EBV is a member of the herpes family. It's carried in the salivary glands and is spread by direct intimate contact such as kissing. Sneezes and coughs can also spread the virus but its transmission as an airborne pathogen is poor.

Sharing a house with someone who has mononucleosis is unlikely to result in infection. It's not nearly as contagious as the common cold. However, the virus can persist in the throat of an infected person for a long time. The virus can be found in the saliva in up to 15% to 25% of people who have been previously infected with the virus. Rarely, the virus can be transmitted through blood transfusion.

There are four symptoms traditionally associated with mononucleosis:

• swollen glands on the sides and back of the neck, under the arms and above the groin
• fever peaking each day in late afternoon or early evening, sometimes up to 40.5°C (105°F)
• fatigue
• sore throat

These symptoms arrive 4 to 8 weeks after infection. They're usually preceded by general unwellness, which may last about a week.

The infection itself lasts from 1 to 3 weeks, though about 2% of people have fatigue that lasts longer. The virus remains infectious in the saliva for several months, and never completely leaves the body.

Not everyone has all of the classic mononucleosis symptoms - some people have no symptoms. Many people just have swollen glands, and some just suffer fatigue. Other people may have a fever, a sore throat, and swollen lymph glands. Infants and young children usually only have a sore throat or tonsillitis, but they may have no symptoms at all.

A small percentage of people may experience jaundice (a yellowing of the skin) caused by the breakdown of red blood cells or liver problems. Some may develop a skin rash. Very rare complications such as encephalitis (brain inflammation) can also occur.

In about half of those who have mononucleosis with symptoms the spleen enlarges, and in about 20% the liver also swells. If you have mononucleosis, you'll be advised to avoid heavy lifting or strenuous sports for 3 months, because the spleen is fragile even if it isn't swollen. The organs slowly return to normal after the infection; however, there's a small but real chance of the spleen rupturing during the first few weeks of the infection and the healing period. In about half of spleen ruptures, the person isn't exercising when it happens. Rupture of the spleen can sometimes be painless, but it can lead to low blood pressure and shock.

Your doctor will ask you questions about your symptoms and perform a physical exam. The Epstein-Barr virus (EBV) is reliably detected by blood tests that look for antibodies and other cells that are only found in the presence of this infection. Another virus, called cytomegalovirus (CMV), causes an illness identical to mononucleosis, except blood tests for EBV are negative.

Some doctor may choose not to test the blood for the virus since there's not much the doctor can do with the information. Blood tests may be done to check for other medical conditions that could cause similar symptoms.

It's important to eliminate the possibility of strep throat, which causes similar symptoms and could be treated with antibiotics. This is done by testing for streptococcal bacteria with a throat swab.

There's really nothing modern medicine can do about viral infections like mononucleosis. Fortunately, most cases are mild. Stay in bed for a few days, and don't hurry back to school or work.

Drink plenty of water and fruit juices to avoid dehydration. You can take various syrups to soothe a sore throat, and acetaminophen to control fever. Children should not be given acetylsalicylic acid* (ASA) when treating mononucleosis because of the possibility of Reye's syndrome, a dangerous brain inflammation.

Rare and severe symptoms, like a massively enlarged spleen or swelling of the airway to the lungs, are treated with corticosteroids to reduce inflammation. Ruptured spleens must be repaired or removed in an emergency operation.

There's little you can do to avoid mononucleosis, except not kissing people who've been diagnosed with the disease. Most carriers have no symptoms, and therefore aren't diagnosed. If you're an adult, chances are you've already had it without knowing it and are now largely immune from re-infection.

If you get mononucleosis, the most important thing is to listen to advice about taking it easy for 3 months afterwards. The risk of a ruptured spleen is small, but not so small as to be ignored.

All material copyright MediResource Inc. 1996 – 2021. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/condition/getcondition/Infectious-Mononucleosis