RICE & MICE: The kissing disease

At some point a few years ago, when I was still in grad school, my mom called me to tell me that my brother was sick and wanted to know if I thought they needed an appointment with his doctor.  He had been extra tired for a few days and had some headaches and body aches and a slight sore throat but thought that maybe it was just his busy schedule between sports and school and his girlfriend.

That day he had spiked a pretty good fever of 103° F, his throat was very sore and his glands in his neck were swollen and my mom said he had a skin rash. I told my mom that is sounded an awful lot like mono, so off to the doctor he went and after a few simple blood tests, it was determined that he had mononucleosis. You know who else had mono? My little brother’s girlfriend, who also had a sore throat, fever and swollen glands; she had mono as well.

Infectious mononucleosis, also called mononucleosis, mono or “the kissing disease,” is a viral infection usually caused by the Epstein-Barr virus (EBV), but sometimes caused by a virus called cytomegalovirus (sounds like a dinosaur from Jurassic Park, eh?). EBV is very common, and many people have been exposed to the virus at some time in childhood, but not everyone that is exposed to EBV develops the symptoms of mono. It is possible to contract mono and never have a single symptom. Once infected with the virus, you will carry it for life an people who get ill with mono infection usually will not get sick or have the same symptoms from it again. Like EBV, once cytomegalovirus is contracted it stays with you for life and may not cause symptoms.

Sean Couturier. Flyers 1st round pick (8th overall) in 2011. Thank you mono! Photo by Nick Laham/Getty Images North America

There is usually an NHL player or two that comes down with mono every year.

Off the top of my head, Phil Kessel, Tyler Kennedy and Mike Comrie all have missed time in past seasons with mono. I lied, I had to look that up. Most people recover from mono without any complications or residual problems, but it can take a long time to go away and a long time for things to get better. Philadelphia’s first-round pick in the 2011 draft, Sean Couturier, battled through mono during the summer of 2010 and even though he maintained his production during the 2010-11 QMJHL season with Drummondville. Anybody that has had mono can tell you it is rough to get over and can sometimes take months to get over. This is what Couturier battled through during his last season in juniors; it is also what kept him from being drafted first overall (thank you mono!) and falling to #8 so that Paul Holmgren could snatch him up.

Mono is spread from person through direct contact with saliva of an infected person. Makes you want to think twice before swapping spit, doesn’t it? Of course kissing isn’t the only way to spread it. Any contact with saliva an infected person can transmit EBV (or cytomegalovirus), such as by sharing a drink, a toothbrush, an eating utensil, or even lip gloss, lipstick, or lip balm.

Once infected, it takes from 4-10 weeks before any symptoms begin. It is most contagious when there is a fever, however it can still be passed if a person has no symptoms at all. Virus particles may be present in the saliva for as long as 18 months after the initial infection.

Mono signs and symptoms. From www.medicinenet.com

Symptoms can include:

  • Fatigue (lots and lots of fatigue)
  • fever
  • sore throat
  • loss of appetite (probably some weight loss to go with this)
  • swollen lymph nodes (commonly called glands, located in your neck, underarms, and groin)
  • headaches
  • sore muscles
  • weakness
  • skin rash
  • abdominal pain
The severity of these symptoms can vary. The swollen tonsils can cause trouble breathing and swallowing.  Tonsils that are swollen due to mono are pretty impressive to look at because they can get pretty huge and they are usually pretty gross looking. Because the symptoms of mono are so general and can be signs of other illnesses, it’s possible to mistake mononucleosis for the flu, strep throat, or other diseases.

Gross, swollen, mono tonsils. From www.medicinenet.com

There is no cure for mono. No pill to take to make it all better. It’s a virus and just has to run its course. It may take 2-4 weeks to start feeling better, however the fatigue may continue for up to 6 weeks. Steroids such as prednisone are sometimes prescribed if the tonsils and glands are very swollen, in order to help reduce their size. An average student may lose almost a semester of school work and a highly conditioned athlete may not be back to normal for almost a year. With that in mind, I think Couturier was a steal at #8 in the draft and will only continue to grow and impress.

Antibiotics will not make mono better and in fact, amoxicillin and ampicillin make cause a rash, if taken when a person is infected with mono. You may have heard that contact sports are a no-no with mono and this is true. Because the spleen works to filter damaged or old red blood cells, it enlarges during a mono infection and the risk of rupturing the spleen increases. The fancy-schmancy word for enlarged spleen is splenomegaly.  A ruptured spleen can cause internal bleeding and abdominal pain and requiring emergency surgery.

Vigorous activities, contact sports, cheerleading, weightlifting, or even “horseplay with friends” is not allowed and should be avoided for at least a month. An person with mono should get the ok from a doctor or medical professional before engaging in any of these aforementioned activities.  Sometimes the liver will also become mildly inflamed (hepatitis). This form of hepatitis is rarely serious and doesn’t normally require treatment. There are other rare but serious complications of mono that I’m not going to discuss.

The first and best treatment for mono is plenty of rest. Rest your brain, rest your muscles, rest everything. Tylenol and ibuprofen are sometimes recommended for aches and pains. Drinking extra fluids will help prevent dehydration and help soothe the sore throat. Once the fever is gone, people can return to work or school, but must be careful not to overdo it and should listen to their body to avoid over-exertion.

Disclaimer: Information on found in RICE & MICE on flyersfaithful.com is not intended to be medical advice. Any information or materials posted on the web site are intended for general informational purposes only, and should not be construed as medical advice, medical opinion, diagnosis or treatment. Any information posted on the web site is NOT a substitute for medical attention. See your health-care professional for medical advice and treatment.