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Really, Mono?

My story

2018 has been a long year.

I started off accidentally putting a leatherman knife through my thumb. I had surgery, I missed all the major tendons, arteries, and nerves. I had started to feel exhausted but I just thought to myself that I have stabbed my self and had surgery in the span of the first three days of third quarter senior year. I should be tired. I only went to school two days that next week because I felt very sick. I thought nothing of it because I hadn’t had the flu yet and just assumed that was what I had. The following week I struggled to stay in school again and only went for two days. The fourth week I only went to school once because I had to go on a scholar ship weekend for a college I was looking at and I couldn’t justify to myself going on this trip and not being in school the day before I left to miss even more school.  The student weekend was in Atlanta, Georgia. So after that day at school I raced to the airport and hopped on a plane to Atlanta. I got off the plane and my ears still had not popped, I was starting getting worse and worse. I managed to get though the weekend but by the end I was such pain breathing was a struggle, swallowing anything was painful and just holding my head up became a difficult task to manage. My lymph nodes were so swollen that you could see them just by looking at my neck. I felt horrible.

On the plane ride home my ears wouldn’t pop because I was so congested. We got home and I went to bed. I was supposed to go to school the next day but I woke up in the middle of the night in in excruciating pain. First thing the next morning my mother took me to my doctor. They suspected that I had mono but I was sure I didn’t because I had not kissed anyone since December when the guy I had started going out with had gone back to college. I was sure he didn’t have mono because I thought he would have told me. I was wrong. The test came up positive. My doctor said that I had the worst case of mono he had seen and if I had been just a little more dehydrated I would need to be hospitalized I would have been mad but I was just to sick and exhausted and I just wanted to feel better and take a long nap. At the doctor I received what seemed to me to be two horse tranquilizer size shots of steroids. I was also told that I could not participate in sports for at least 4 weeks because my spleen was enlarged and if I got hit to hard my spleen could burst. I later did ask him why he didn’t tell me he had mono. He said that he didn’t know he had it. Which at first I found hard to believe but after a little research I found out that I was an oddity. most cases are either symptom-less or have such mild symptoms the patient does not even know they have mono.

I spent the next 3 weeks sleeping, eating, drinking lots of fluid, and watching a lot of television. Adding up all of my absences I had only been in school for about six days out of the first six weeks of the third semester of my senior year. I then miraculously made up the entire third quarter in three weeks just in time for the end of the quarter. Though during that time I almost relapsed from over stressing and working to much. I am now almost fully recovered and back on track at school. It became apparent to me that most people in my school where not aware of how mono worked with some of my friends on my return not sure if they could hug me or not because they didn’t get mono. As common as mono is I think it is important for the public to know about mono. How it is transmitted, symptoms, treatment, and most importantly what mono is. This website is my way to reach out and spread knowledge and information about mono.


 

 

A friends story

At one of my symphony concerts the girl next to me forgot her reed soaker so she had to borrow mine. She had been hooking up with another member of the symphony. I woke up with 2 sores but I didn’t think anything of it at the time. When I went to a check up many months later they tested me for mono because I had a swollen lymph node. There I found out that I did not have mono, but I did have it before. I most likely got it from that girl.

 

What is Mono

Infectious Mononucleosis is an infectious disease caused by the Epstein Barr Virus characterized by extreme fatigue and swollen lymph nodes, and most commonly spread through the exchange of saliva, however, it can also be transmitted through contact with blood, semen and other bodily fluids.

 

Demographics

90-95% of people over 21 have had Epstein Barr Virus in their life, however not all people infected end up displaying symptoms that are then called Infectious Mononucleosis

Before puberty, children infected typically show either only flu-like symptoms similar to a throat infection or no symptoms at all. Only 10% of children infected with the Epstein Barr Virus show symptoms.  

Infectious Mononucleosis is most common in the age group between 15-24 because it is usually spread through intimate oral contact.

Older adults very rarely show symptoms of Infectious Mononucleosis, however, when they do they are more likely to develop uncharacteristic symptoms and more severe and dangerous forms of the disease.

