Mononucleosis (Mono) In Teens: Causes, Symptoms And Treatment

Mononucleosis In Teens

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Mononucleosis or the teenage kissing disease sounds both complex and perplexing. It may look like the common flu and cold, but the symptoms are more severe than that.

So what is mono in teens and why is it called the kissing disease? Read on as MomJunction tells you about the reasons and treatment, and shares some tips for the prevention of mononucleosis in teens.

What Is Mononucleosis?

Mononucleosis is an infectious disease most commonly caused by the Epstein-Barr virus (EBV) (1). Also called the infectious mononucleosis, glandular fever, mono, or just IM, it may be caused by another virus cytomegalovirus (CMV) as well but less frequently. Both viruses are related to the herpes simplex virus.

Other viruses that can cause the disease are HIV, hepatitis virus, and rubella virus. Nevertheless, EBV is the most common cause of mononucleosis. EBV affects multiple parts of the body, but the most affected are the lymphocytes, a type of white blood cell.

Several other situations lead to the transmission of the disease.

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How Can A Teen Get Mononucleosis?

A teenager can get the illness by contracting the virus through the following ways and scenarios:

  1. Direct transfer of saliva: The Epstein-Barr virus usually finds its way into a healthy person through the transfer of saliva from an infected individual. Therefore, the illness is called “the kissing disease” or “teenage kissing disease”. A person with mono can transmit the EBV at multiple stages of the illness. It means, the infected person may not show any apparent signs of the disease, and a teen may unknowingly get the virus through a kiss with them.
  1. Sharing of utensils and straws: Transfer of saliva can also happen by using common utensils and sharing straws.
  1. Through bodily fluids: Contact with bodily fluids during sexual contact can transmit the pathogen.
  1. Blood and organ transfusion: Blood and organ transfer from an infected person can cause mono. But it is the least likely reason due to extensive laboratory testing of blood and organs before transfusion.
    Teens can be more susceptible than adults.

[ Read: Asperger’s Syndrome In Children And Teens ]

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How Common Is Mono In Teens?

The US Department of Health & Human Services states that about 95% of adults in the US get infected by EBV at some point in their lives (2). According to the US National Library of Medicine, about 25% of teenagers and young adults develop who get infected with EBV develop mononucleosis (3).

Knowing the symptoms of the disease can help you act early.

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What Are The Symptoms Of Mono In Teens?

The incubation period of EBV is about four to six weeks. Then you see the below symptoms:

  • Fever
  • A severe headache
  • A sore throat. Tonsils get infected and enlarged leading to tonsillitis
  • Muscle ache
  • Tiredness and extreme fatigue
  • Enlarged spleen
  • Mild jaundice (yellowed skin and eyes) due to impaired liver function caused by the infection
  • Swollen lymph nodes especially armpits, neck, and groin

The teenager can transmit the disease right from the moment of contracting the virus. The above symptoms will cause discomfort, and you will invariably consult a doctor.

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How Is Mononucleosis Diagnosed?

A blood test is the most accurate method of diagnosing the presence of EBV in the body. A blood test checks for the following attributes to diagnose mononucleosis:

  • White blood cell count, especially lymphocytes.
  • The shape and size of lymphocytes.
  • The count of platelets and neutrophils, which is also a type of white blood cell that plays a significant role in immunity.
  • Any indicators in the blood that point towards liver problems.
  • The presence of antibodies made by the body to fight the virus.

The doctor will also run a physical examination to check the swelling in the lymph nodes, tonsils, and the spleen.

[ Read: Seizures In Teens ]

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How Is Mono In Teens Treated?

There is no medicine to cure mononucleosis since it is caused by a virus. You will have to wait for the immune system to subdue the virus. Home care can help the body heal better and faster:

  1. A lot of rest. Let the teen avoid exertion and intense physical activity until they recover. It is because the lymph nodes and spleen are swollen, and may rupture if you subject the body to severe physical activity.
  1. Drink plenty of fluids. Give the teen regular sips of water. Provide liquid food like meat and vegetable broth that are easy to swallow and packed with nourishment.
  1. You can give the teen over-the-counter fever medicine like acetaminophen (paracetamol) to reduce the fever and discomfort. Avoid giving antibiotics as they are not effective against viruses.

