Infectious mononucleosis, or mono, is often called "the kissing disease" because that's one of the ways you can get it. It's caused by the Epstein-Barr virus (EBV), spread through saliva. Symptoms include:
Mono can also be spread by sharing eating utensils or glasses. A person is contagious several days before symptoms appear and for some time after. Symptoms usually resolve within 2 to 6 weeks.
Signs and Symptoms
Symptoms may not show up until 4 to 7 weeks after you've been exposed to the virus. Symptoms may last only a few days or as long as several months. In most cases, they go away in 2 to 6 weeks.
What Causes It?
The Epstein-Barr virus (EBV) causes mono. Direct contact with saliva that's infected with the virus, mainly through kissing, can pass the virus on. You can also get mono through transfusions with infected blood products.
Mono affects about 45 out of 100,000 people, mostly teens and young adults. It usually isn't a serious disease. But it can cause fatigue and weakness that interfere with daily life.
About 90% of adults have been exposed to EBV and have antibodies, meaning they are immune to the virus.
Who's Most At Risk?
The following factors can raise your risk for developing mono:
What to Expect at Your Doctor's Office
Your doctor will do a physical examination, checking for fever, sore throat, swollen glands, and swelling of your spleen or liver. Your doctor may also do a blood test to confirm the diagnosis.
Someone who has mono doesn't need to be isolated because the virus isn't usually spread through the air. Family members or college roommates have only a slight risk of being infected, unless they kiss the person. It's best not to share eating utensils or toothbrushes.
Treatment for mono includes bed rest and plenty of fluids. You may feel so tired and weak that you can hardly get out of bed for about a week. Symptoms typically begin to improve after about 2 weeks. People with mono should avoid contact sports and heavy lifting for 2 months due to the risk of rupturing the spleen.
There is no cure for mono, but your health care provider may prescribe the following medications to treat your symptoms:
Surgical and Other Procedures
In the case of a ruptured spleen, you may need surgery to remove it.
Complementary and Alternative Therapies
Several studies report that stress and relaxation affect our immune systems. Stress can make your body more vulnerable to infection. So reducing stress may help prevent infection with viruses such as EBV.
While no herbs or supplements treat mono specifically, some may help reduce the long-term effects of EBV infection and complications linked to EBV.
Always tell your doctor about any herbs and supplements you are using or considering using.
Nutrition and Supplements
These nutritional tips may help reduce symptoms and strengthen your immune system:
These supplements may also help:
Herbs are a way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider before starting treatment.
The following herbs have not been studied for treating mono, but they are sometimes suggested because they strengthen the immune system:
Few studies have examined the effectiveness of specific homeopathic remedies. A professional homeopath, however, may recommend one or more of the following treatments for mono based on his or her knowledge and clinical experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type, includes your physical, emotional, and intellectual makeup. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for a particular individual.
The following remedies may be effective for fever related to EBV:
Professional homeopaths may also recommend the following remedies:
Other helpful remedies include Lachesis, Conium, Hepar sulphuricum, and Baryta carbonica.
Research also suggests that a combination of homeopathy and traditional Chinese medicine (TCM) may effectively improve symptoms of mononucleosis. The most common homeopathic remedies used with TCM include Lycopodium, Silicea, Phosphorous, Sulphur, Mercurius, Nux vomica, Sepia, and Pulsatilla.
Although no scientific studies have reviewed the use of acupuncture for mono, it may help reduce symptoms, improve immune function, and relieve congestion (blockage of qi, or energy flow) of the liver, spleen, and lymph.
Traditional Chinese Medicine
Studies show that people with EBV have fewer symptoms when given a combination of homeopathic remedies noted in the section on homeopathy and TCM remedies including Atractylodes alba, Glycyrrhiza recens, Rehmannia preparata, Bupleurum, Cortex magnolia, Phragmites, Belamcanda, Sophora, subprostrata, Siler, Angelica dahurica, Paeonia alba, Dendrobium, Polygonatum officinal, and Cnidium. Chinese herbs are prescribed on an individual basis. They may have side effects and can interact with many medications, and with other herbs and supplements. You should not take herbs without the supervision of a practitioner trained in TCM.
Prognosis and Possible Complications
Most people with mono recover fully, and can return to school or work in a few weeks. A small number of people may experience fatigue for several months. Severe complications are uncommon. They may include anemia, problems with the central nervous system or liver, rupture of the spleen, or inflammation of the heart. People who have had mononucleosis are at incresed risk of developing multiple sclerosis (MS).
Bope ET, Kellerman RD, eds. Conn's Current Therapy 2017. 1st ed. Philadelphia, PA: Elsevier; 2017.
Cabrera C, Artacho R, Gimenez R. Beneficial effects of green tea--a review. J Am Coll Nutr. 2006;25(2):79-99.
Carillo-Vico A, Reiter RJ, Lardone PJ, et al. The modulatory role of melatonin on immune responsiveness. Curr Opin Investig Drugs. 2006;7(5):423-431.
Chiang LC, Ng LT, Cheng PW, Chiang W, Lin CC. Antiviral activities of extracts and selected pure constituents of Ocimum basilicum. Clin Exp Pharmacol Physiol. 2005;32(10):811-816.
Clancy RL, Gleeson M, Cox A, et al. Reversal in fatigued athletes of a defect in interferon gamma secretion after administration of Lactobacillus acidophilus. Br J Sports Med. 2006;40(4):351-354.
Doron S, Gorbach SL. Probiotics: their role in the treatment and prevention of disease. Expert Rev Anti Infect Ther. 2006;4(2):261-275.
Ferri FF, ed. Ferri's Clinical Advisor 2017. 1st ed. Philadelphia, PA: Elsevier; 2017.
Fujimoto H, Asaoka K, Imaizumi T, Ayabe M, Shoji H, Kaji M. Epstein-Barr virus infections of the central nervous system. Intern Med. 2003;42(1):33-40.
Mayer KE, Myers RP, Lee SS. Silymarin treatment of viral hepatitis: a systematic review. J Viral Hepat. 2005;12(6):559-567.
Petersen I, Thomas JM, Hamilton WT, White PD. Risk and predictors of fatigue after infectious mononucleosis in a large primary-care cohort. QJM. 2006;99(1):49-55.
Porter RS, Kaplan JL, eds. The Merck Manual of Diagnosis and Therapy. 19th ed. Whitehouse Station, NJ: Merck Research Laboratories; 2011:chap 11.
Ramagopalan SV, Giovannoni G, Yeates DG, Seagroatt V, Goldacre MJ. Sex ratio of infectious mononucleosis and possible relevance to multiple sclerosis. Mult Scler. 2013;19(3):359-361.
Reiche EM, Morimoto HK, Nunes SM. Stress and depression-induced immune dysfunction: implications for the development and progression of cancer. Int Rev Psychiatry. 2005;17(6):515-527.
Rotsein OD. Oxidants and antioxidant therapy. Crit Care Clin. 2001;17(1):239-247.
Simopoulos AP. Omega-3 fatty acids in inflammation and autoimmune diseases. J Am Coll Nutr. 2002;21(6):495-505.
Wang HK. The therapeutic potential of flavonoids. Expert Opin Investig Drugs. 2000;9(9):2103-2119.
Yao Y, Duan HM, Yan HM, et al. Clinically controlled study on children's infectious mononucleosis treated by Chinese medicine. Chin J Integr Med. 2009;15(5):347-352.
Yoon JH, Baek SJ. Molecular targets of dietary polyphenols with anti-inflammatory properties. Yonsei Med J. 2005;46(5):585-596.
Review Date: 1/1/2017
Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.
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