Signs of Mononucleosis: Some May Surprise You - Children's Physicians Medical Group

Signs of Mononucleosis: Some May Surprise You

Infectious mononucleosis is a contagious disease most commonly seen in teenagers and young adults, especially college students.  It’s called mono, mononucleosis, or “the kissing disease”, but this name tends to be a misnomer as there are many different ways to spread the virus.  Younger children can also get mono, but it often goes undiagnosed, as their symptoms are much milder.  Older adults usually don’t get mono, because they have immunity to the virus.  What are the signs of mono?  It’s helpful to know the signs making it easier to identify it in your child/teen and hopefully avoid contracting it or passing it along to someone else if you get it.

The virus that typically causes mono is the Epstein-Barr virus (EBV) which lives in saliva and mucus, meaning it can spread via any medium that carries these substances – from dirty tissues to drinking glasses and silverware.  It’s a sneaky virus: as you can carry it for as long as 4 to 6 weeks, spreading it around and passing it along to others, before you even start to show symptoms of getting sick.  What’s worse, you can pass it along after you are no longer sick as the virus hangs around, dormant, and reactivates itself every so often without showing any symptoms. This means your child could give mono to someone several months or even years after he has recovered.

Many people carry EBV without ever showing signs of mono.  It’s often difficult to tell how a person contracted the disease if no one they interact with showed any symptoms of mono in recent months.  All of these factors make mono a difficult illness to prevent.  Fortunately, it’s usually not a serious disease once contracted, other than the impact it can have on your child’s ability to make it to school or sports. Most children make a full recovery and avoid any serious complications. There is no specific treatment for mono other than drinking fluids to stay hydrated, getting plenty of rest, and taking over-the-counter medications for pain and fever.  That said, you should make yourself familiar with what are signs of mono, so that you can recognize and treat the illness effectively if you or your child should catch it.

What Are the Most Common Signs of Mono?

If you want to know what the signs of mono are, most people who get mono experience some or all of the following symptoms:

  • Fatigue: A constant feeling of tiredness, even to the point of being unable to get out of bed.
  • Fever: A high fever is common with mono and should be monitored closely.
  • Malaise: Generally feeling unwell, as if something is not quite right health-wise.
  • Headache: Often accompanied by soreness in other areas of the body and general muscle soreness.
  • Sore throat: Many describe the sore throat associated with mono as the worst sore throat they have ever experienced in their lives.
  • Swollen spleen: Some people do not even realize this is occurring, but severe pain in the left side should be addressed immediately as it could be a sign of a ruptured spleen due to the swelling.

The virus has an incubation period of approximately four to six weeks, although in young children this period may be shorter. Signs and symptoms such as fever and sore throat usually lessen within a couple of weeks, although fatigue, enlarged lymph nodes and a swollen spleen may last longer. If you or your child has some or all of these symptoms, you should make an appointment with your doctor. He or she can order blood tests to determine whether the illness is mono. These tests include an antibody test to determine if the body is developing antibodies to EBV, and a test to check on white blood cell count.

Most people recover from mono without any problems. However, aside from monitoring your child’s spleen, you should also be careful to watch your child’s breathing, as the swelling in throat and tonsils could make things difficult. If your child is having a hard time breathing, you should seek help from your pediatrician. If your child’s condition is severe, he or she may prescribe corticosteroids to reduce inflammation and open up your child’s airways.

What Are Some Uncommon Signs of Mono?

Just as people can carry EBV without being aware of it, sometimes people develop lesser-known symptoms of mono and do not always realize what they have. Below are a few symptoms that occur less frequently:

  • Hives
  • Jaundice or yellowing of the skin
  • Eyes become sensitive to light
  • Shortness of breath
  • Stiffness in the neck
  • Bleeding nose

When asking your doctor what are signs of mono, make sure you ask about these uncommon symptoms as well if you are having a hard time diagnosing your illness.

How to Treat Mono

First verify that you or your child has mono with a doctor; if you are looking for one, Children’s Physicians Medical Group may be able to help. If your child/teen is diagnosed, it’s important to know what the treatment for mono is. While most of it is common sense, there are a few precautions you should take to avoid creating any complications.

  • Get plenty of rest. You usually will not have a problem with this part of treatment, as mono tends to cause fatigue. However, some people struggle as mono can last for several weeks or even a few months. It is important not to get frustrated and to give yourself or your child time to heal so that you do not end up prolonging the illness or making it worse.
  • Drink plenty of fluids.
  • Take only medications that your doctor recommends for pain and fever. Some medications can cause problems with individuals who have mono and should be avoided altogether, such as aspirin.
  • Treat a sore throat with gargling salt water.
  • Avoid strenuous physical activity of any kind for up to 2 or 3 months. The spleen takes a long time to heal. Your child has an increased chance of rupturing it if he starts playing sports or exercising before he is ready. A ruptured spleen is a medical emergency that can be fatal.

One of the most frustrating parts of having mono is how long it lasts. You or your child may end up missing a lot of school or work, which can be frustrating for you, your child, your parents, your teachers, your boss, etc. Unfortunately, the only way to deal with the situation is to allow time to recover.

Please feel free to share your experience on our Facebook page – CPMGSanDiego ( or on Twitter ( Discussion Points: Did you suffer from mono at some point in your life? What treatment seemed to help you the most? How long did it take you to recover from being sick?