Mono In Children: Symptoms, Treatment, And Prevention

Mono In Children: Symptoms, Treatment, And Prevention

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Mono, also known as infectious mononucleosis, kissing disease, or glandular fever, is a common viral infection in children. It is characterized by fever, sore throat, swollen lymph nodes, and fatigue.

The infection is commonly caused by the Epstein-Barr virus (EBV) of the herpes virus family. It is highly infectious and can be transmitted through infected saliva and other bodily fluids. Once a child is infected, the virus remains dormant in their blood for life (1).

Read the post to learn about the symptoms, causes, diagnosis, and treatment for mono in children.

Causes Of Mono In Children

While EBV is the most common cause of mono in children, mild mono-like symptoms can also be caused by cytomegalovirus (CMV) (2).

EBV and CMV are extremely common, and most children get exposed to them at some point in their lives. While infected infants and young children develop mild or no symptoms, infected teens and young adults have a 50% chance of developing some mono symptoms (3).

Is Mono A Contagious Infection?

Mononucleosis is highly contagious and generally spreads from one person to another through bodily fluids, such as saliva. It often spreads through sneezing, kissing, eating or drinking from the same utensils, or sharing items with saliva on them. Occasionally, the viral illness might be transmitted sexually or through blood transfusion.

Once a child is infected with the virus, their likelihood of developing the illness again is rare. However, the virus stays dormant in their throat and blood for life. In rare cases, when this virus becomes active again, the child can transmit the disease to others without presenting any symptoms themselves (4).

Symptoms Of Mono In Children

The symptoms of mono in children may vary from mild to severe. Once a child is infected with EBV, it takes four to six weeks for the symptoms to show.

Some common symptoms of mono in children may include (1) (3)

  • Fever and chills
  • Extreme fatigue
  • Sore throat that makes swallowing difficult
  • Headache
  • Sensitivity to light
  • Loss of appetite
  • Muscle aches and weakness
  • Swollen lymph glands in the neck, armpits, and groin
  • Enlarged spleen and liver
  • Rash

Complications Of Mono

Often, mono does not cause any serious complications. However, in some rare cases, a child may manifest the following complications(5) (6).

1. Ruptured spleen: An enlarged spleen occurs in more than half of the people with mono. When the enlarged spleen ruptures, it can be life-threatening and requires immediate surgery. Advise the child with infectious mononucleosis to avoid strenuous exercises and contact sports (such as wrestling, boxing, rugby, or soccer) until their symptoms subside and the spleen returns to its actual size.

2. Cardiac problems: Children infected with mono might have irregular heart rhythms during the first three weeks of the infection. However, the issue often resolves on its own.

3. Meningitis: EBV can cause meningitis, a disease characterized by the inflammation of the membranes and fluid of the brain and spinal cord.

4. Encephalitis: Encephalitis is the inflammation in the brain that can cause behavioral changes, muscle weakness, and dizziness.

5. Hemolytic anemia: Hemolytic anemia is a condition wherein the red blood cells in the body are destroyed at a much faster rate than they are made.

Diagnosis Of Mono

The diagnosis of mono may be made based on your child’s symptoms, medical history, blood test, and physical examination (7) (8).

A heterophile antibody test called the mono test or monospot may be performed as an initial test for mono as it provides 71 to 90% accurate results. A positive monospot test indicates the presence of infectious mononucleosis.

A blood test is done to detect the antibodies that fight against EPV in the body. It also helps check an abnormal white blood cell count and the presence of atypical lymphocytes.

The physical examination enables the doctor to check for signs of enlarged lymph nodes, liver, and spleen.

How Is Mono Treated In Children?

No cure or vaccine for mono exists. And since it is a viral disease, antibiotics are not recommended. Moreover, antibiotics might sometimes cause skin rashes in children with mono (4).

Your child’s doctor may suggest the following measures to relieve the symptoms of mono (9) (10).

  • Taking plenty of rest to help the body fight the infection
  • Drinking water to prevent dehydration
  • Drinking soups and smoothies to nourish the body
  • Gargling with warm salt water or sucking throat lozenges to soothe a sore throat
  • Taking over-the-counter medications such as acetaminophen or ibuprofen to alleviate pain and fever
  • Taking multivitamins and probiotics to boost the immune system
  • Taking steroids after consulting with the doctor to reduce swelling in the throat and tonsils
  • Avoiding vigorous exercise and contact sports at all costs to avoid spleen rupture

Note: Do not administer aspirin to children with mono, as it can lead to a severe illness called Reye syndrome, which can affect the liver and even prove fatal.

How Long Does It Take A Child To Recover From Mono?

The recovery period varies from person to person. Most children feel better within two to four weeks. However, in some children, fatigue or tiredness can last for several more weeks (4) (11).

Can Mono Be Prevented?

No vaccine is available to prevent mono. However, children can take the following precautions to protect themselves from mono (10).

  • Avoiding contact with those who show signs of mono or any other infection
  • Washing hands often
  • Avoiding sharing drinks, utensils, toothbrushes, straws, lip balms, etc.

When To See A Doctor?

If your child develops flu-like symptoms that do not go away in a few days, you should see a doctor. Keep an eye on the following symptoms (1) (10).

  • Extreme weakness and fatigue
  • Difficulty in breathing, swallowing, or eating
  • Constant high fever
  • Severe headache and body ache
  • Pain on the left side of the abdomen
  • Dizziness

Mono is a self-limiting infection, and most children recover without any serious complications. Since the infection may cause disruption at school and home and the symptoms may mimic those of cold and flu, make sure to consult your doctor for the right diagnosis and treatment plan.


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Pragya Bhargavi

Pragya Bhargavi has been in the field of content research, writing and editing for over five years. Her passion for academics and science has enabled her to write creative as well as research-based articles. She has completed her Masters in Microbiology and obtained a Bachelor’s degree in Education (B.Ed). As a writer at MomJunction, Pragya aims to bring about a... more