Infectious Mononucleosis in Adolescents

What is infectious mononucleosis?

Infectious mononucleosis, also known as mononucleosis, "mono," glandular fever, or sometimes the "kissing disease," is characterized by swollen lymph glands and chronic fatigue.

What causes infectious mononucleosis?

Infectious mononucleosis is either caused by the Epstein-Barr virus (EBV) or the cytomegalovirus, both of which are members of the herpes simplex virus family. Consider the following statistics:

When children are infected with the virus, they usually do not experience any noticeable symptoms. However, according to the Centers for Disease and Prevention (CDC), uninfected adolescents and young adults who come in contact with the virus may develop infectious mononucleosis in nearly 35 to 50 percent of exposures.
The cytomegalovirus is actually a group of viruses in the herpes simplex virus family that often cause cells to enlarge. Most healthy persons who become infected with the CMV virus have few, if any, symptoms and have no long-term effects on their health. Some people may develop symptoms of mononucleosis.
The Epstein-Barr virus (EBV) may cause infectious mononucleosis in adolescents and young adults. However, even after the symptoms of infectious mononucleosis have disappeared, the EBV will remain dormant in the throat and blood cells during that person's lifetime. The virus can reactivate periodically, however, usually without symptoms.

What are the symptoms of infectious mononucleosis?

Mononucleosis usually lasts for one to two months. The following are the most common symptoms of mononucleosis. However, each adolescent may experience symptoms differently. Symptoms may include:

Fever
Swollen lymph glands in the neck, armpits, and groin
Constant fatigue
Sore throat due to tonsillitis, which often makes swallowing difficult
Enlarged spleen
Liver involvement, such as mild liver damage that can cause temporary jaundice, a yellow discoloration of the skin and eye whites due to abnormally high levels of bilirubin (bile pigmentation) in the bloodstream

Once a person has had mononucleosis, the virus remains dormant for the rest of that person's life. Once a person has been exposed to the Epstein-Barr virus, a person is usually not at risk for developing mononucleosis again.

Very rarely, carriers of this virus can develop Burkitt's lymphoma and nasopharyngeal carcinoma many years after infection. These two cancers are seen often in the United States.

The symptoms of mononucleosis may resemble other medical conditions. Always consult your adolescent's doctor for a diagnosis.

How is infectious mononucleosis diagnosed?

In addition to a complete medical history and physical examination of your adolescent, a diagnosis of mononucleosis is usually based on reported symptoms. However, diagnosis can be confirmed with specific blood tests including:

White blood cell count
Antibody test

How is infectious mononucleosis spread?

Mononucleosis is often spread through contact with infected saliva from the mouth. According to the CDC, symptoms can take between four to six weeks to appear and usually do not last beyond four months. Transmission is impossible to prevent because even symptom-free people can carry the virus in their saliva.