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Mono (Infectious Mononucleosis)

Symptoms

Severe sore throat
Large red tonsils covered with pus
Swollen lymph nodes in the neck, armpits, and groin
Fever for up to 7 days
Tiredness and increased sleeping
Enlarged spleen (in 50% of children)

Diagnosis

Mono is diagnosed by positive blood tests
Blood smear shows many atypical (unusual) white blood cells

Cause

Mono is caused by the Epstein-Barr virus (EBV).
This virus is passed to others in infected saliva (spit).
Occurs more often in 15- to 25-year-olds. Reason: more intimate contacts with others.
After the virus enters the body, it can take 4 to 7 weeks before symptoms begin.

Chronic Fatigue Syndrome

The symptoms of chronic fatigue syndrome are tiredness and weakness. There is also a constant feeling that you need more sleep.
The symptoms must be present for at least 6 months.
Any connection to mono has never been proven.

Prevention of Spread to Others

Mono is not very contagious. People in the same household rarely come down with it.
Avoid kissing at least until the fever and sore throat are gone.
Also use separate drinking glasses and utensils for the same time.

Overview:

Mono is a viral infection of the lymph nodes.
Symptoms will go away on their own. This is usually within a week to 10 days.
There is no drug that can cure mono.
Here is some care advice that should help.

Sore Throat Pain Relief:

Age over 1 year. Can sip warm fluids such as chicken broth or apple juice.
Age over 6 years. Can also suck on hard candy or lollipops. Butterscotch seems to help.
Age over 8 years. Can also gargle. Use warm water with a little table salt added. A liquid antacid can be added instead of salt. Use Mylanta or the store brand. No prescription is needed.
Medicated throat sprays or lozenges are generally not helpful.

Pain Medicine:

To help with the pain, give acetaminophen (such as Tylenol) or ibuprofen. Use as needed.

Fever:

For fevers above 102° F (39° C), give acetaminophen (such as Tylenol) or ibuprofen. Note: Lower fevers are important for fighting infections.
For ALL fevers: Keep your child well hydrated. Give lots of cold fluids.

Antibiotics Not Needed:

Only bacterial infections are helped by antibiotics.
Antibiotics will not kill viruses.

Fluids and Soft Diet:

Try to get your child to drink adequate fluids. Goal: Keep your child well hydrated.
Cold drinks, milk shakes, popsicles, slushes, and sherbet are good choices.
Solids. Offer a soft diet. Also avoid foods that need much chewing. Avoid citrus, salty, or spicy foods. Note: Fluid intake is much more important than eating any solids.
Swollen tonsils can make some solid foods hard to swallow.

Rest:

Bed rest will not shorten the course of the illness or reduce symptoms.
Your child can select how much rest he or she needs.

Activity and Precautions for an Enlarged Spleen:

The spleen gets bigger than normal in 50% of those with mono.
A blow to the belly area could rupture the enlarged spleen. This can cause serious bleeding and is a surgical emergency.
All children with mono need to avoid contact sports and exercise. Avoid these activities for at least 4 weeks.
Your doctor will check your child's spleen size by exam. You should get the medical okay to return to sports from your doctor.

What to Expect:

Most children have only mild symptoms that last about a week.
Even those with severe symptoms usually feel completely well in 2 to 4 weeks.
The most common complication is dehydration from not drinking enough fluids.

Return to School:

Children can return to school when the fever is gone. They should also be able to swallow normally.
Most children will want to be back to full activity in 2 to 4 weeks.

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