Mono is the common term for a virus called infectious mononucleosis. This virus is caused by an organism called Epstein-Barr virus and has been around for a very long time. After exposure, it can take four to six weeks to have symptoms. You can transmit it when you are completely asymptomatic, so it’s sneaky and hard to prevent. On this week’s On Call for All Kids, Ebony Hunter, M.D., a pediatric emergency medicine physician at Johns Hopkins All Children’s Hospital, answers other commonly asked questions about mono.
How can you get mono? Is it true it’s from kissing, which is why it’s called the “kissing disease”?
Actually, that is only partially true! Saliva or oral secretions is the primary way in which you can get mono. If you drink after someone, share the same utensils, share personal items such as a toothbrush or pillows, or, yes, kiss them, you can get it any of those ways.
What are some of the symptoms of mono?
The typical triad of fever, sore throat and lymphadenopathy (or swollen lymph nodes). Other common symptoms are headache, body aches, rash, enlarged spleen, swollen tonsils and fatigue. The swollen lymph nodes are usually on both sides of the neck and can be quite impressive. It’s important to know that the swelling is usually outside but not inside. A good way to know that is if your child is talking, swallowing and breathing normally, the swelling is mainly outside. Fatigue is also a hallmark of mono and can last as long as the symptoms persist or longer. Unfortunately, fatigue can last up to six months in some and there is no way to predict who will have chronic fatigue after a mono infection.
How do you treat mono?
Since mono is a virus, you treat it with supportive care mainly. Treating the fever with over-the-counter medications if you don’t have any contraindications to them is ideal. Pain management and proper hydration are important to help with comfort and to prevent dehydration respectively. Steroids can be used in severe cases but not all cases. Consulting with your provider first to determine if they would help your child’s symptoms would be best.
Are there any concerns you should have specific for mono?
Yes, actually. Mono infections can cause the spleen to become large. The spleen is an organ filled with blood that normally sits nested just under our left-sided ribs and protected. Since it gets larger in 50-60% of the patients with mono, it is advised that those with mono not play sports for four weeks after symptoms start. Contact sports can lead to injury and rupture of the spleen, which is rare but a serious complication.
What should I do if I suspect my child has mono?
If your child is otherwise well appearing with symptoms noted above, then you can manage the symptoms and follow up with your doctor routinely. Testing can be helpful for confirmation but is not absolutely needed to manage the illness. If you child shows signs of dehydration or other significant concerns, they can seek medical management urgently or emergently to get a provider’s evaluation and opinion.
On Call for All Kids is a series featuring Johns Hopkins All Children's Hospital experts. Visit HopkinsAllChildrens.org/Stories for the latest report. You also can explore more advice from Ebony Hunter, M.D., or download our free Pocket Doc app, which features a symptom checker, parenting advice and other tools for staying in touch with us.