Mononucleosis In Teens – Causes, Symptoms & Treatment

Mononucleosis In Teens

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Is your teen complaining of constant fatigue? Does he experience a sharp, shooting pain while swallowing food or drinking water? Is he down with mild fever and general malaise, but isn’t exhibiting any other symptoms of the flu, you might want to consult your doctor. There are chances your teen has mono or mononucleosis. But, before you panic, consider reading our post below. Here, we list some important information about mononucleosis in teens and how it affects them.

What Is Mononucleosis?

Mononucleosis, or mono, is a viral infection. Typically, the disease infects teens and young adults aged 15 to 25 [1]. Annually, 11 to 48 cases of mono occur in 1000 people. While the Epstein-Barr virus causes this infection, other viruses too can lead to mononucleosis.

Since the infection is transmitted through saliva, mono is also called the kissing disease. Another name for the infection is glandular fever. Once your teen contracts the infection, the virus will stay put in his body for the rest of his life. There is a possibility that in the future the virus can become active again, but most probably it won’t cause any symptoms [2].

[ Read: Glandular Fever In Teenagers ]

Mononucleosis In Teenagers:

As we mention earlier, mononucleosis is more common among teens than adults. Its contagiousness makes it more likely to spread easily among adolescents as they are usually in direct contact with friends.

The infection often goes unnoticed initially because it begins with mild symptoms like throat pain and fever. These symptoms are common to a mild cold or flu. Hence, teenagers infected with the mono may not even realize it.

You need to remember that a person can be a carrier of the Epstein-Barr virus and still be asymptomatic. However, this person can infect your teen via saliva. Of course, you may not like to hear of it, but your adolescent may be sexually active and could indulge in a lot of kissing. This may be the reason for his infection. But, you can heave a sigh of relief as once the doctor diagnosis mono in your teen, one of the first things he will ask your adolescent to do is refrain from kissing people and sharing glasses, spoons, and toothbrushes.

What Happens When Your Teen Has Mono?

Typically, mono is not a life-threatening infection. The symptoms subside without the need for medical intervention. The symptoms also vary. For instance, the sore throat may be really bad in the initial three to five days and then gradually subside. In the meantime, your teen may have the mono-induced fever for nearly two weeks. The swollen lymph nodes may last up to four weeks, and it may take several weeks for your kid’s energy levels go back to normal.

It is imperative your teen gets adequate rest as that will give his body an opportunity to heal itself. If your teen keeps pushing himself, his condition may aggravate.

The mono-associated spleen inflammation can complicate things. And, as we mention above, mono in teens could lead to spleen enlargement, and make it more prone to physical injury. The complications are rare with mono as the infection dissipates by itself with adequate rest and hydration.

Why Mono Is Called the Kissing Disease?

Mononucleosis is more commonly known as the kissing disease. You can laugh if you want, but there is a valid reason for this moniker. Saliva is the primary source of infection transfer. This occurs when kissing involves the exchange of saliva, which leads to the spread of mono among teens!

[ Read: Chronic Fatigue Syndrome In Teenagers ]

Causes Of Mononucleosis In Teens:

There are two viruses that can result in mono in teens. The Epstein-Barr virus (EBV) or the cytomegalovirus (CMV). Both belong to the herpes family.

a. Epstein-Barr Virus:

The most common cause of mono is the Epstein-Barr virus (EBV). The virus is found in the saliva and mucus of an infected person. While this virus is highly contagious, it does not usually spread by casual contact. This means that you and the rest of the family can still stay in the same house as your infected teen, but not contract mono. But the moment you and your teen begin sharing eating utensils and glasses, the chances are high that the infection will spread.

The EBV virus also spread through blood transfusion, sexual contact, and organ transplantation. Make sure you keep your adolescent’s toothbrush and drinking glass separate, as the virus can survive as long as the object it is on is moist [3]. Disinfecting the brush or glass will not get rid of the virus.

