University of Iowa Health Science Relations and
Bradley Britigan, MD
Professor of Internal Medicine
First Published: November 2000
Last Revised: December 2003
Peer Review Status: Internally Peer Reviewed
When fatigue, a sore throat, a high fever, a headache or swollen
lymph nodes in the neck don't seem to go away, you may have the most
common symptoms of infectious mononucleosis, better known as mono.
Anyone who experiences these symptoms for weeks at a time should
contact his or her family doctor. A blood test called mono spot is
the most common way to diagnose mono, says Dr. Bradley Britigan,
professor of internal medicine at the University of Iowa College of
Medicine and a staff physician at UI Hospitals and Clinics.
"After diagnosis, little medical treatment is needed since 95
percent of patients with mono recover on their own," Britigan says.
The best ways to recover from mono are to avoid participating in
tiring physical activities and get lots of sleep, especially during
the first two weeks of the disease.
Other common treatments include plenty of liquids and aspirin or
acetaminophen. "Most treatment depends on each patient's specific
symptoms," he adds. "For example, someone with a sore throat should
gargle with salt water."
Recovery may take anywhere from two weeks to two months. Fevers
and sore throats generally last one to two weeks, but fatigue may
last up to a couple months. Hospitalization is uncommon, although it
is not unusual for people to miss two or more weeks of school or
If a person has difficulty swallowing or breathing because of
severely swollen lymph nodes or tonsils, or has other rare but
dangerous complications of the disease, steroids may be prescribed,
Britigan says. However, steroids can have negative side effects such
as stomach ulcers, retention of fluids, or suppression of the immune
system, so they aren't routinely prescribed for patients. Antibiotics
are prescribed only if a secondary bacterial infection sets in.
Mono can also cause an enlarged spleen. "When this happens, people
should avoid physical contact sports or anything that involves
contact with the abdominal area," he says. Those with mono should
also avoid drinking alcohol because it may aggravate the mild
hepatitis--liver injury--which often accompanies mono.
Mono is caused by a virus called the Epstein-Barr virus (EBV) and
is transferred through saliva. EBV causes lymphocytes--white blood
cells that fight infections--to enlarge and increase in number. "You
can acquire this virus at any age," Britigan notes. "Symptoms vary
with your age. Many people acquire the virus as children. A person
may have no symptoms whereas in some cases it may show up as a common
cold or other brief viral infection." People who acquire the virus
during childhood are carriers and can pass it on to others, even
though they do not exhibit any symptoms of mono.
"If the virus is passed on to someone who was exposed to the virus
during childhood, this person won't get mono," Britigan explains.
However, if someone is exposed to the virus for the first time as a
teenager or adult, he or she has the potential to develop mono.
Perhaps the best news about mono is that once you have it, you
won't experience the disease again.