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What is Epstein-Barr virus?

Viruses are one of the smallest infectious agents. Epstein-Barr virus is a member of herpes virus. Herpes virus causes symptoms such as cold cores. Epstein-Barr virus is a very common virus that infects about 95% of people and can cause infectious mononucleosis.


What is infectious mononucleosis?

Infectious mononucleosis, also known as "kissing disease," or glandular fever is a very common illness caused by the Epstein-Barr virus. The term "mononucleosis" refers to an increase in one type of white blood cells in blood relative to the other blood components as a result of the Epstein-Barr virus infection. While there are other illnesses falling under the broad classification of mononucleosis that can cause similar symptoms (cytomegalovirus [CMV] is one example) and an increase in blood lymphocytes, the form caused by the Epstein-Barr virus is by far the most common.


What are the risk factors for infectious mononucleosis?

The Epstein-Barr virus can infect any person. Most of us have been exposed to this virus during childhood. In response to this infection our body’s immune system develops an antibody against Epstein-Barr virus. Therefore by adulthood almost everyone would have developed immunity to fight against Epstein-Barr virus. Therefore it is commonly seen in adolescents and young adults. However, it is less severe in young children.


What are the signs and symptoms of infectious mononucleosis?

These early symptoms can last from one to three days after which the more intense symptoms of the illness may set in. these include severe sore throat, fever (102 F-104 F), and swollen glands in the neck and armpit. Generally in most people the severe sore throat prompts people to consult a physician.

The most common signs of infectious mononucleosis include a fever, reddened throat and tonsils and swollen lymph glands in the neck. The tonsils may have a whitish coating. The spleen, an organ found in the left upper abdomen underneath the rib cage may be enlarged or swollen. Liver may also enlarge.


How do people get infectious mononucleosis?

People infected with infectious mononucleosis shed Epstein-Barr virus in saliva. You may catch this virus if you are in close contact with infected people such as kissing or sharing a cup, container or utensil.

In fact infectious mononucleosis is also called "kissing disease" due to this common mode of transmission of the infection among teenagers. This disease can also spread when an infected person coughs or sneezes, shedding infected saliva and mucus in the air that can be inhaled by others.


How is infectious mononucleosis diagnosed?

Patient history, symptoms and signs along with laboratory findings may guide the physicians to diagnose infectious mononucleosis. One common test used to diagnose mono is called the Monospot test that is a test to detect heterophile antibody that are formed in response to infection with Epstein-Barr virus. If the Monospot test is not clear then blood tests including a complete blood count, liver function tests, can help confirm the diagnosis.


Can infectious mononucleosis be cured?

Infectious mononucleosis has no cure. However, the infection subsides on its own with symptoms usually lasting for about 4 weeks.


Do we need antibiotics for infectious mononucleosis?

Infectious mononucleosis is caused by virus and antibiotics are not effective against viruses. People affected by infectious mononucleosis have reduced immunity and hence may develop bacterial infections like Strep throat. Doctors may prescribe antibiotic to treat that infection and the best treatment option is penicillin or erythromycin. Many people with infectious mononucleosis may develop rash with ampicillin and amoxicillin and therefore it is avoided


What is the treatment of infectious mononucleosis?

The therapeutic strategy for infectious mononucleosis is to provide treatment to relieve the symptoms. Antiviral drugs do not provide significant benefit and may even prolong the course of the illness. People with infectious mononucleosis are advised to take rest as sleep aids our body fight infection. It is also advised to increase the fluid intake to prevent dehydration. Gargling with salt water, or using throat lozenges, hard candy or flavored frozen desserts may help in providing relief from sore throat. Sore throat is severe during the first five to seven days of illness and then improves over the course during the next 7 to 10 days.

Acetaminophen (Tylenol) or ibuprofen (Advil, Motrin, Nuprin) may be used to relieve headache or body aches and fever. Aspirin is not recommended in children.

Fatigue or tiredness may persist for months following the illness and so it is advised not to participate in any contact sports for at least four weeks after the onset of symptoms.

Corticosteroids may be prescribed in rare cases of airway obstruction, hemolytic anemia (an autoimmune process in which red blood cells are destroyed), severe thrombocytopenia (a decrease in platelets, which are clotting components in the blood), and complications involving the heart and nerves.


What are the complications of infectious mononucleosis?

Mild inflammation of the liver, or hepatitis, enlarged spleen that occurs that may increase the risk of traumatic rupture of the spleen, swelling of the throat and tonsils that may cause difficulty in breathing are some of the mild complications of infectious mononucleosis The severe complications of infectious mononucleosis include destruction of red blood cells, inflammation of the sac surrounding the heart, heart muscle and the brain.


When do I seek medical care?

If you develop any signs or symptoms of infectious mononucleosis, please contact your doctor. It is very important to confirm the diagnosis and to ensure it is not ant other severe medical condition requiring extensive and immediate medical treatment.

If you have difficulty breathing, difficulty swallowing , abdominal pain, bleeding from the gums or easy bruising, seizures, severe headaches, chest pain, inability to drink fluids, severe weakness in the arms or legs, and yellow discoloration of the skin then you should consult your physician immediately.