The Lincoln News Sentinel ~ FAMILY MEDICINE

	FAMILY MEDICINE

	NOT SHARING FOOD, DRINKS OR UTENSILS CAN STOP MONO SPREAD Question: I got a notice home from the high school that several students have "mono." They referred to it as the "kissing disease." Could you tell me more about "mono" so I can help my teenager stay free from this infection? Answer: Infectious mononucleosis, often referred to simply as "mono," is caused by the Epstein-Barr virus. This virus is spread through the saliva, so engaging in an activity such as kissing an infected person can spread the disease. It can also be transmitted to others by coughing and sneezing, or sharing food, glassware or utensils. The incubation period of the virus is 14 to 50 days, so many people are never sure where they contracted the virus. Mononucleosis is most common between the ages of 15 and 35, with the peak incidence being in the middle teen years from 15 to 17. However, it also can occur in young children. The reason that the incidence falls off after 35 is that, by that age, most of us have already been exposed to the disease. In many cases, we've actually had mono, but the symptoms were so mild that we don't have any recollection of it. The good news is that once your body has developed antibodies to the Epstein-Barr virus, it's very unlikely that you will ever get mono again. The symptoms of mono are similar to many viral illnesses: fatigue, weakness, sore throat, fever, swollen glands, headache, and rash. With mono, both the fatigue and the swollen glands are quite pronounced. There can also be enlargement of the spleen and liver. Mono can be diagnosed by a simple blood test that can be done in your doctor's office. Once the diagnosis is confirmed, the treatment is directed at relieving your symptoms. This includes the use of medications such as acetaminophen or ibuprofen to reduce the fever, and throat lozenges to soothe the throat pain. Your doctor will probably also suggest you get plenty of clear fluids and bedrest. In general, antiviral medications are not used to treat mono. Some experts, though, are now recommending that in severe cases the antiviral drug valacyclovir be given. This drug, which is quite expensive, has had some success in recent clinical trials where previous antiviral drugs had failed. While mono is usually self-limiting to a few weeks and a full recovery is made, there can be complications. Restricting physical activity is important to prevent trauma to the swollen spleen. This period of restriction generally lasts for about 21 days after the mono diagnosis is made. It can be longer if the spleen is slow in returning to its normal size. Also, when the liver becomes inflamed during a mono infection, the person's skin can take on a yellow appearance, a condition called jaundice. Rarely, a mono sufferer may experience heart inflammation. The best treatment is prevention. This starts with practicing good personal hygiene. It's also a good idea to avoid the sharing of food, drinks and utensils. Finally, I'll offer a few recommendations in your specific case. Should your teenager get mono, I'd recommend using paper cups in the bathroom and kitchen, and not letting the ill person prepare food for others. Taking these steps can decrease the spread of mono among other children in your family. Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.

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