Infectious mononucleosis is also known as “mono.” It is caused by the Epstein-Barr Virus (EBV), which was discovered about 70 years ago. The virus can be contracted at any age, but is most common in teenagers. As it is spread through contact with saliva, it is also referred to as the “kissing disease.” Mono is easy to diagnose and incredibly common. However, it may still be interesting to know further details about it, because it could have potential complications later in life.
Symptoms of Mononucleosis
The virus has an incubation period of between 4 to 6 weeks. The symptoms of mono last between one and 2 months. These symptoms include a sore throat, a fever, a headache, swollen lymph glands (particularly in armpits and neck), fatigue, swollen tonsils, muscle weakness and night sweats. Some patients report a swollen liver or spleen. It can be very difficult to distinguish mononucleosis from other virus infections, particularly the flu. Most people choose to opt for home treatment, including rest and painkillers. And only 65% of people who contract the virus never experience symptoms. Children usually don’t have symptoms at all. Mono is rarely fatal.
Diagnosis of Mononucleosis
Diagnosing mono is quite easy. Those who have the virus present symptoms such as a sore throat, fever and swollen lymph glands. Additionally, if the patient is a teenager, no further tests are generally needed. If required, however, a white blood cell can be done, with an elevated count being a good indicator for an infection. Additionally, doctors can do a mono spot test, which looks for EBV antibodies. This is a very quick test that looks for antibodies against the virus. This test is conclusive, but it often only works once the virus has been active for around two weeks or so.
Possible Causes of Mononucleosis
Mono is caused by EBV, which was discovered in 1933. The CDC (Centers for Disease Control and Prevention) explains that the virus is part of the herpes family and is one of the most common viruses globally. Mono spreads by direct contact with saliva. It cannot be transferred through blood. A cough or sneeze, a kiss or sharing cutlery or glasses can all lead to someone contracting the disease.
Some demographics are at a higher risk of contracting the virus. These include those between the age of 15 and 25, interns, students, caregivers, nurses and those with a compromised immune system. Anyone who, through work or other activities, frequently spends time with larger groups of people have increased risk of contracting the virus. This is why it is so common amongst college and high school students.
Prevention and Treatment
No real treatment exists for mono, and there are no vaccines or antiviral drugs either. Indeed, the majority of patients simply treat the virus at home with rest. In some cases, a doctor may prescribe corticosteroids, which help to reduce the swelling of the tonsils and throat. Without treatment, the symptoms will generally stop within two months. Any treatment provided by a doctor is about easing symptoms, rather than curing them. Painkillers and over-the-counter fever reducing medicine is generally enough. Additionally, taking products such as honey or gargling with salt water can help with the sore throat. People with mono generally require a lot of rest and they must ensure they remain hydrated by drinking plenty of water. Warm chicken soup is also highly beneficial because it both nourishes and hydrates.
In very rare cases, symptoms do escalate. Some people start to experience strong abdominal pains. It is vital to contact a medical professional at this time, as a possible (but rare) complication of mono is a ruptured spleen. This condition is life-threatening.
Unfortunately, it is near impossible to prevent mono. This is because people who have been infected will carry the virus for the rest of their lives. Periodically, the virus will become active again and can spread. However, symptoms are only experienced once. By the age of 35, almost every adult in the modern world has been affected by mono but has antibodies to stop them from being sick. As such, most people will only get mono once, except in very rare occasions.
New Discoveries/Vaccines for Mononucleosis
Important strides have been made in terms of developing a vaccine against the EBV. This followed a discovery by Canadian scientists, who have worked out how the infection is able to bypass the immune system. It was found that molecular events are triggered at infection, which turns key proteins off. This means that the T (NKT) immune cells no longer see the infected cells and allow them to thrive. Scientists have found that these proteins must be expressed, so that the NKT cells are able to see the infected cells and destroy them. A vaccine that addresses this would provide lifelong immunity.
It is very rare for mononucleosis to last longer than 4 months, with most people recovering after about three weeks. Indeed, most who have the illness can return to work or school after two weeks. However, one of the reasons why it is important that scientists continue to work towards developing a vaccine is because 38% of the infected take more than two months to recover, which is a significant period of time. Additionally, the potential complications of the virus, could be mainly with the ruptured spleen, is very real and dangerous, albeit rare.
Additionally, some people develop chronic EBV symptoms. Although anyone who has had the virus will remain a lifelong carrier, a small percentage of people notice that their symptoms come back whenever the virus flares up. As a result, their overall quality of life is significantly reduced.
Finally, in some cases, the virus can lead to two types of very rare cancer later on in life. These are nasopharyngeal carcinoma and Burkitt’s lymphoma. These cancers are very rare and don’t usually occur in the modern world. Additionally, EBV is just one of the factors that has a role to play in the development of these cancers.