Infectious mononucleosis (mono), sometimes called the kissing disease, is a fairly serious disease that can be risky for the patient. Its cause is the Epstein-Barr virus or cytomegalovirus which is part of the same group of herpes viruses that cause cold sores, chickenpox and genital herpes. Because the symptoms are similar to the flu and other illnesses, it is sometimes difficult to detect and choose the right treatment.
The transmission of Mono
The cause of mono, the Epstein-Barr virus, is quite widespread within the human population and is thought that about 95% of the population is infected. The illness is transmitted by saliva, mostly when kissing or through infected objects. Whether the illness manifests symptoms depends mainly on the current state of the organism. Like any disease, mono mostly endangers patients with a weakened immune system, individuals under stress, the chronically tired or patients undergoing another illness. In most cases it affects children and young adults. Mono in adulthood is not excluded, however it tends to have more severe manifestations.
Symptoms of Mono
One of the first symptoms of mono is long-term, excessive fatigue, which is sometimes referred to as chronic fatigue syndrome. Usually the patient develops a fever and a sore throat as well. As with tonsillitis, the tonsils have a white coating on their surface, typically accompanied by difficulty swallowing and bilateral swelling of the anterior and posterior cervical lymph nodes. During the course of mono, the patient tends to sweat excessively and experiences shivering as well as a head ache and muscle pain. The patient experiences long term fatigue and weakness which may last several weeks. The patient may also have a fever, usually reaching 39°C (102°F). Other typical symptoms of mono which may not appear in every patient, is an enlarged liver, manifested by the sensation on pressure under the right ribcage. The spleen can also be enlarged, in which case the pressure would be on the left side of the torso. Once the symptoms are gone, the virus survives in the blood, thought a large amount of antibodies are created. This provides a lifetime of immunity against a reoccurrence of mono. Only in the case of severe weakening of the immune system can the virus be reactivated, in which case the symptoms would be much less intense than the first time.
Complications of Mono
Mono, as with most other illnesses, has its own list of rare complications. The main complications include liver damage, which can significantly reduce its function and occasionally cause jaundice. Mono can also cause rupturing of the spleen, lowered red and white blood cell count or damage to the heart. It can also cause respiratory oppression, enlarged cervical lymph nodes, breathing difficulties or meningitis.
It is not always easy to diagnose mono due to its symptoms being very similar to the flu. However, the symptoms are important in making a diagnosis. It is also necessary to take the patient's age into consideration. A throat swab is necessary in order to exclude bacterial tonsillitis. Next, a blood test is performed where a lowered white blood cell count or an elevated level of liver enzymes can be found. To confirm a diagnosis, the Paul-Bunnel reaction can be used, where the presence of antibodies against the virus are detected. Because mono has similar symptoms to the flu, antibiotics are often mistakenly prescribed, which do not have any effect on viral illnesses. Their long-term use can impair the immune system of the patient in the fight against mono.
Treatment of Mono
The treatment of mono is mainly conservative, usually taking place at home. Only in severe cases does the patient need to be hospitalized. This is not a bacterial disease therefore patients are not prescribed antibiotics. The patient must visit his or her doctor regularly and follow the home treatment plan. Bed rest is very important and limiting physical activity as well as a special diet low in animal fats and high in carbohydrates are necessary. Light, easily digestible food is appropriate and to aid in the recovery of liver function, herbal teas are recommended. It is also necessary to reduce the accompanying symptoms, such as lowering the fever and if necessary, administering supplements to lowered fatigue. It is important to follow the treatment regimen for 6 months after the symptoms disappear, limit contact sports and dangerous physical activity. Enlarged liver and spleen lie close to the skeleton and are much more prone to rupturing.
Recovering from Mono
Even though a number of complications can occur from mono, if the treatment regimen is followed and the patient is taking a responsible approach to his or her health, the course of the illness is usually mild. Even so, it is necessary to adhere to the prescribed procedures so that the diet and other measures do not affect the patient longer than necessary. Changes in blood count should normalize within 3 months, though this does not mean the patient can resume an active life style. The patient should keep to the treatment plan for another few weeks. It is important to avoid the possibility of infection or exposure to the common cold. Physical activity should be limited to 6 months after recovery. Failure to follow the treatment plan can reactivate mono and it can reoccur with more severe symptoms.