The symptoms of mono usually subside in two to four weeks. However, the infection may sometimes last for four to six months, and lethargy may continue even after the disease is gone. Therefore, make sure the teen is taking adequate rest and care even after the symptoms are gone because the Epstein-Barr virus can cause severe complications when left unchecked.

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What Are The Complications Of Mono In Teens?

Mononucleosis, if left untreated, can lead to these complications in extreme cases (4):

  1. Ruptured spleen: It is most likely to occur when the teen does not get rest and indulges in physical activities. A severely swollen spleen can burst even by a minor impact caused during sports and other exercises.
  1. Severe liver problems: Sometimes, the functions of the liver are impeded to the point that the organ becomes susceptible to other issues and infections.
  1. Neurological problems: The virus can eventually cause problems such as meningitis and delirium and in severe cases even coma.
  1. Pneumonia: Severe cases of mono can cause intestinal pneumonia.
  1. Anemia: The red blood cells may be affected, leading to anemia.
  1. Heart problems: The problems include chronic chest pain called angina, which is quite commonly a result of complications in the heart.
  1. Chronic active EBV infection: In very rare cases, people infected with EBV may develop a condition called chronic active Epstein-Barr virus infection (CAEBV). The disorder causes long-term problems in the lymphocytes. CAEBV is most likely to affect individuals with a weakened immune system, which itself will arise due to other problems.

Preventing the disease is the best way to avoid any problems.

[ Read: Teen Peer Pressure ]

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How To Prevent Mono In Teens?

There is no vaccine to prevent mononucleosis (5). But you can prevent it with some simple precautionary measures:

  1. Do not share personal items: Do not share objects that come in direct contact with a person’s saliva. They include utensils, straws, and even food.
  1. Avoid kissing: Parents must educate their teen about the importance of abstaining from kissing a stranger or an individual whom they do not know well enough to be aware of their medical history. A person infected with mono can appear normal and healthy with very faint symptoms. But they can transmit the virus through the transfer of saliva. The same precautions apply to sexual contact, which is another mode of mononucleosis transmission.
  1. Covering nose and mouth when someone sneezes: If the teen is around someone with a severe sore throat and flu-like symptoms, then they should cover their nose and mouth when the affected person sneezes/coughs. Saliva particles can disperse through the air from where they can find their way into a healthy person’s body.

The following section has answers to some other essential questions about mono in teens.

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Frequently Asked Questions

1. Can mono occur more than once?

Very rarely. The virus continues to stay in the body but cannot resurge due to the antibodies permanently developed by the immune cells. The immune system keeps the virus under check for the rest of the life, and re-infection is very rare.

2. Can a person transmit the virus even after being cured?

Yes. The dormant Epstein-Barr virus may periodically reactivate and multiply in the saliva. The affected person may not display any symptoms due to immunity. But transmission of the virus can still occur if a healthy person comes in direct contact with the saliva. Therefore, a person may transmit EBV despite being cured of the disease (6).

While the EBV virus is common, it seldom causes any lasting impact. The kissing disease may be painful to experience, but it is easy to prevent. Parents can play a significant role in its prevention by educating the teen on the ways to avoid the illness.

[ Read: Female Athlete Triad Syndrome ]

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Do you have something to share on mono? Do tell us by leaving a comment in the below section.


1. Infectious Mononucleosis (Mono) in Teens and Young Adults; University of Rochester
2. Chronic active Epstein-Barr virus infection; U.S. Department of Health & Human Services
3. Mononucleosis (Glandular Fever); U.S. National Library of Medicine
4. Complications of Infectious Mononucleosis; U.S. National Library of Medicine
5. About Infectious Mononucleosis; Centers for Disease Control and Prevention
6. J. M. Steckelberg, Mononucleosis: Can it recur?; Mayo Foundation for Medical Education and Research


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Rohit Garoo

Rohit Garoo took writing as a profession right after finishing his MBA in Marketing. Earlier he graduated with a Bachelor’s degree in Botany & Zoology from the autonomous St. Xavier’s College in Mumbai. Rohit has also done a Stanford University certification course on breastfeeding. This botanist-zoologist turned writer excels at life sciences, and at MomJunction he writes everything about pediatrics and maternal care. In between writing and being overly curious, he spends time cooking, reading, and playing video games. LinkedIn profile –
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