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Mononucleosis |
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Mononucleosis - glandular fever - kissing disease
Infectious mononucleosis (mono), or glandular fever, is often called the kissing disease. Kissing can spread the virus that causes this disease, but more commonly coughing, sneezing, or sharing a glass or cup transmits mononucleosis. It's not highly contagious. Mononucleosis is caused by the Epstein-Barr virus. Mono usually isn't very serious, although the virus remains in your body for life. Some people with mono have minimal symptoms, and the infection goes unrecognized. Most people have been exposed to the Epstein-Barr virus by the time they're 35 years old and have built up antibodies. They're immune and won't get it again. Full-blown mono is common in people ages 7 to 35, and the highest incidence is in people between the ages of 15 and 24. In non-Western countries, mononucleosis has become increasingly common in children younger than 3 years. Signs and symptoms Signs and symptoms of mononucleosis may include:
In children between the ages of 4 and 15, the virus may cause a mild illness that resembles a common respiratory infection. In older adults, mono causes more severe signs and symptoms and lasts longer. The virus typically has an incubation period of four to six weeks, although in young children this period is shorter. Symptoms such as fever and sore throat usually lessen within a couple of weeks, although fatigue, enlarged lymph nodes and swollen spleen may last for a few weeks longer. When to seek medical adviceIf you've been feeling tired and weak; have had a persistent fever, headache, loss of appetite, rash and muscle aches; and have had swollen lymph nodes, tonsils and spleen — these are strong indications that you have mononucleosis. If rest and a healthy diet haven't resulted in easing your symptoms within a week or two or if your symptoms recur, see your doctor. Screening and diagnosisYour doctor may suspect mononucleosis based on your signs and symptoms and a physical examination. If there's a need for additional confirmation, a Monospot test is generally done to check your blood for antibodies to the Epstein-Barr virus. This is a screening test with a result within a day. But it may not detect the infection during the first week of the illness. Another antibody blood test requires a longer result time, but can detect the disease even within the first week of symptoms. Other blood tests that may be used look for elevated numbers of white blood cells (lymphocytes) or abnormal-looking lymphocytes. Significant complications of mononucleosis include enlargement of the spleen. In extreme cases, the spleen may rupture, causing sharp, sudden pain in the left side of your upper abdomen. If such pain occurs, seek medical attention immediately — you may need to have surgery. Most people with mono have mild liver inflammation (hepatitis). Jaundice occurs occasionally, usually in people older than 35. About half of the people with mono have a low count of platelets, which are blood cells involved in clotting. Mononucleosis can also result in the following less common complications:
The Epstein-Barr virus can cause much more serious illness in people who have impaired immune systems, such as people with HIV/AIDS or people taking drugs to suppress immunity following an organ transplant. Growing evidence suggests a possible link between mononucleosis and an increased risk of developing multiple sclerosis — a muscle-weakening disease of unknown cause. In one study of more than 60,000 women, researchers found that study participants who had multiple sclerosis had higher antibody levels to the Epstein-Barr virus in their blood compared with those without multiple sclerosis. Another even larger study found that people with the highest level of antibodies against the Epstein-Barr virus were more than 30 times more likely to develop multiple sclerosis later than those with the lowest level of antibodies. However, because so few people exposed to the Epstein-Barr virus ever develop multiple sclerosis, scientists point out that other factors must be involved in causing the disease. Mononucleosis > 1 > 2 > 3 > 4
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