What is Infectious Mononucleosis (Glandular Fever)?
Infectious mononucleosis or “mono” is a disease caused by a viral infection. It’s contagious and can last from a few weeks to a few months.
Infectious mononucleosis is usually more common in young adults and teenagers. Adults can contract it, but it’s less prevalent in people over 24 years old.
Also known as glandular fever, infectious mononucleosis usually presents as severe fatigue. (1)
The most common virus which causes infectious mononucleosis is the epstein-barr virus (EBV).
Other viruses that can cause the disease include HIV, cytomegalovirus, rubella and hepatitis. (2)
EBV is part of the herpes family, which contains 7 other viruses which infect humans. It is highly common worldwide, meaning you are likely to contract it at some point in your life.
Most individuals contract EBV during childhood. However, the virus usually causes very mild symptoms or no symptoms at all in children.
EBV can be spread through saliva, semen, and blood. This means you can catch it even by sharing a glass with an infected person. (3)
It is estimated, at least one in four young adults or teenagers who contract EBV will eventually get infectious mononucleosis. (4)
Infectious mononucleosis is often referred to as the “kissing disease”. This is because kissing is the main transmission method of EBV in young adults and teenagers. (5,6)
Signs of the condition can include the following symptoms:
Fatigue is different from feeling sleepy or tired. Rest, a healthy diet, and avoiding stress can help reduce sleepiness or low energy levels.
Fatigue is not usually relieved by any of these practices and is often accompanied by a serious lack of energy.
Severe fatigue can be a symptom of infectious mononucleosis. (7)
A sore throat can be caused by various conditions, from flu to vocal strain. A sore throat which occurs suddenly is a typical sign of infectious mononucleosis.
Many patients describe it as the most intense sore throat they have ever experienced. (8)
You’re likely familiar with feeling sore or worn out after a bout of sickness. Infectious mononucleosis can cause a similar sensation, often described as myalgia.
Myalgia is the onset of pain in your muscles, or a group of muscles. These aches and pains tend to appear gradually as the illness progresses. (9)
Swollen Lymph Nodes
Infectious mononucleosis can result in swollen lymph nodes. The cervical lymph nodes found in your neck region are most likely to be affected.
Usually, lymph nodes to the side and back of the neck will also grow enlarged. This symptom can give the appearance of your entire neck being swollen. (10)
A fever can be caused by many different conditions. A high fever alongside swollen lymph nodes and fatigue is a typical sign of infectious mononucleosis. (11)
Your spleen may swell slightly as infectious mononucleosis runs its course. The swelling will usually reside when you are well again. (12)
An enlarged spleen may cause mild abdominal pain. Associated symptoms such as bloating or a loss of appetite may also occur. (13)
Although it’s uncommon, your spleen could rupture. If you experience extreme pain to the upper left of your abdomen, seek urgent medical attention. (14)
The epstein-barr virus, is the most common cause of infectious mononucleosis, yet it can remain inactive in your body for years.
If you become infected with EBV, your body will harbor the virus for the rest of your life.
It can reactivate without symptoms and you can spread EBV to other people. (15)
Infectious mononucleosis is usually provoked by a primary (first time) EBV infection. The condition passes through the following stages: (16)
You are negative for EBV infection. It is unlikely you will develop infectious mononucleosis as a result of EBV.
At this stage, you will not experience any symptoms. The incubation period is estimated to last for approximately 6 weeks.
EBV begins to reproduce in your mouth. From there onwards the virus infects your B cells, a type of white blood cell. It can also target the upper exposed area of your tonsils.
Eventually, EBV will move into your blood. However the precise mechanisms behind this transition are not fully understood. (17)
As the virus replicates, your body will begin to produce antibodies against it.
A blood test would show a very high viral load (amount of the virus) of EBV. Similarly, there will be significant increases of white blood cell production. (18)
The symptoms of infectious mononucleosis will then manifest. Most of the symptoms such as sore throat and fever, tend to last for around the two-week mark. (19)
However, fatigue and swollen lymph nodes can linger for up to 3 weeks or more. (20)
Infectious mononucleosis is usually a transient condition. This means symptoms will clear up by themselves over time.