Also, people with weak immune system, which can happen with the common cold or the flu, are at a higher risk of contracting the EBV virus.

Statistics show EBV infects 95% of the population in the U.S. [4] Once your teen gets mono, the virus will stay put in a latent state for the rest of his life. The virus will not cause any symptom. Statistics also reveal that about 90% people have antibodies for EBV by the time they reach the age of 40. This means this group of the population is relatively immune to the infection-causing virus.

b. Cytomegalovirus:

CMV is also quite common. Most people contract the virus in their lifetime, but may not have the symptoms. Such individuals will be carriers and infect those with weakened immune system. People with a healthy immune system may get mono on being exposed to the virus.

In the U.S., CMV infection is common among kids and adults between the ages of 10 and 35 [5]. However, since the virus doesn’t cause symptoms, many don’t realize they have the virus. If symptoms occur, it can be mild and similar to a cold. Just like EBV, CMV also stays put in the body, but there is a chance it will reactivate. When it does, it can cause symptoms in people with weakened immune system.
When Does The EBV Virus Spread And What Is Its Incubation Period?

People who are carriers of the virus are the most common source of transmission of mono. They have the virus in their bodily fluids, such as saliva, semen, and blood.

As stated earlier, the virus spread through saliva exchange, which occurs during intimate kissing. It also passes to others through blood transfusion, sexual contact and organs transplants. Newly infected people become the primary source of infection without realizing it. They spread the virus to others before they have symptoms.

The incubation period for EBV is about 4 to 6 weeks. Incubation period refers to the time between contracting the virus and experiencing the symptoms.

What Increases Your Teen’s Risks Of Getting Mono?

Mono is a highly contagious viral infection, and teenagers seem to be the most common target group. In fact, as stated several times, people between the ages of 15 and 25 years are the most susceptible group when it comes to mono.

The chances of your adolescent contracting mononucleosis increase if he is constantly in a crowded place, such as dormitory and college hostel. This is because in such places the likelihood of sharing eating and drinking utensils is high.

[ Read: Loss of Appetite In Teens ]

Symptoms Of Mono In Teens:

Though mono in teens is a common infection, the disease may not always manifest signs and symptoms. This is particularly the case with little children and adults. The symptoms are most prominent in individuals in the age group of 15 to 25 years.

The most common and obvious signs and symptoms of mono in teenagers are as follows:

  • Fever with chills. Your adolescent will initially have a temperature of about 101 degrees Fahrenheit and a couple of days later it will spike. The fever will come with chills and rigor
  • A sore throat with visible white patches on the tonsils. This often gives an appearance of strep throat
  • Swollen lymph nodes, especially in the neck and armpits
  • Inflammation of the tonsils
  • A headache and other body ache
  • Extreme fatigue
  • Loss of appetite
  • Skin rash
  • Pain in the upper left region of the abdomen. This happens when your child’s spleen enlarges. This is the worst effect of this infection on your kid’s body [6]

Once your teen gets infected, there is an incubation period of about four to six weeks. Then the symptoms appear and last for anywhere from one week to four weeks. While the signs of mono in teens go away with bed rest, it could take as long as two to six months before your child feels healthy again to lead his regular life.

The mono symptoms in teens are very similar to a sore throat and strep throat. This could result in your doctor prescribing antibiotics, like amoxicillin. On taking the antibiotics, your child could develop a skin rash. This is a reaction to the medication, but not an allergic reaction.

The worst effect of mono is enlargement of the spleen. Your adolescent’s spleen could swell up two to four times its normal size. The inflammation makes the spleen extremely tender, and in the worst case scenario, it could rupture. Hence, teens should refrain from contact sports until they are 100% fit. If your child complains of sharp and sudden pain in the upper left side of his abdomen, it’s a medical emergency. His spleen may have ruptured.

Teenagers who have an impaired immune system or who have a rare genetic condition, like X-linked lymphoproliferative syndrome, may experience the symptoms of mono longer than a couple of months.

