Middlebury

 

Mononucleosis

What is mono and how did I get it?

Mono is a common illness on college campuses. It is caused by the Epstein-Barr virus.

It is transmitted through saliva, or mucous through kissing, sharing drinks, or silverware and occasionally through a sneeze or cough if the infected person is close enough.

Your roommate is not likely to get it unless you are sharing glasses or silverware.

How long will I be sick?

Common symptoms of mono are fevers, sore throat, swollen glands and fatigue. The syndrome is often preceded by malaise, headache and low grade fever before the development of the more specific signs.

Fatigue may be mild, or persistent and severe. It may linger long after the other symptoms have resolved.

Some people with mono become overly sensitive to light, or may note swelling around the eyes or sometimes a rash.

Most patients develop enlargement of the spleen, usually 2-3 weeks after they first become sick. Mild enlargement of the liver may occur also.

Most symptoms of mono usually resolve in 4-8 weeks, however, some patients can develop severe infections which last longer.

The virus remains dormant in a few cells in the throat for the rest of your life, but you will not experience any symptoms.

How is mono diagnosed?

In most cases of mono, patients will have the characteristic triad of symptoms of fatigue, fever and sore throat.

Diagnosis is confirmed by measurement of EBV–specific antibodies. These tests are more reliable than the “monospot” test. The results are available in 4-7 days and in most cases a distinction can be made as to whether you have a current infection, have had infection in the past or are still susceptible to EBV infection.
You may also have a throat culture done to rule out a strep throat. About 10% of mono patients also have strep pharyngitis. Results are available after 48 hours. Your clinician will discuss with you the best way for you to get your test results.

How is mono treated?

Since mono is caused by a virus, antibiotics are not useful. Your body should be able to fight the infection if you take extra good care of yourself.

Because your spleen is often enlarged and softer than normal, avoid all sporting activities for the first 4 weeks that could cause rupture. This includes running, swimming, lifting weights and other gym work. Your clinician will discuss with you how to gradually increase activity after 3-4 weeks. Athletes will need to be cleared before returning to practices.

You may attend class if you feel up to it. Contact your professors and Dean if you are too sick to attend class. Try to get 8-10 hours of sleep each night. Complete bed rest in most cases is not necessary. Try to space activities to prevent fatigue.

Drink plenty of fluids. 2-3 liters per day is a good rule of thumb. Try to include liquids such as soups, broth, sport drinks and water. Avoid caffeinated drinks and alcohol which can cause dehydration.

Warm salt water gargles 3-4 times a day help soothe sore throats.

Ibuprofen or Tylenol for fever, sore throat, or aches and pains. Follow the recommended dosing schedule or call the Health Services if you have questions. Notify the Health Services if your pain is not controlled by these medications.

Rarely, when the tonsils are very enlarged, you may be given steroids. These are given for short periods of time and only for specific indications.

Do not drink alcohol as the liver is commonly inflamed and alcohol is metabolized by the liver.

Call Health Services if you are too ill to care for yourself.

Are there any possible complications from mono?

The enlargement and softening of the spleen, make traumatic rupture a possible complication. Report any abdominal pain, left shoulder pain or feelings of lightheadedness to the Health Services or emergency room immediately.

Severe sore throat and gland swelling can cause difficulty breathing. Report to the Health Services or Emergency Room immediately.

Commonly there is a mild inflammation of the liver called hepatitis. This form of hepatitis is rarely serious or requires treatment, but may require monitoring. Report severe nausea, vomiting, abdominal pain or yellowing of the skin.

Severe complications are rare and include anemia, pericarditis and encephalitis.