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

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Mononucleosis is an infectious disease most commonly caused by the Epstein-Barr virus (EBV) (1). It is also known as infectious mononucleosis, glandular fever, mono, kissing disease, or just IM.

Mono can occur at all ages, but most cases are seen in adolescence and early childhood. According to the US Centers for Disease Control and Prevention (CDC), mono is common among teenagers and young adults, and at least one out of four teenagers developed infectious mononucleosis after getting infected by the EBV virus (2).

Mono in teens rarely causes serious complications during the initial stages of infection. However, there are a few long-term consequences if not treated. With a few tips and precautions, you may be able to prevent this disease, and mono rarely occurs more than once except in people with an impaired immune system (3).

Read on as MomJunction tells you about the symptoms of mono in teenagers, its treatment, and some tips for its prevention.

What Are The Symptoms Of Mono In Teens?

The incubation period of EBV is about four to six weeks, after which you will notice these symptoms:

  • Fever
  • Headache
  • Sore throat. Tonsils get infected and enlarged leading to tonsillitis
  • Muscle ache
  • Tiredness and extreme fatigue
  • Lack of appetite
  • Vomiting
  • Abdominal discomfort
  • Nausea
  • Chills
  • Enlarged spleen
  • Mild jaundice (yellowed skin, eyes and urine) due to impaired liver function caused by the infection
  • Swollen lymph nodes, especially armpits, neck, and groin (2).

These symptoms of primary EBV infection look similar to those of a cold or flu, but in the case of mono, the symptoms may last longer and be more severe.

Causes Of Mono In Teens

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

  1. The direct transfer of saliva: This 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 when they kiss someone who has the infection.
  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. However, there are no studies to back it.
  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 (2).

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 spleen (2).

How Is Mono In Teens Treated?

There is no medicine to cure mononucleosis. You will have to wait for the immune system to subdue the virus.  Research states that patients with uncomplicated acute mono may usually require home care and a few over-the-counter medications for fever and pain.

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 nutrients.
  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. Moreover, antibiotic ampicillin can cause a rash.
  1. Contact sports should be avoided for at least a month or until there is clinical verification suggesting that the spleen is not enlarged anymore.

Chronic infectious mononucleosis

If there are additional complications such as airway obstruction, critical hemolytic anemia (anemia due to breakdown of red blood cells), or thrombocytopenia (deficiency of blood platelets), then it might turn into a chronic infection. Your doctor might put your child on additional treatments such as a corticosteroid or antiviral therapies.

The symptoms of mono might 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 getting adequate rest and care even after the symptoms are gone, because the Epstein-Barr virus can cause additional complications when left unchecked  (2).

Note: Doctors may not prescribe antibiotics such as ampicillin or amoxicillin for infectious mononucleosis, as it could lead to rashes.

What Are The Complications Of Mono In Teens?

Mononucleosis, if left untreated, could lead to these complications, but in extreme cases (3):

  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, delirium, and in severe cases, even coma.
  1. Pneumonia: Severe cases of mono can cause interstitial pneumonia.
  1. Anemia: The red blood cells may be affected, leading to hemolytic 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 disease is the best way to avoid any problems.

How To Prevent Mono In Teens?

There is no vaccine to prevent mononucleosis (3). 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 strangers: Parents must educate their teens 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.
  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.

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?

Once a person gets infected, the EBV virus stays in the body for life. However, it can be contagious for six months after the onset of the infection. The virus can be found periodically in small amounts in the throat of an otherwise healthy person.

As mono can be transmitted through saliva, it is best to avoid sharing lip balms or drinking glasses and kissing. Also, it is best to try and avoid contact with the infected saliva to reduce the risk of EBV infection (5).

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.

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


MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.
1. Henry H Balfour, Jr Samantha K Dunmire, and Kristin A Hogquist; Infectious mononucleosis; Clinical and Translational Immunology
2. About Infectious Mononucleosis; Centers for Disease Control and Prevention
3. Stephen E. Straus, MD; Jeffrey I. Cohen, MD; Giovanna Tosato, MD; Jeffery Meier, MD; Epstein-Barr Virus Infections: Biology, Pathogenesis, and Management; Annals of Internal Medicine
4. Complications of Infectious Mononucleosis; U.S. National Library of Medicine
5. Mononucleosis; Cornell Health

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