Infectious mononucleosis, commonly called "mono," is a disease caused by the Epstein-Barr virus (EBV). EBV is one of the most common viruses worldwide. Most people are exposed to EBV as children, but the infection often goes unnoticed because they experience minimal symptoms. The majority of people have been exposed to EBV by the age of 35 and have developed immunity. However, when EBV infection occurs during late adolescence or early adulthood, there is a 35% to 50% chance of developing mono.
As many as 95% of adults in the U.S. become infected with EBV at some point in their lives. For those that develop mono, the highest incidence occurs in people between the ages of 15 and 24.
EBV is transmitted through direct contact with virus-infected saliva. Intimate kissing or sharing drinking glasses are the most common routes of transmission. The majority of people with mono are most likely to transmit it just prior to feeling ill. This is called asymptomatic shedding and accounts for the majority of the disease's transmission.
The symptoms of mono may include one or more of the following:
- Persistent "tired all over" feeling
- Sore throat and tonsils
- Swollen lymph glands
- Enlarged spleen and liver
- Occasionally, a skin rash or jaundice (yellow tint to the skin)
If symptoms appear, it typically takes 4 to 6 weeks after being infected.
Mono is diagnosed based on the presence of fever, sore throat, and swollen lymph glands. Your medical provider will also request lab tests to confirm the diagnosis. The tests may include a throat culture and blood tests. Be aware that you may need to have symptoms for a week or more before lab tests can identify the virus.
Because mono is a virus, there are no specific cures or treatments. To help relieve symptoms, you should get plenty of rest, drink plenty of fluids, take an over-the-counter pain reliever such as Tylenol or Advil as needed, and gargle with salt water to relieve a sore throat. Sometimes your provider can give you a stronger prescription pain reliever. Steroids are used in rare cases to decrease swelling of the tonsils. Since the virus can affect the liver, it is also recommended that you abstain from alcohol for 3 months after diagnosis. And because your spleen can become enlarged, it is very important to protect it from rupturing. Strenuous exercise, especially contact sports, must be avoided.
Recovery may be quicker than you think. Symptoms will ease within 10 days, but don't expect to return to your normal activities for 2 to 3 weeks. 85% of all people with mono are well in 2 weeks and 90% are well in 4 weeks. It is rare for a student to drop out of school because of mono. A few cases of mono are severe enough to interfere with academic work, but these are the exception, not the rule. If you continue to experience symptoms beyond 6 weeks, talk with your medical provider.
Most people have been exposed to the EBV at some point in their life and so are not at risk of developing mono. Because of this, it is not recommended that people with mono isolate themselves from others. Roommates rarely get mono from each other. Avoiding contact with the saliva of an infected person for about 1 month after he/she becomes ill is recommended.
If you are a Brown student and you are concerned about mononucleosis, you can make a confidential appointment at Health Services by calling 401.863-3953. Health Services provides a range of services including general health care, inpatient services and emergency medical care. You can request a medical provider by gender or by name. We are located at 13 Brown Street on the corner of Brown and Charlesfield Streets.
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Disclaimer: BWell Health Promotion is part of Health Services at Brown University. Health Promotion maintains this site as a resource for Brown students. This site is not intended to replace consultation with your medical providers. No site can replace real conversation. Health Promotion offers no endorsement of and assumes no liability for the currency, accuracy, or availability of the information on the sites we link to or the care provided by the resources listed. Health Services staff are available to treat and give medical advice to Brown University students only. If you are not a Brown student, but are in need of medical assistance please call your own health care provider or in case of an emergency, dial 911. Please contact us if you have comments, questions or suggestions.