Mono, also referred to as infectious mononucleosis or glandular fever, is a common viral infection. It’s most often caused by the Epstein-Barr virus (EBV). Approximately 85 to 90 percent of adults have antibodies to EBV by the time they’re 40 years old.
Mono is most common in teenagers and young adults, but it can also affect children. Keep reading to learn about mono in children.
EBV is spread through close contact, particularly through coming into contact with the saliva of an infected person. For this reason, and because of the age range of people it most commonly affects, mono is often referred to as “the kissing disease.”
Mono isn’t just spread through kissing, though. The virus can also be transmitted through the sharing of personal items, such as eating utensils and drinking glasses. It can also be spread through coughing or sneezing.
Because close contact promotes the spread of EBV, children can often become infected through interactions with playmates at daycare or at school.
The symptoms of mono typically appear between four to six weeks after infection and can include:
- feeling very tired or fatigued
- sore throat
- muscle aches and pains
- enlarged lymph nodes at the neck and armpits
- enlarged spleen, sometimes causing pain in the upper-left part of the abdomen
Children who’ve been recently treated with antibiotics such as amoxicillin or ampicillin may develop a pink-colored rash on their body.
Some people may have mono and not even know it. In fact, children may have few, if any, symptoms. Sometimes symptoms can resemble a sore throat or the flu. Because of this, the infection may often go undiagnosed.
Because the symptoms can often be very similar to those of other conditions, it can be difficult to diagnose mono based on the symptoms alone.
If mono is suspected, your child’s doctor may perform a blood test to see if your child has certain antibodies circulating in their blood. This is called a Monospot test.
Testing isn’t always necessary, though, as there’s no treatment and it usually goes away without complications.
The Monospot test can give results quickly — within a day. However, it can sometimes be inaccurate, particularly if it’s performed within the first week of infection.
If the results of the Monospot test are negative but mono is still suspected, your child’s doctor may repeat the test a week later.
Other blood tests, such as a complete blood count (CBC), can help support a diagnosis of mono.
People with mono usually have a higher number of lymphocytes, many of which may be atypical, in their blood. Lymphocytes are a type of blood cell that helps to fight viral infections.
There’s no specific treatment for mono. Because a virus causes it, it can’t be treated with antibiotics.
If your child has mono, do the following:
- Make sure that they get plenty of rest. Although children with mono may not feel as fatigued as teenagers or young adults, more rest is needed if they begin to feel worse or more tired.
- Prevent dehydration. Make sure that they get plenty of water or other fluids. Dehydration can make symptoms such as head and body aches worse.
- Give them an over-the-counter pain reliever. Pain relievers such as acetaminophen (Tylenol) or ibuprofen (Advil or Motrin) can help with aches and pains. Remember that children should never be given aspirin.
- Have them drink cold liquids, suck on a throat lozenge, or eat a cold food such as a popsicle if their throat is very sore. Additionally, gargling with salt water may also help with a sore throat.
Many people with mono observe that their symptoms begin to go away within a few weeks. Sometimes feelings of tiredness or fatigue may last for a month or longer.
While your child is recovering from mono, they should be sure to avoid any rough play or contact sports. If their spleen is enlarged, these types of activities increase the risk of a spleen rupture.
Your child’s doctor will let you know when they can safely return to normal activity levels.
It’s often not necessary for your child to miss daycare or school when they have mono. They’ll likely need to be excluded from some play activities or physical education classes while they recover, so you should inform your child’s school about their condition.
Doctors are unsure of exactly how long EBV can remain present in a person’s saliva following illness, but typically, the virus can still be found for a month or longer afterward.
Because of this, children who’ve had mono should be sure to wash their hands often — particularly after coughing or sneezing. Additionally, they shouldn’t share items such as drinking glasses or eating utensils with other children.
There’s no vaccine currently available to protect against infection with EBV. The best way to prevent becoming infected is to practice good hygiene and to avoid sharing personal items.
Most people have been exposed to EBV by the time they reach middle adulthood. Once you’ve had mono, the virus remains dormant within your body for the rest of your life.
EBV may reactivate occasionally, but this reactivation typically doesn’t result in symptoms. When the virus reactivates, it’s possible to pass it on to others who haven’t already been exposed to it.