What is it about ?
Mononucleosis is often presented as the “kissing disease”. It is also sometimes referred to as Pfeiffer’s disease.
Mononucleosis is a disease caused by the Epstein-Barr virus (EBV). This virus is spread through saliva, hence its name “kissing disease”.
Most people who are infected don’t mind. However, they can transmit the virus and thus infect other people. In people who become ill, the severity and duration of the illness vary widely.
Once infected, you are then immune for life.
In whom and how often does it occur?
Mononucleosis is very common. About 1 in 2 children under the age of 5 and 9 in 10 adults living in northern Europe have antibodies to mononucleosis, suggesting a history of infection or exposure without symptoms.
Mononucleosis can occur at any age, but there are two peak ages: children under 5 and young adults.
How to recognize it?
Most people infected with the virus do not get sick. If symptoms of the disease appear, they vary by age and person:
- A mild fever and rash can occur in young children. The interval between contamination and the onset of symptoms is short: 4 to 10 days.
- In young adults, the interval between infection and the onset of symptoms is longer: 4 to 7 weeks. The symptoms are also more marked:
- fever high;
- sore throat ;
- swelling that makes it painful to swallow (painful swallowing);
- layer of pus on the tonsils;
- swollen and painful lymph nodes (around the angles of the jaw, under the chin, under the armpit, above the collarbones);
- swollen eyelids;
- tired marked;
- loss of appetite ;
- dilated and soft spleen (splenomegaly);
- inflammation of the liver (hepatitis) which in some people causes a slight yellowing of the whites of the eyes and skin (jaundice);
THE’angina usually lasts 2 weeks.
the swelling of the glands most often disappears after 3 weeks.
The fever can last up to 6 weeks after the onset of symptoms.
The tired may persist for several months after the other symptoms of the disease resolve.
In about 1 in 10 patients, a rash appears all over the body. The risk of a rash increases if the person takes certain antibiotics (amoxicillin). This rash can be easily mistaken for an allergic reaction.
In some people, the symptoms of mononucleosis become chronic. In others, the disease recurs regularly, although they have not had any symptoms in the meantime. As the virus remains in the body for life after infection, it can indeed manifest itself in the event of a weakened immune system.
How is the diagnosis made?
Your doctor will ask you what your complaints are and perform a physical examination. The combination of a angina and swollen, painful lymph nodes reminiscent of mononucleosis.
Mononucleosis can be confirmed by performing a rapid test. But this test fails to establish the diagnosis in about 20% of people with mononucleosis.
The detection of antibodies against the virus in the blood presents an alternative. The antibodies are detectable as soon as the first symptoms appear. Although rare, the antibodies may not be detectable at this time and the doctor may need to take another blood test after a week.
Sometimes it is also necessary to take a swab. A small amount of pus from the tonsil is then removed with a cotton swab. This pus is then checked in the laboratory for pathogens. It may indeed be that it is not mononucleosis, but another contamination for which it is necessary to take antibiotics.
What can you do ?
It is useless to avoid contact with others. Mononucleosis is very common and often proceeds without symptoms (asymptomatic). However, people who are infected without signs of the disease spread the virus. Sometimes the virus is still transmitted for some time after the last symptoms have disappeared.
As the virus is transmitted through saliva, the spread can be somewhat limited by avoiding direct contact with the saliva of a sick person (do not kiss each other, wash and dry cutlery thoroughly, do not drink from the same glass ).
Most often, mononucleosis does not require treatment.
- Get enough rest to recover.
- But you can continue to practice your daily activities, if possible.
- If the spleen is swollen, it may rupture, which can cause a potentially fatal bleeding. In this case, avoid intense efforts, do not lift heavy loads, do not play contact sports, and do not work with vibrating equipment.
Contact your doctor again in the event of:
- fever which lasts ;
- difficulty in eating;
- difficulty in breathing;
- skin rash ;
- irregular heartbeat;
- yellow color (jaundice) of the whites of the eyes or skin;
- loss of physical strength;
- difficulty in enduring light;
- numb mind (altered consciousness);
- drowsiness.
Blood donation is prohibited for 6 months after infection with the Epstein-Barr virus. Donating plasma and platelets is also not recommended.
What can your doctor do?
There is no vaccine against mononucleosis. Medication is usually not needed. In the event of severe complaints, it is possible to prescribe medicines that relieve the symptoms (medicines for fever (antipyretics), anti-inflammatory, painkillers (analgesics)). Sometimes cortisone is used.
Your doctor will only prescribe antibiotics for you if your tonsils are infected with streptococci. In general, it is best to avoid takingantibiotics, because they do not speed healing and can trigger a rash.
Mononucleosis can have serious consequences, although only exceptionally. In this case, your doctor will decide whether hospitalization is necessary.
Want to know more?
- Paracetamol – CBIP – Belgian Center for Pharmacotherapeutic Information
- Non-steroidal anti-inflammatory drugs – CBIP – Belgian Center for Pharmacotherapeutic Information
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