Mono affects an estimated 45 out of every 100,000 people. While it is rarely serious, symptoms can persist for up to two months, and can be debilitating.

What Causes Mono?

Mononucleosis is caused by the Epstein-Barr virus, or less frequently, by cytomegalovirus. Both are forms of the herpes virus. Mono is transferred from one person to the next only through close contact with the saliva or mucus of someone who is infected. Although it is no more contagious than a cold or flu, mono can develop and become contagious well before symptoms appear, so you may unknowingly be infected or infect someone else through coughing, sneezing, kissing, or sharing a drinking glass or bottle.

Once you are infected, the Epstein-Barr virus stays in your saliva for at least six months, although generally you are no longer contagious once your symptoms subside. The virus actually stays in your body for the rest of your life, but once you've had mono, you have been "vaccinated," and most likely won't get sick from it again.


The most common symptoms of mono include:

  • fever
  • sore throat
  • white patches on the back of the throat
  • swollen lymph nodes in the neck
  • fatigue
  • loss of appetite

Mono is usually accompanied by an overall sense of discomfort and, sometimes a rash. Symptoms usually last from a few days up to several weeks, though fatigue may linger longer. In rare, complicated cases, the spleen enlarges and is in danger of rupture. Your liver can also be affected. Warning signs of serious complications include:

  • rapid heartbeat
  • pain in upper left side of abdomen
  • lightheadedness
  • difficulty breathing
  • bleeding gums
  • yellowing skin


No treatment will cure mono, and unless you develop strep throat at the same time (which sometimes happens) prescription medications such as antibiotics are useless. However, you may find the following tips helpful:

  • Take over-the-counter NSAIDs (non-steroidal anti-inflammatories) such as ibuprofen or acetaminophen as indicated to help reduce fever and ease the pain of a sore throat.
  • Gargle with salt water and suck on throat lozenges or frozen snacks like ice pops to relieve sore throat pain.
  • In the case of a severe sore throat, your doctor may prescribe steroid medications.
  • Stay hydrated by drinking plenty of fluids and eating watery foods such as yogurt and fruit, especially if you have a fever.
  • Avoid alcohol and strenuous activities until you have recovered completely.
  • Be sure to get plenty of rest.

Once your symptoms fade, you can resume normal activities as you feel up to it. If your symptoms don't improve, or get worse, call your doctor.




David Levine, MD, FAAP
Summit Medical Group, NJ

Centers for Disease Control and Prevention. "Epstein-Barr Virus and Infectious Mononucleosis." Web. Page last updated 16 May 2006. Page last accessed 22 June 2013.

University of Maryland Maryland Center. "Mononucleosis." Web. Page last updated 17 May 2013. Page last accessed 22 June 2013.