Mono Myths and Facts

Mononucleosis—or mono for short—is often referred to as the kissing disease and frequently affects college students. Other names include the Epstein-Barr Virus (EBV). But no matter what you call it, it can make you feel really ill.

Liesa Harte, MD, the founder and medical director of Elite Care in Austin, Texas, provides the following mono facts and myths about this disease.

1. Mono is spread by kissing.
True. Mono can certainly be transmitted through saliva. But this isn't the only way to get this disease. It can also be spread by sharing utensils, foods, drinks, a toothbrush, lipstick, and through coughing and sneezing.

2. Only young people can get mono.
False. Anyone can get mono, regardless of age. However, many older adults have been exposed in the past and have built up immunity over time. Young people may have had less contact to build up the immunity and are also more apt to kiss or otherwise be exposed to infected saliva.

3. The only symptom of mono is fatigue.
False. Fatigue is one major mono symptom, but it is usually accompanied by other mono symptoms, a high fever, sore throat, swollen lymph nodes in your neck and under your arms, weakness, and a general feeling of being unwell.

4. There is no concrete way to diagnose mono.
False. Mono can be diagnosed through a monospot blood test and through the Epstein-Barr virus antibody test. Both of these test for the presence of Epstein-Barr antibodies.

5. You can test positive for mono even if you never knowingly had this illness.
True. Most people have been exposed to the Epstein-Barr virus, which causes mono. Even if it never made you sick, you may still be actively carrying the virus.

6. A negative reading on a mono test doesn't always mean you don't have the disease.
True. It takes a little while for the Epstein-Barr antibodies to develop, which means you may already have the disease and accompanying mono symptoms before it shows in your blood test. If your test is negative and your mono symptoms persist, your doctor should repeat the test in a week or two.

7. Mono can be treated with antibiotics.
False. Since mono is a virus, it doesn't respond to antibiotics. The best way to treat mono is with bed rest and fluids. However, antibiotics may sometimes be needed if you have a secondary infection, such as strep throat.

8. Mono can affect your spleen.
True. Mono can sometimes cause your spleen to swell. In some cases, you might need a steroid to help address the swelling. This can be important because in severe cases, there's the risk that your spleen could swell and rupture, causing a life-threatening medical emergency.

9. Mono always lasts for an extended period.
False. While it isn't uncommon for mono symptoms to linger for months, this isn't true for everyone. Some people can have a mild case of mono that goes away quickly, or doesn't even present any noticeable mono symptoms. When it comes to mono facts, remember that lots of variation exists.

Liesa Harte, MD, reviewed this article.




US Centers for Disease Control and Prevention (CDC). "Epstein-Barr Virus and Infectious Mononucleosis." 16 May 2006. Web. 21 Jan. 2013.

Harte, Liesa MD, founder and medical director of Elite Care, Austin, Texas. Email interview 21 Jan. 2013.