Mononucleosis (Mono) In Teens: Causes, Symptoms & Treatment

As a viral infection, mono does not have a specific treatment, but the symptoms are treated.

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Infectious mononucleosis (mono) is a contagious viral infection that is most prevalent in teens and young adults. According to the Centers for Disease Control and Prevention (CDC), one in four teens infected by EBV contract mono (1). However, infectious mononucleosis in teens is seldom serious though it may cause potential long-term complications if severe or left untreated.

Read on to know more about the causes, symptoms, risks, and treatment of mononucleosis in teens.

What Are The Causes Of Mono In Teens?

The most common causative agent of mononucleosis is the Epstein Barr Virus (EBV), a member of the Herpesviridae family. Other viruses of the same family, such as the cytomegalovirus, can also cause the infection (2).

This virus is mostly transmitted via salivary secretions. For example, it could spread from an infected person to a healthy person while kissing; hence, it is also known as the kissing disease. Besides, the infection may also spread through blood transfusions, bodily fluids (sexual contact), mucus secretions, organ transplantations, and by sharing food and drinks with the same utensils (3).

What Are The Symptoms Of Mono In Teens?

Most teens may develop the infection without recognizable signs. In some, the signs of infection usually start appearing after some weeks of being exposed to the infection. The symptoms of mono in teens may include (4)

  • Fatigue and weakness
  • Body aches
  • Abdominal discomfort or sharp pain in the abdomen
  • Headache
  • Fever
  • Sore throat
  • Swollen lymph nodes (especially in the armpits, neck, and groin region)
  • Spleen enlargement
  • Nausea and vomiting
  • Yellowed skin and eyes and mild jaundice-like symptoms (liver involvement may lead to temporary jaundice)

The signs of mono may resemble the flu or other medical conditions and are mostly mild. However, if your teen experiences severe and persistent symptoms, consult a healthcare provider.

How Long Does Mono Last In Teens?

Acute forms of infectious mononucleosis may last for two to three weeks, but sometimes, the infection may resolve within a week. However, owing to the long incubation periods and inconsistent nature of the virus, recognizing the onset of the infection is tricky. Though the infection is self-limiting, the symptoms may even last for six months (5).

How Is Mono Diagnosed In Teens?

Mononucleosis is mainly diagnosed based on symptoms. The following modalities help in diagnosing mono in teens (5):

  • Physical examination: The doctor checks for swollen tonsils or lymph nodes may ask about your teen’s health history.
  • Blood tests: They include complete blood count and white blood cells (WBC) count tests, monospot tests for heterophile antibodies, and PCR tests to detect EBV DNA.

Note: As per the CDC, heterophile tests are not advised for general use, especially in children, due to the possibility of false-negative results (6).

  • Liver function tests: They are checked for an elevation in liver enzymes.

Blood tests usually demonstrate a high WBC count and abnormalities in neutrophils, platelet counts, lymphocytes, and liver enzymes in individuals with infectious mononucleosis (1).

When Should You See A Doctor?

Most teens spontaneously get better after a few weeks of being infected. However, consult your healthcare professional if your teen’s symptoms aren’t reducing or they report other symptoms such as (7)

  • Drowsiness
  • Breathing or swallowing difficulties
  • Unresponsiveness
  • Dehydration
  • Decreased urine output
  • Sudden, extreme abdominal pain
  • Any other serious symptoms that begin to worsen

What Are The Treatments For Mono In Teens?

No specific treatments or vaccines exist for mononucleosis in children or teens. In most cases, acute infections are treated with home care. If the disease persists and the symptoms are severe, your doctor may advise management options to relieve the symptoms, such as (8)

  • Medications: Over-the-counter pain medications such as ibuprofen and acetaminophen may be given for fever, aches, and inflammation.
  • Fluid intake: Drink plenty of fluids to prevent dehydration.
  • Resting: Get ample amounts of sleep to help the body fight the infection.
  • Gargling: Gargling with warm salt water or using throat lozenges may help ease throat discomfort.
  • Avoiding contact sports: Intense exercises or sports are not advisable in case of an enlarged spleen. They should resume physical activities only after receiving a go-ahead from the doctor.

What Are The Complications Of Mono In Teens?

