‘Kissing disease’ exhausting, but it strikes only once

FALLS CHURCH, Va. — Tremendous fatigue, a very sore throat and achy body – Cheryl vividly recalls how bad she felt after coming down with infectious mononucleosis, commonly called mono, during her sophomore year at the U.S. Military Academy at West Point, New York.

“I felt really dizzy, but it wasn’t just my head,” said Cheryl, whose last name isn’t being used to respect her privacy. “It was like my whole body was twirling around inside.”

Mono is a contagious disease caused by the Epstein-Barr virus, or EBV. Spread through saliva, mono’s nickname is the “kissing disease.” But transmission of the virus isn’t limited to kissing; people can become infected by using someone else’s utensils or drinking from the same container, as Cheryl believes happened to her. She shared a cup with another member of the West Point orienteering team who later was diagnosed with mono ahead of Cheryl.

Teenagers and young adults are more likely than others to get mono. According to the Centers for Disease Control and Prevention, about 25 percent of people in this age range who are exposed to EBV will develop mono.

“Over 90 percent of adults will have antibodies to mono – meaning, at some point in their lives they’ve been exposed,” said Dr. Jason Okulicz, an Air Force lieutenant colonel and chief of the Infectious Disease Service at San Antonio Military Medical Center in Texas.

“It’s also possible to not have any symptoms, though that’s more likely for young children,” he said.

Symptoms can occur anywhere from four to six weeks after being infected, according to the CDC. Along with what Cheryl experienced, they can include swollen lymph nodes in the neck and armpits, a fever, and a rash.

As bad as patients might feel, mono is a self-limiting illness for the vast majority, Okulicz said. That means it resolves on its own, usually over several weeks.

“The fatigue might linger for a few weeks after that, but long-term effects on a person’s overall health are uncommon,” he said.

Another good thing about mono? It’s a one-and-done event. “With the flu, there are many different types and you can get infected numerous times over your lifetime,” Okulicz said. “But infectious mononucleosis doesn’t recur.”

One possible complication of mono is an enlarged spleen that can rupture when performing strenuous exercises or engaging in contact sports. That’s why, even though an enlarged spleen is rare, doctors recommend people with mono avoid these activities at least three or four weeks after illness, Okulicz said. Any mono patient experiencing abdominal pain should seek help immediately, he added.

Otherwise, Okulicz said, there’s not much to do for mono except offer supportive care: lozenges for a sore throat; over-the-counter medications for pain and fever; plenty of fluids to stay hydrated; and, of course, rest.

Cheryl spent a week in Keller Army Community Hospital recuperating. Classmates delivered her books and assignments so she could keep up with her schoolwork. She said she felt better by the time she was discharged, but it took several weeks before the fatigue went away.

“I didn’t realize how long it would take to feel like myself again,” she said.