INFECTIOUS MONONUCLEOSIS

("MONO")

The illness: Mono is an acute virus illness lasting two to four weeks.  The principle things noted by victims are: swollen lymph nods in the neck, sore throat, fever, and headache.  Tiredness, weakness, and generalized aching are noted, but only to the extent experienced in other virus infections such as influenza.  The above group of symptoms are noted by virtually all adult persons with the disease.  Less frequently, people may note puffiness of the eyes, jaundice (yellow eyes and skin), a congested nose, and soreness or aching at the lower edge of the ribs due to swelling of liver and spleen.

Severity of the illness is quite variable.  Half of all adults who acquire the illness are unaware of having it, even though its presence can be verified by blood tests.  Children below age 15 usually are unaware of the disease.  At the other end of the scale, a few unfortunate people are severely ill for as much as two weeks.  All the other variations occur between the extremes.  Length of symptoms is also variable: some people are aware of illness for only a few days, while a few unfortunates have substantial symptoms for as much as three weeks. Mono is rumored to produce prolonged aftereffects-especially prolonged fatigue, but this is not really true.

Cause:  Mononucleosis is an infection caused by the Epstein-Barr virus.  The virus infection attacks lymph nodes, spleen, liver, and occasionally other body organs.  The virus concentrates in the lymph tissue in the tonsils and throat and is present in the mouth and throat secretions during the active disease and for six months or longer after the active disease in 60 percent of victims.  Transmission is most common with direct oral contact (kissing), but may rarely occur as droplet infection when droplets of mouth and throat secretions are sprayed into the air by coughing, sneezing, etc.

The majority of Americans of college age are immune to the disease:  specifically 85% of black Americans and 55% of white Americans already have immunity as college freshmen.  If you have had the disease, you will be immune.  Many other people are also immune due to a very mild, un-noticed attack of the disease.  Twelve to thirteen percent of those who do not have immunity acquire the disease in either symptomatic or unapparent form in each of the college years.  At present, there is no available test for individual immunity (the above information comes from research laboratories.)  As a practical matter, it is extremely rare to acquire the disease without kissing contact.  Roommates or classmates who do not have such contact acquire the disease only with exceeding rarity.

What to do if you have mono:  It is impossible to make a do-it yourself diagnosis with mononucleosis.  Even the doctor can't always tell and needs laboratory tests to confirm his suspicions.  Therefore, you should see a physician for an examination and for the ordering of blood tests if indicated.  A white blood count, differential blood count, and a serologic test known as a spot test or heterophil test are required for confirmation.  Stop by Student Health if you think you have mono.

Treatment:  There is no specific drug treatment to kill the Epstein-Barr virus.  Fortunately, the human body forms antibodies which control the virus during a period from ten days to three weeks.  Medical science can only offer some relief from the symptoms during that time.  Aspirin or Tylenol - two 300 mg tablets every four hours - may be used for the headache, muscle ache and sore throat.  When these symptoms are more severe, your doctor may order a stronger pain reliever such as codeine or Darvon.  Steroid medication such as prednisone may be ordered by your physician if you are severely ill, specially if you have severe tonsil swelling which is interfering with eating, swallowing or breathing.  In addition, you should respond to the tiredness by obtaining extra hours of sleep or bed and chair rest.