However, for some people the disease is a precursor to chronic illness, usually related to chronic fatigue.
Individuals with lower rates of physical activity tend to be more prone to this problem. (21)
You may still expel EBV and remain contagious for an average of up to six months after the outbreak of infectious mononucleosis. (22)
Infectious mononucleosis is suspected in healthy patients aged 10 to 30 years old who present with typical symptoms.
To be absolutely certain, your doctor will likely perform a blood test. This will reveal if any heterophile antibodies are present, indicating the epstein-barr virus is active.
A blood test for infectious mononucleosis will also analyze your lymphocyte (white blood cell) activity.
A very high number of lymphocytes along with a positive heterophile result will likely confirm the diagnosis. (23)
Treatment is focused primarily on managing and reducing your symptoms.
Infectious mononucleosis can cause extreme fatigue and a general feeling of malaise (sickness). Most doctors will recommend getting proper rest as the condition runs its course.
This does not mean confining yourself to bed. Your day-to-day energy levels should dictate how much activity you feel comfortable doing. (24)
Staying hydrated is important to your overall well-being. However, when you are ill drinking enough water should be a priority.
As the infection goes through the motions, your doctor will likely suggest adequate and regular fluid intake to reduce symptoms. (25)
Non-prescription aspirin can be used to treat fever and other symptoms of the condition.
Infectious mononucleosis can cause sore muscles and headaches, which can be relieved with over-the-counter painkillers.
Avoiding Abdominal Injury
Your spleen may swell while you have infectious mononucleosis. In rare cases, it can rupture suddenly or because of outside trauma.
It is likely your doctor will recommend avoiding contact sports – like hockey or basketball – for the duration of your illness. (26)
What is infectious mononucleosis (glandular fever)? Infectious mononucleosis is a condition that results from a viral infection.
What are the signs of infectious mononucleosis (glandular fever)? The symptoms of infectious mononucleosis can include fatigue, swollen lymph nodes, sore throat and muscles. In some cases, your spleen may also swell.
How do you develop infectious mononucleosis (glandular fever)? Infectious mononucleosis is the result of a viral infection. The culprit is usually the epstein-barr virus, which is a member of the family of herpes viruses.
How are you diagnosed for infectious mononucleosis (glandular fever)? Diagnosis of infectious mononucleosis is performed through a blood test to detect certain antibodies.
What is the best treatment for infectious mononucleosis (glandular fever)? There is no established or ideal treatment for infectious mononucleosis. Your doctor may recommend fluids, bed rest, and non-prescription medications for aches, pains and fever.
What are the long term complications of infectious mononucleosis (glandular fever)? Some individuals can experience fatigue and related symptoms (irritability, excessive sleep, etc) for months after diagnosis of infectious mononucleosis. (27)
Is infectious mononucleosis (glandular fever) considered a disability? It unlikely you will be eligible for disability with infectious mononucleosis. Individuals who qualify for disabilities have chronic conditions that prevent them from working. However, if your doctor certifies your infectious mononucleosis could last for more than a year and it makes normal work impossible, you may certify. (28)
Is there any cure for infectious mononucleosis (glandular fever)? There is no vaccination against infectious mononucleosis or cure besides remedies to manage the symptoms. (29)
Is infectious mononucleosis (glandular fever) life threatening? No, not usually – the condition is generally classified as harmless. However, in very rare cases, infectious mononucleosis can cause your spleen to rupture. (30,31)
Infectious mononucleosis can be inconvenient to deal with. Symptoms of fatigue and general sickness (fever, sore throat, etc) can interfere with your daily activities.
Luckily, most people who contract infectious mononucleosis due to the epstein-barr virus only have to go through it once.
After that, they develop a level of immunity to EBV and symptoms do not reappear even though you will still carry the virus.
Normally, you will be able to get back to your usual schedule within a few weeks. Your doctor may recommend taking things slowly if you are still experiencing fatigue or have a swollen spleen. (32)