It takes around four to seven weeks to start presenting with symptoms which can make it difficult to determine what the source was. It can also take between two weeks to six months to fully recover, with six months being on the extreme side of the spectrum. Though you are not like to get mono again it is possible to relapse if you over stress yourself and your body.

Causes

Mono is caused mostly by contact with someone who has the Epstein-Barr virus.

Mono is transmitted thru saliva and it is widely thought to be only transmitted by kissing someone who has mono. Mono can be transmitted through almost any means that bodily fluid is transmitted. This includes: kissing, sneezing, coughing, sharing food, drinks, or utensils, semen during sexual contact, exchange of blood, and organ transplants. Sexual contact, exchange of blood and organ transplants are the least likely way to contract this virus. Once you have had mono it is highly unlikely that you will get it again.

     

(Pictures of Epstein Barr virus)

 

People at risk

  • young people between the ages of 15 and 30
  • students
  • medical interns
  • nurses
  • caregivers
  • people who take medications that suppress the immune system
  • Anyone in close contact with a large number of people especially high school and college students

Symptoms

  • extreme fatigue
  • fever
  • sore throat
  • head and body aches
  • swollen lymph nodes in the neck and armpits
  • swollen liver or spleen or both
  • Rash
  • Muscle weakness
  • Swollen tonsils
  • Night sweats

In severe cases

  • Enlarged Spleen
  • Affected liver

Diagnosis

The process for diagnosing Infectious Mononucleosis involves several steps because of its similarity to Hepatitis A and sometimes nonspecific symptoms

Step 1: Initial Exam

Typically the doctor will ask how long you have been displaying symptoms and if you are between 15 and 24 they will often also ask if you have been in contact with someone who has had mono. Your temperature will be taken and then a physical exam will be performed,  looking particularly for swollen lymph nodes and an enlarged spleen.

 

 

Step 2: Labs

Blood will be drawn to determine the severity of the illness depending on the levels of different blood cells. Special attention will be paid to the white blood cell count; a high white cell count can indicate an infection.

The monospot test (a version of the heterophile test) looks for the presence of a group of antibodies (called heterophile antibodies) that may be produced in response to the Epstein Barr Virus in the blood. This test is most effective if done within 2-4 weeks of symptoms appearing. Although not always very accurate, it is very quick and easy to do and results are usually available within the hour.

If the monospot test comes back negative, an EVB antibody test may be performed, which looks for EVB-specific antibodies. It can determine mono as early as the first week of symptoms, but it takes much longer to get the results.

 

 

Treatment 

Treatment depends on the severity of your case but all cases should be treated with the following.

  • Hydration
  • Getting a lot of rest
  • Avoid contact sports
  • Over the counter drugs

 

Complications

By itself, mono is not typically serious, however, there are some more life threatening complications. Some individuals develop secondary infections like strep throat, sinus infection or tonsillitis. In severe cases, an enlarged spleen can rupture if the patient doesn’t refrain from vigorous activity for at least a month. Hepatitis (liver inflammation) and jaundice can also occur. Extremely rare complications include anemia, thrombocytopenia (a decrease in platelets), inflammation of the heart, meningitis, Guillain-Barre syndrome and breathing obstruction due to swollen tonsils.

 

 

 

 

Works Cited

“About Infectious Mononucleosis” Center for Disease Control. 14th September 2016. https://www.cdc.gov/epstein-barr/about-mono.html

“AccuTest Mononucleosis (Mono) Rapid Test (Whole Blood/Serum/Plasma) CLIA-Waived – 25 Tests Per Box.” Medical Supply, 16 Mar. 2017, medsupplyexchange.com/product/accutest-mononucleosis-mono-rapid-test-whole-bloodserumplasma-clia-waived-25-tests-per-box/.

“Alpha: Making the World’s Knowledge Computable.” Wolfram, www.wolframalpha.com/input/?i=infectious%2Bmononucleosis&lk=1&rawformassumption=%22ClashPrefs%22%2B-%3E%2B%7B%22Disease%22%2C%2B%22ICDNine075%22%7D.