How Is Mononucleosis Diagnosed?

The doctor will diagnose mono based on a physical examination and a few other tests. During the physical examination, the health practitioner may ask your teen questions regarding his symptoms and lifestyle. He may also check your child’s throat, skin, and abdomen to look for signs of the infection.

Some of the tests the doctor will ask for to confirm diagnosis include:

1. Mononucleosis Tests:

Mononucleosis tests include the monospot test and the EBV antibody test. The monospot test may turn out negative even when your child has mono. The false negative occurs when the test is conducted too early to detect the presence of the virus.

2. Complete Blood Count (CBC):

A complete blood count is necessary for differential diagnosis. It allows the doctor to evaluate the erythrocyte sedimentation rate (ESR) and look for infections that have symptoms similar to mononucleosis. Typically, patients with mono have an elevated rate of erythrocyte sedimentation [7].

If your kid has mono, his WBC count will show a high level of lymphocytes. If the lymphocyte count is low or normal, it will require an alternative diagnosis. In the initial few weeks of the infection, lymphocyte count will be high, and then slowly it returns to normal.

If your teen’s symptoms aggravate after the diagnosis, the doctor will recommend the following tests:

a. Liver Test:

Mononucleosis can result in liver inflammation. A liver test helps the healthcare provider figure out if your child’s liver is swollen due to the virus.

b. Cytomegalovirus Test:

If the monospot test is negative and your kid still has characteristic symptoms of mononucleosis, the doctor will suggest a test for CMV. This involves blood culture to grow the virus in the lab and check the blood for CMV-specific antibodies.

[ Read: Fever In Teens ]

How Is Mono Treated?

There is no specific treatment for mono in teens. Hence, the doctor will suggest complete bed rest until the symptoms abate. During recuperation, your teen will have low energy levels. You can combat this with nutritious food and plenty of fluids.

It will be several weeks before your kid will enjoy normal energy levels. So make sure he doesn’t indulge in anything strenuous and sapping.

Your healthcare practitioner may prescribe medication for secondary infections. If your child has a sore throat brought on by mono, he may develop strep throat, tonsillitis or sinus infection. If this happens, your teen will require antibiotics.

Some kids with mono develop skin rash due to antibiotics. Typically, antibiotics like amoxicillin and other penicillin derivatives are not ideal for patients with mono. Don’t panic if your teen gets a rash. It is not an allergic reaction. Chances of developing a rash after taking antibiotics are minimal if the treatment is for secondary infections that occur alongside mono. Just keep your doctor in the loop should your kid get a rash.

Make sure you rush your child to the ER if he complains of the following:

  • Severe pain in the left side of the abdomen. It is a sign your adolescent has a ruptured spleen
  • Your teen’s tonsils are so swollen that he finds it difficult to breathe through his mouth.

In the case of complications brought on by mono, your medical practitioner may prescribe corticosteroids. These steroids help in reducing swelling of the spleen and throat. Corticosteroids may also lessen the duration of the infection, but have the tendency to cause other side effects in the long-term. Hence, doctors don’t prescribe corticosteroids if there are no complications.

Home Care For Mono In Teens:

Unless your teen has a serious complication due to mono, home care is what he needs. There is no need for medication to hasten the recovery. The right home care also prevents complications.

Here are some tips to ensure your kid is comfortable at home after a diagnosis of mono:

1. Bed Rest:

The best way to start the recovery process is to keep your teen at home and ensure he gets enough bed rest. This allows the body to heal and fight off the infection. Also, rest will help with the fatigue that your teenager will experience.

2. Fever And Pain Medications:

After consulting with your doctor, you can give your teen acetaminophen or ibuprofen for the fever and body aches. If your teen is under 15, refrain from giving him aspirin. It can lead to Reye’s Syndrome, which is a serious liver problem.

