibody Test: Typically done when your doctor suspects mono, but a monospot test comes back negative; this test can help show whether you have been infected with EBV and if the infection happened recently.
- Blood Tests: These look for elevated levels of lymphocytes (white blood cells), which indicate infection.
There is no cure for mono and no specific therapy for treating it.
However, your doctor will direct you on things you can do to manage the condition.
Symptoms usually resolve on their own after some weeks.
While the symptoms of mono can be severe (enough to disrupt your daily routines temporarily), the good news is that they gradually improve with rest, plenty of fluids, and other at-home remedies to help you feel better.
Some of the home remedies include:
To relieve a sore throat, you can gargle with a mixture of warm water and salt several times a day.
You can mix about ¼ teaspoon of salt in 8 ounces of warm water.
You can take over-the-counter medications like acetaminophen (Tylenol) to help relieve symptoms of a sore throat, headache, fever, and muscle aches.
Boosting your immune system
Eating a healthy diet and staying hydrated are important for helping you to feel better.
Remember, you need your immune system to be strong in order to fight off the infection.
It’s important to get plenty of rest when you have mono.
You may need to take a break from work, school, or your regular routine until you feel better.
Drinking fluids is important when you have mono because you may become dehydrated from the fever and other symptoms.
Drink water, and take other healthy fluids like broth and natural fruit juice to stay hydrated.
How To Prevent Mono
Mononucleosis is spread through saliva.
If you’re infected, you can help prevent spreading the virus to others by not kissing them and by not sharing food, dishes, glasses, and utensils until several days after your fever has improved — and even longer, if possible.
Wash your hands regularly to prevent the spread of the virus.
It’s important to remember that EBV may be present in someone who’s had mono for months after the infection, so even if many of their symptoms — such as fever or sore throat — have improved, they may still be infectious.
When To See a Provider
A major complication with mono is the enlargement of the spleen. The spleen is like a large gland.
It’s located in the upper part of your abdomen on the left side and helps filter your blood.
In severe cases of mono, the spleen can rupture (tear open).
While this condition is rare in people with mono, here are some signs to beware of:
- Sharp pain in the left upper part of your abdomen (under the left chest)
- Feeling lightheaded
- Feeling confused
- Blurred vision
Other complications can include anemia, nervous system problems, or hepatitis with jaundice.
If you notice any of these symptoms, you should immediately visit a doctor or healthcare provider.
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Frequently Asked Questions
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CDC: Epstein-Barr Virus and Infectious Mononucleosis. (2020).
Common questions about infectious mononucleosis. Am Fam Physician. (2015).
Infectious mononucleosis. (2015).
Mononucleosis (Mono) (2020).