Almost every teen has heard about the kissing disease. Though only about 5-10 percent of them actually come down with the symptoms of Mono, tales of this infection are well known in adolescent circles.
When I see a teen in the clinic with the classic symptoms of fever, sore throat, fatigue and enlarged lymph nodes, I tell them it could be Mono. Many of them nod knowingly and flash an embarrassing smile because now they think their parents must know they’re kissing someone.
Truth is, while Mono can be commonly spread by sharing kisses, it’s also spread by sharing eating or drinking utensils and by sexual contact. Coming into contact with the bodily fluids of someone currently infected with Mono increases your chances of catching it.
What is Mono?
Mono is a viral infection caused by EBV (Epstein-Barr Virus). It’s incredibly ubiquitous and most children are exposed to it prior to adolescence. The difference is children rarely come down with the symptoms of Mono. So, the illness is most common in 15- to 24-year-olds who were not exposed in childhood. Eventually 90-95 percent of the population becomes EBV positive.
Fatigue and sore throat are by far the most common and most severe complaints of Mono. Fever may occur early in the disease but is not the most significant symptom. It’s often mistaken for strep throat or the flu since symptoms can greatly overlap. To confirm suspicions of Mono, many teens will need a blood test checking their white blood count and for presence of antibodies to EBV. A strep culture may also be done to rule out strep throat.
Caution in Mono
About 50-60 percent of teens with Mono will also have an enlarged spleen. Rupture of the spleen is rare but can be life threatening and for this reason, teens are not to participate in all sports activities for a minimum of 3 weeks. Contact sports, such as football, are definitely sidelined until 4 weeks after the onset of illness. Check with your child’s doctor to know when your teen gets the green light.
When can my teen return to school?
Once your teen is afebrile, sore throat is under control and fatigue has lifted then he/she is likely ready to return to school. There’s no hard and fast rule on this since contagiousness starts before onset of symptoms and shedding of the virus continues long after initial infection.
Remind your teens to not share eating or drinking utensils and to avoid intimate contact with someone else recently infected.
Dr. Mom's bottom line: The fatigue of Mono can linger for months. Make sure your teen is getting enough sleep (8.5 to 9 hours per night) and that any residual throat pain and/or swelling is addressed.