“The Basics: Mononucleosis” WebMD. https://www.webmd.com/a-to-z-guides/video/basics-mono

Blahd, William. “What is Mononucleosis? What Causes it?” WebMD. 9th January 2017. https://www.webmd.com/a-to-z-guides/understanding-mononucleosis-causes#2

Ebell, Mark H. “Infectious Mononucleosis.” JAMA, American Medical Association, 12 Apr. 2016, jamanetwork.com/journals/jama/fullarticle/2512787.

Gross, Thomas G. “Infectious Mononucleosis and Other Epstein-Barr Virus-Related Disorder” Oncohema Key. 21st October 2016. https://oncohemakey.com/infectious-mononucleosis-and-other-epstein-barr-virus-related-disorders/

“Infectious Mononucleosis” Medline Plus. 17th April 2018.

https://medlineplus.gov/infectiousmononucleosis.html

“Infectious Mononucleosis” Wikipedia. 24th April 2018. https://en.wikipedia.org/wiki/Infectious_mononucleosis

Kaye, Kenneth M. “Infectious Mononucleosis” Merck Manual. February 2018. https://www.merckmanuals.com/professional/infectious-diseases/herpesviruses/infectious-mononucleosis

Macsween, Karen & Higgins, Craig & Mcaulay, Karen & Williams, Hilary & Harrison, Nadine & J Swerdlow, Anthony & H Crawford, Dorothy. “Infectious Mononucleosis in University Students in the United Kingdom: Evaluation of the Clinical Features and Consequences of the Disease” Research Gate. March 2010. https://www.researchgate.net/publication/41397004_Infectious_Mononucleosis_in_University_Students_in_the_United_Kingdom_Evaluation_of_the_Clinical_Features_and_Consequences_of_the_Disease

“Mononucleosis” Mayo Clinic. 3rd January 2018. https://www.mayoclinic.org/diseases-conditions/mononucleosis/symptoms-causes/syc-20350328

PatvanN100. “Epstein Barr Virus (EBV) Diagnosis and Testing.” YouTube, YouTube, 2 Feb. 2017, www.youtube.com/watch?v=kKPkG1gflfo.

Shilling, Ray. “Infectious Mononucleosis” Net Health Book. 1st December 2016.

http://nethealthbook.com/ear-nose-and-throat-diseases-otolaryngology-ent/throat-problems/infectious-mononucleosis/

Stoppler, Melissa C. “Infectious Mononucleosis” Medicine Net.

https://www.medicinenet.com/infectious_mononucleosis/article.htm

“Tests and Treatments for Mononucleosis” WebMD. https://www.webmd.com/a-to-z-guides/understanding-mononucleosis-treatment

“What Are the Symptoms of Mononucleosis?” FindATopDoc. https://www.findatopdoc.com/Healthy-Living/Symptoms-of-Mono.

“What is Mononucleosis?” Healthline. https://www.healthline.com/health/mononucleosis

“What is Mononucleosis?” Web MD,  1st September 2017. https://www.webmd.com/a-to-z-guides/qa/what-is-mononucleosis

“What is Mononucleosis?” YouTube. 25th March 2012. https://www.youtube.com/watch?v=BGgjy58PmX4

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COMMENTS: 3
  1. April 29, 2018 by Kate.Miller

    Hey Kat! I think it is so interesting that you were able to research and create a project so relevant to your life, thank you for sharing your story and your experience. One of my close friends was recently diagnosed with Mono, but until reading your site I did not know much about the disease. In terms of the treatment, since it can take up to 6 months to fully recover, do you know of any other treatment options that doctors are working on creating other than rest, hydrating and over the counter drugs?

    Kate

  2. April 30, 2018 by Donna

    Good article! I had it as a kid and it was one of those things you never forget!

  3. May 11, 2018 by Aurelie Verdiell

    Hi Kat, I didn’t know how horrible mono was, I had always assumed it was like a long cold. What would you think would be a preventative measure to take to make sure mono could possibly become less common?

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