Moving Away from Mononucleosis
You feel very weak or tired. You have a fever, sore throat. You have no appetite. You eventually visit the doctor’s office and she explains you have mononucleosis.
Mononucleosis is the name of a condition presumably caused by the Epstein Barr virus. In mononucleosis, sometimes called the “kissing disease” the virus is believed to be transmitted through saliva most of the time and in blood products some of the times. It is not believed to be transmitted sexually. Symptoms include fever, sore throat, and swollen lymph glands in the neck. Some people develop chills, malaise, nausea, abdominal discomfort, vomiting, and loss of appetite.
Half of young adults with mono develop enlarged spleens. The symptoms last from two to six weeks. The fever persists for 10 to 14 days. The disease is rarely fatal. It is usually so mild in children that it goes undiagnosed. It is rarely diagnosed in older adults, probably because earlier bouts gave them resistance. Adolescents and young adults usually have the most trouble with mono.
The Epstein Barr virus occurs worldwide and most people become infected with it sometime during their lifetime. In developing countries entire populations often become infected with the virus in early childhood. In areas with better sanitation like the United States and Europe, people are more likely to become infected with the virus during adolescence or young adulthood.
The incubation period is four to six weeks. People can spread it for up to a year or more after their symptoms disappear and a few people don’t have symptoms but seem to be permanent carriers. Mono isn’t as contagious as many other common viral infections, such as the common cold.
Since infectious mononucleosis is caused by a virus, antibiotics don’t help. Rest, drinking fluids, salt water gargles, throat lozenges and ibuprofen or acetaminophen relieve some symptoms, which can last several weeks. One should also avoid exercise or contact sports until your doctor says it’s okay to resume them. During the time of spleen enlargement, a blow to that area of your body, on the left side of the abdomen below the ribs, can cause it to rupture. The spleen is affected in more than half of the people.
Other infections that can act like it include diptheria, gonococcal infections and streptococcal infections. Other viruses, such as adenovirus and herpes simplex can produce symptoms similar to those with mono, as can the side effects of some drugs and noninfectious diseases. A blood test can detect antibodies to the Epstein Barr and will confirm mono.
Because the immune system is weakened, someone with mono is more likely to contract another infection, especially in the throat, but the heart is also susceptible. Other complications, such as anemia and hepatitis, can occur.
Epstein Barr virus is a member of herpes virus family. Herpes infections are forever. The virus incorporates themselves into the genes of the host cell. When the viruses are not reproducing themselves, which in most people is nearly all of the time, there are no symptoms. When they are replicating, symptoms occur. That’s why herpes infections, whether on the lips, the genitalia or deep inside the body, tend to come and go throughout life.
In fact, researchers say something like 90 to 95 percent of all Americans have been exposed to the Epstein Barr virus and the past exposures usually show up on laboratory tests.
Epstein Barr virus has been implicated in some types of cancers. Strangely enough, in the early part of this century, doctors often misdiagnosed mononucleosis as acute leukemia because the early symptoms of leukemia sometimes mimic those of mononucleosis. When a misdiagnosed mono patient returned to good health in the early 1900s, the recovery often was attributed to a spontaneous remission from leukemia.
Many people with classic mononucleosis due to Epstein Barr virus have a very long period of neurasthenia: They feel tired all the time, depressed, have trouble functioning for six months to a year. After recovery (from the initial acute illness) there may be months or a year or so before they feel back to normal as far as regaining strength and not feeling tired.
Your doctor will test you to see if there are antibodies to the Epstein Barr virus in your blood but the test isn’t foolproof because it might indicate past infection in a healthy person. Best bet: Tests to rule out similar diseases with similar symptoms. Also once you are diagnosed, you will be advised to drink plenty of liquids and have plenty of rest.
If you should develop mono symptoms, you should immediately contact your doctor, who may order blood tests to help confirm the diagnosis. Please note that a large majority who do get infected have relatively minor symptoms.
