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(Infectious Mononucleosis; Mono)
Mononucleosis (mono) is an infection caused by a virus. It is marked by fever, lack of energy, and swollen glands.
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Mono is caused by the Epstein-Barr virus (EBV). Found mainly in saliva and mucus, it is passed from person to person by intimate behavior, such as kissing.
Many people get EBV during their lifetime. Here are factors that raise the chance that EBV will turn into mono:
- Getting EBV after age 10
- Lowered immune system due to other illness, stress, or lack of energy
- Living in close quarters with many people, such as in a college dormitory
Getting mono once means you will be immune to it in the future.
Signs of mono start 4 to 7 weeks after you were exposed to the virus. The first symptoms may be a sense of weakness that lasts about 1 week. Next, you may have:
- High fever
- Severe sore throat/swollen tonsils
- Swollen glands
- Lack of energy
- Loss of hunger
- Muscle aches
- Belly swelling
- Yellowing of the skin and whites of the eyes— jaundice
You will be asked about your symptoms and health history. A physical exam will be done.
Your bodily fluids may be tested. This can be done with blood tests.
There is no way to cure mono or to shorten the length of the illness. It lasts 4-6 weeks, but the lack of energy may last longer.
During the first few weeks, you should not play contact sports or lift anything heavy. A swollen spleen puts you at high risk of splenic rupture. This needs surgery. In rare cases, it can be fatal.
Get plenty of rest. Other steps may be to:
- Take pain relievers, such as ibuprofen
- Gargle with warm, salty water
- Drink plenty of fluids
- Take steroids to reduce swelling in the throat, if advised by your doctor
You can prevent mono by:
- Avoiding intimate contact, especially kissing, with anyone who has active mono
- Do not share drinks or food with anyone who has mono
Centers for Disease Control and Prevention
National Institute of Allergy and Infectious Diseases
About Kids Health—The Hospital for Sick Children
The College of Family Physicians of Canada
Balfour HH Jr, Hokanson KM, et al. A virologic pilot study of valacyclovir in infectious mononucleosis. J Clin Virol. 2007;39:16-21.
Ebell MH, Call M, et al. Does this patient have infectious mononucleosis?: The rational clinical examination systematic review. JAMA. 2016 Apr 12;315(14):1502-1509.
Epstein-Barr virus infection. EBSCO DynaMed Plus website. Available at: https://www.dynamed.com/topics/dmp~AN~T904534/Epstein-Barr-virus-EBV-infection . Updated January 5, 2018. Accessed July 17, 2018.
Luzuriaga K, Sullivan JL. Infectious mononucleosis. N Engl J Med. 2010 May 27;362(21):1993-2000.
Mononucleosis. Academy of Family Physicians Family Doctor website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/mononucleosis.html. Updated October 24, 2017. Accessed July 17, 2018.
- Reviewer: James Cornell, MD
- Review Date: 05/2018
- Update Date: 07/18/2018