3. Saltwater Gargle:

You can combat the sore throat with saltwater gargles. Let your teen gargle several times a day. It will soothe the throat and also make it easier for him to swallow.

4. Fluid Intake:

Keeping your adolescent well-hydrated is necessary. Make sure he drinks water and other fluids throughout the day. It will aid in recovery.

5. No Contact Sports:

Even after the symptoms abate, do not let your child indulge in contact sports, like football and basketball. Remember, his spleen will be inflamed, and it will take time for the spleen to go back to its normal size. Until such time, any blow to the abdomen can rupture the spleen.

With these home care tips, you will notice a considerable difference in your kid’s mono symptoms. Of course, recovery will take a month or so. Hence, make sure you have enough books and other things to keep your adolescent occupied. We don’t advocate visits from friends, as your teen could transmit the infection to them. The more rest your child has, the more energetic he will feel, and it will reduce the chances of relapse.

Can Mono Cause Complications?

Mono does not always cause complications. However, there may be instances when complications occur, and your teen will require medical intervention. Some of the complications due to mono in teens includes:

  • Enlarged spleen
  • Inflamed liver and jaundice
  • Pink, measles-like rash on the skin
  • Mild anemia, though this is very rare and tends to get better on its own after a few months

Typically, your teen should recover from mono with no signs of long-term problems. The fatigue brought on by the infection will persist for a few months, even after the other symptoms and the fever disappear. Severe complications due to mono in teens are rare, but not impossible.

[ Read: Mononucleosis In Children ]

Acute Complications Due To Mono In Teens:

Apart from the above, more complicated conditions include:

1. Ruptured Spleen:

People with mono may have an enlarged spleen and hence, are at a higher risk of rupturing their spleen. A splenic rupture will need immediate surgery.

2. Airway Obstruction:

If the throat glands and tonsils get severely inflamed, your teen may find it difficult to breathe. This could result in a tonsillectomy to remove the inflamed tonsils.

3. Neurologic Syndromes:

Although rare, your teen could get optic neuritis, aseptic meningitis, encephalitis, cranial nerve palsy, Guillain-Barre Syndrome or meningoencephalitis.

4. Cardiac Problems:

Your teen may get myocarditis in the initial three weeks of the infection. It leads to pain in the chest, arrhythmia, palpitations and in the worst case scenario, heart failure.

Prevention Of Mono In Teens:

Mono is a highly contagious disease, but there are no prevention tips for it. However, exercising caution can minimize the risk of acquiring the infection. Some ways to prevent mono include:

Educate your teen about the importance of not kissing or sharing utensils with a friend or family member who has mono.

Once your teen has mono, it is best to prevent him from donating blood. While the virus can be latent, it can be present in your child’s blood, and this could transmit the virus to anyone who receives the tainted blood.

Mononucleosis – Can It Recur?

The good news is once your teen gets mono, the chances are minimal that the infection will recur. However, the virus doesn’t leave the body, so your teen could get the symptoms of the infection if the virus reactivates.

Even though your teen will have EBV, and the virus may wake up from its latent state, you may not have any symptoms. Even if your child gets the symptoms, they will be mild, similar to the flu. Hence, he may not notice them. On the other hand, if your teen has a weak immune system, the reactivation of the virus could bring on the symptoms with a vengeance. A weakened immune system can occur due to a common cold or another chronic ailment, such as HIV/AIDS.

In Conclusion

Since there is no way to prevent your teen from contracting mono, the best way to handle the infection is to take it in your stride. Remember, this infection has a long, protracted recovery period, and this could upset your teen. So spend time with him. You or any other family member cannot contract the infection from your teen unless saliva exchange or sharing of utensils takes place. So you can rest assured.

It is tough to get through mono since the fatigue can last for several months. However, make sure your adolescent gets enough rest to begin the healing process. With no cure for mono, bed rest and staying hydrated are the best way to overcome the symptoms and return to normal life.

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