Health Care and Mono

They call it the kissing disease, but actually mononucleosis is an illness that can be contracted by exposure to someone who is carrying the bug in their system without having any direct personal contact. Mononucleosis, or mono, is often spread by saliva and close contact, according to the National Institutes for Health (NIH). It occurs most often in those age 15 to 17. However, the infection may develop at any age. Mono is usually linked to the Epstein-Barr virus (EBV), but can also be caused by other organisms such as cytomegalovirus (CMV).

According to WebMD, "mono," is a common viral illness that can leave you feeling tired and weak for weeks or months. Mono goes away on its own, but lots of rest and good self-care can help you feel better. It is most often seen in adolescents and young adults. Children can get the virus, but it often goes unnoticed because their symptoms are mild. Older adults usually do not get mono, because they have immunity to the virus.

Mono can be spread through contact with saliva, mucus from the nose and throat, and sometimes tears. If you have mono, you can avoid passing the virus to others by not kissing anyone and by not sharing things like drinking glasses, eating utensils, or toothbrushes. As soon as you get over mono, your symptoms will go away for good, but you will always carry the virus that caused it. The virus may become active from time to time without causing any symptoms. When the virus is active, it can be spread to others.

According to the NIH, mono may begin slowly with fatigue, a general ill feeling, headache, and sore throat. The sore throat slowly gets worse. Your tonsils become swollen and develop a whitish-yellow covering. The lymph nodes in the neck are frequently swollen and painful. A pink, measles-like rash can occur and is more likely if you take the medicines ampicillin or amoxicillin for a throat infection. (Antibiotics should NOT be given without a positive Strep test.) Symptoms of mononucleosis include:

• Drowsiness
• Fever
• General discomfort, uneasiness, or ill feeling
• Loss of appetite
• Muscle aches or stiffness
• Rash
• Sore throat
• Swollen lymph nodes, especially in the neck and armpit
• Swollen spleen

Less frequently occurring symptoms include:

• Chest pain
• Cough
• Fatigue
• Headache
• Hives
• Jaundice (yellow color to the skin)
• Neck stiffness
• Nosebleed
• Rapid heart rate
• Sensitivity to light
• Shortness of breath

Much more detail about mono and how to deal with it can be found at this website: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001617/ .

Symptoms usually start 4 to 6 weeks after you are exposed to the virus, according to WebMD. Mono can cause the spleen to swell. Severe pain in the upper left part of your belly may mean that your spleen has burst. This is an emergency. Your doctor will ask you questions about your symptoms and examine you. You may also need blood tests to check for signs of mono (monospot test) and the Epstein-Barr virus. Blood tests can also help rule out other causes of your symptoms. Usually only self-care is needed for mono:

• Get plenty of rest. You may need bed rest, which could keep you away from school or work for a little while.
• Gargle with salt water or use throat lozenges to soothe your sore throat.
• Take acetaminophen (such as Tylenol) or ibuprofen (such as Advil) to reduce fever and relieve a sore throat and headaches.
• Avoid contact sports and heavy lifting. Your spleen may be enlarged, and impact or straining could cause it to burst.

In severe cases, medicines called corticosteroids may be used to reduce swelling of the throat, tonsils, or spleen. More material on Mono can be found at this site: http://www.webmd.com/a-to-z-guides/infectious-mononucleosis-topic-overview .

According to MedicineNet.com, research has shown that, depending on the method used to detect the virus, anywhere from 20%-80% of people who have had mononucleosis and have recovered will continue to secrete the EBV (Epstein-Barr virus) in their saliva for years due to periodic "reactivations" of the viral infection. Since healthy people without symptoms also secrete the virus during reactivation episodes throughout their lifetime, isolation of people infected with EBV is not necessary.

It is currently believed that these healthy people, who nevertheless secrete EBV particles, are the primary reservoir for transmission of EBV among humans. Patients can continue to have virus particles present in their saliva for as long as 18 months after the initial infection. When symptoms persist for more than six months, the condition is frequently called "chronic" EBV infection. However, laboratory tests generally cannot confirm continued active EBV infection in people with "chronic" EBV infection.

There can be rare complications due to contracting mono, which is typically not seen in healthy people, according to MedicineNet. Fortunately, the more severe complications of mono are quite rare, and mono is very rarely fatal in healthy people. The rare severe complications include destruction of red blood cells (hemolytic anemia) and inflammation of the sac surrounding the heart (pericarditis), the heart muscle itself (myocarditis), and the brain (encephalitis). Mono tends to be more aggressive in patients with abnormal immune systems, such as people with AIDS or those who are taking medications that suppress immune function.

The EBV has been associated with some types of cancers, most commonly lymphomas. This occurs most frequently in people whose immune systems have been compromised due to disease or immune suppressive drugs. EBV infection has also been found to be associated with two types of cancer found in other cultures -- nasopharyngeal carcinoma (cancer of the pharynx and nose) in southern China and Burkitt's lymphoma of the jaw among children in equatorial Africa. Further, numerous studies have also found that EBV infection is associated with the development of at least one subtype of Hodgkin's disease. However, since the vast majority of people have been infected with EBV and never develop these types of tumors, EBV infection cannot be the sole cause of these cancers. The overwhelming majority of people who have had mono recover completely without any serious complications. Much more detail can be found at this website: http://www.medicinenet.com/infectious_mononucleosis/article.htm .

According to the Mayo Clinic, mononucleosis can be a prolonged condition, keeping you at home for weeks as you recover. But be patient with your body as it fights the infection. For young people, having mononucleosis will mean some missed activities — classes, team practices and parties. Without doubt, you'll need to take it easy for a while. Students need to let their schools know they are recovering from mononucleosis and may need special considerations to keep up with their work. If you have mononucleosis, you don't necessarily need to be quarantined. Many people are already immune to the Epstein-Barr virus because of exposure as children. But plan on staying home from school and other activities until you're feeling better. Seek the help of friends and family as you recover from mononucleosis. College students should also contact the campus student health center staff for assistance or treatment, if necessary. More info can be found at this website: http://www.mayoclinic.com/health/mononucleosis/DS00352 .

If you suspect that you or a family member may be coming down with mononucleosis, consult a physician or health care provider as soon as possible. Containing the contagious disease as early as you can helps to prevent the spread of mono to others. Be careful not to over exert yourself, and follow the advice of your doctor. Although not fatal in most cases, there are some lingering issues that can cause more problems if you don’t treat it as prescribed.

Until next time.