Some of the complications of mono in teens include (9)

  • An enlarged spleen and increased risk of spleen rupture
  • Upper airway obstruction
  • Liver problems
  • Health conditions such as mild hepatitis and hemolytic anemia
  • Lymphocyte abnormalities
  • Eye inflammation
  • Hypersensitive skin
  • Abnormal heartbeats
  • Increased risk of neurological disorders (10)

Reye syndrome is a serious condition that may develop due to adverse reactions caused by aspirin given to treat mono. Hence, do not give any medicines without a doctor’s prescription. One in ten gets a red-spotted rash. The rash almost always occurs if the patient is taking the antibiotic amoxicillin during the illness. In this case, it is not a drug allergy but a drug-virus interaction.

How To Prevent Mono In Teens?

The following measures may help prevent mono in teens (7):

  • Refraining from sharing personal items such as straws, spoons, toothbrushes, and lip balms, which may result in indirect contact with another person’s saliva
  • Educating them to avoid kissing strangers they may not know well enough
  • Encouraging them to cover their mouth and nose while someone around them is sneezing or coughing
  • Practicing thorough and frequent handwashing

Frequently Asked Questions

1. Can my child go to school with mono?

A child may be sent to school after the fever has subsided. However, if your child feels weak, it is better to rest at home and recover properly (11).

2. Can a teenager get mono more than once?

The Epstein-Barr virus (EBV) stays in the body for the rest of your life after you get mono. However, you will not likely get mono symptoms twice, though the virus may reappear in your saliva from time to time (12).

3. Why is mono called the kissing disease?

Mononucleosis caused by the Epstein-Barr virus spreads mainly through saliva. Any contact with saliva, such as a kiss or sharing cutlery, may cause an infection. Hence mono is called the kissing disease (13) (14).

Mononucleosis is an infectious disease caused by the Epstein-Barr virus (EBV). It is a contagious infection spread from the affected person to others through close contact. Mononucleosis (mono) in teens may not show obvious signs and symptoms, or the onset of symptoms may occur a few weeks after contracting the infection. You may seek medical care if the symptoms are not improving within a few days. There are no specific medications to cure mono, and usually symptomatic treatments are given. Maintaining hand hygiene, not sharing personal items, and avoiding close contact with infected people may help prevent the infection.

Key Pointers

  • The Epstein-Barr virus (EBV) is the most prevalent cause of mononucleosis.
  • Most teens develop mono without noticeable indications that may resolve within one to three weeks.
  • Physical examination, liver function tests, and blood tests, including complete blood count and white blood cell count, can detect mononucleosis in teens.
  • Drinking enough water, taking appropriate rest, avoiding contact sports, and using OTC pain medications may provide symptomatic relief.

References

  1. About Infectious Mononucleosis.
    https://www.cdc.gov/epstein-barr/about-mono.html
  2. Infectious Mononucleosis.
    https://www.childrenshospital.org/conditions-and-treatments/conditions/i/infectious-mononucleosis
  3. Henry H Balfour Jr et al.; (2015); Infectious mononucleosis.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4346501/
  4. Infectious Mononucleosis (Mono) in Teens and Young Adults.
    https://www.cedars-sinai.org/health-library/diseases-and-conditions—pediatrics/i/infectious-mononucleosis-mono-in-teens-and-young-adults.html
  5. Jonathan A. Becker and Julie Anne Smith; (2014); Return to Play After Infectious Mononucleosis.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4000473/
  6. Samantha K. Dunmire et al.; (2015); Infectious Mononucleosis.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4670567/#R97
  7. Mononucleosis (Infectious).
    https://www.nationwidechildrens.org/conditions/mononucleosis
  8. Mononucleosis.
    https://my.clevelandclinic.org/health/diseases/13974-mononucleosis
  9. Mononucleosis Complications.
    https://www.mottchildren.org/health-library/hw168267
  10. K P Connelly and L D DeWitt; (1994); Neurologic complications of infectious mononucleosis.
    https://pubmed.ncbi.nlm.nih.gov/8060419/
  11. Mononucleosis (Mono)
    https://kidshealth.org/en/teens/mononucleosis.html
  12. Can a Person Get Mono More Than Once?
    https://kidshealth.org/en/teens/expert-mononucleosis.html
  13. Epstein-Barr virus and infectious mononucleosis.
    ttps://www.cdc.gov/epstein-barr/index.html
  14. Can You Get Mono From Just a Quick Kiss?
    https://kidshealth.org/en/teens/quick-mono.html
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