Does My Teen Have the Kissing Disease?

By Lindsey Johnson


Mononucleosis, also commonly called “mono” or “the kissing disease,” is common among children, particularly teens and young adults. Mono is highly contagious and can have some lingering effects that make it a disruptive illness.

What is Mononucleosis?

Infectious mononucleosis is caused by a virus, most commonly by the Epstein- Barr virus (EBV). In fact, Cleveland Health credits up to 90% of mono cases with an origin of EBV. However, hepatitis A, B, and C, herpes simplex (HSV), adenovirus, cytomegalovirus (CMV), human immunodeficiency virus (HIV), toxoplasmosis, and rubella can all trigger mono symptoms.

How common is it and who gets it?

Cleveland Clinic estimates that 95% of Americans will be infected by the age of 35. There are two peak times when people are most likely to acquire EBV: early school-age children and again at adolescence or early adulthood. Nemours Teens Health says that infants and young children often exhibit little to no symptoms, while teens and young adults may experience a variety of ailments.

Mono is very contagious and is spread primarily by saliva, earning it the nickname “the kissing disease.” Saliva droplets spread through kissing, coughing, sneezing, sharing food, beverages, straws or utensils, or even sharing toothbrushes. While easily spread by saliva, mono can also be spread through sexual contact as well as blood transfusions and organ transplants, though these forms are less common.

According to Nemours Teens Health, “People who’ve been infected carry the virus for life, even after symptoms stop and even if they had no symptoms. The virus is then “dormant,” or inactive. Sometimes the dormant virus “wakes up” and finds its way into a person’s saliva. This means that they can be contagious from time to time over the course of their life, even when they have no symptoms.”

Therefore, if your teen contracts mono, it may be difficult to trace the source of infection if they haven’t been around someone exhibiting symptoms.

If infected with mono, symptoms may develop four to six weeks after exposure. One of the most common symptoms
is extreme fatigue, often coupled with swollen lymph nodes in the neck (or groin or armpits), fever, sore throat (sometimes with white patches on the tonsils), headaches, rash, loss of appetite, muscle aches or weakness, or belly pain caused by an enlarged liver or spleen. Symptoms may be mild or severe and often resolve on their own within about four weeks, though the exhaustion can linger longer.

What about prevention and treatment?

Prevention involves basic hygiene precautions, including frequent handwashing, covering your mouth when you cough or sneeze and not sharing food with others. Even with best hygiene practices, it may be difficult to fully protect oneself from contracting mono and there is currently no vaccine available to prevent this disease.

Treatment primarily consists of treating the symptoms as mono will not respond to available antibiotics or antivirals.
The body will need a lot of rest to recover from this illness. Over the counter or prescription medications can help with sore throat, fever, muscle aches and more, coupled with a lot of fluids to make symptoms as manageable as possible. Because of the risk of rupture of an enlarged spleen, healthcare providers often recommend avoiding exercise and contact sports until further along in recovery.

If you or your child exhibit these symptoms, particularly if they are prolonged, make an appointment with your provider to be evaluated. They will likely check the lymph nodes as well as signs of spleen or liver enlargement. They may perform blood tests to check for antibodies that fight EBV and/or check white blood cell count. If the doctor diagnoses mono, have patience in the long recovery. Help your child keep up to date with school as best as possible and discuss the situation with teachers to create a plan to help your child not get too far behind. Most importantly, rest, rest, rest. The body is calling for it!

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