What you should know about ‘the kissing disease’: Mononucleosis?

Updated on September 28, 2020

Infectious mononucleosis is known as glandular fever and also colloquially known as “the kissing disease”. This virus is transmitted via saliva. Most people are infected with the virus as kids where the disease exhibits mild or no symptoms. In adolescents however it manifests in sore throat, fever or enlarged lymph nodes. 

A throat specialist will be able to validate your condition with additional examinations or tests to confirm the condition.

What is infectious mononucleosis?

It is an infectious disease caused by the Epstein-Barr virus and is more common among the teenagers, although it can occur at any age. The spread of the virus occurs through saliva, which is why it is referred to as the ‘kissing disease’. This condition is rather non-existent in paediatric patients and affects mostly high-schoolers and college students.

How is infectious mononucleosis caused?

The causative agent, Epstein-Barr Virus is part of the herpes virus family. Many individuals have an exposure as children, but that does not necessarily mean that everyone gets mononucleosis. It could be dormant in the body for a lifetime.

This virus is passed through body fluids such as saliva, blood and semen. Sharing of cutlery, food items and utensils might infect people as the virus tends to sit on moist surfaces. Medical procedures like organ transplants and blood transfusions too can give rise to mononucleosis.

What are the symptoms of mononucleosis?

Patients may present with different symptoms, however the most commonly observed symptoms include:

  • Enlarged lymph nodes in neck and armpits
  • Sore throat
  • Fever
  • Loss of appetite
  • Tiredness
  • Tenderness in muscles
  • Skin rash

Symptoms generally subside in a fortnight to a month. However, tiredness can linger for longer and carry on even for 6 months.

Mononucleosis can rarely have severe complications, making it essential to be reviewed by an ENT specialist. If your symptoms don’t improve within a week, it is wise to seek the opinion of an ENT doctor. A ruptured spleen, systemic nervous problems like meningitis, anaemia, inflammation in kidneys, arrhythmia in heart and other heart muscle inflammation are some of the common difficult complications you have to deal with.

Who is at a higher risk of contracting Mononucleosis?

  • Young adolescents generally in the age group between 15 to 30 years
  • College goers
  • Medical interns
  • Immune-compromised patients
  • Caregivers

Individuals who frequently come in touch with large gatherings of people such as university students have a higher chance of contracting the infection.

How is Mononucleosis diagnosed?

Mononucleosis has symptoms which tend to be similar to infections like Hepatitis A, thus, your clinician will conduct several tests to rule out these possibilities. When you visit your ENT physician, he will conduct an initial physical examination. The age of the patient is critical in diagnosing the condition too, along with common factors like sore throat, fever, swollen lymph nodes and fever. Spleen may also be checked to see if it is enlarged.

Some of the common tests done include:

  • Full Blood Count: This test will help to indicate the various levels of your blood cells. If there is a high count of lymphocytes then it indicates an infection.
  • White Cell Blood Count: If there is an elevated white cell count, it indicates your body is trying to fight an infection. It is suggestive of mononucleosis
  • Monospot Test: This is an antibody test done to detect antibodies against proteins produced during mononucleosis. These are termed as heterophile antibodies. It is a usual screening test for the condition and these antibodies appear between 2 to 4 weeks of infection.
  • Epstein Bar Virus Antibody Test: If the Monospot Test is negative, your ENT doctor may order this test to look specifically for Epstein Bar Virus antibodies. It is an easy test which can be done early to detect the infection within the first week.

What are the home remedies for mononucleosis?

If you want to ease your symptoms, you can try some of these home remedies to calm your sore throat.

  • Rinsing your throat with salt water
  • Keeping your throat hydrated
  • Warm soups like a chicken broth
  • Bed rest
  • Taking foods which improve your immunity like fresh fruits and vegetables
  • Over the counter medications like Tylenol, however aspirin is not recommended.

What are the treatment options available?

Being a viral infection, antibiotics cannot treat this condition, however your ENT doctor may prescribe corticosteroids to help ease the swollen throat and tonsil inflammation. If there is a secondary bacterial infection like a sinus infection or tonsillitis, then the doctor will prescribe the relevant antibiotics. If you develop a rash, then ointments will be prescribed to ease the condition.

A well-balanced diet, rest and plenty of fluids will help to overcome the condition in due course.

When should you contact a doctor?

Reach out to a health professional after a diagnosis of glandular fever if you are experiencing any of the following conditions:

  • Abdominal pain
  • Difficulty swallowing fluids
  • Breathing difficulty
  • Chest infection
  • Rash

The ENT Clinic  is a prominent otolaryngology practice in Singapore to consider when the need arises to see a physician. The practice has a team of renowned ENT doctors and friendly support staff. The clinic offers modern diagnostic and treatment options. Located conveniently at Mt. Elizabeth Novena Hospital and Gleneagles Hospital, the clinic is a centre for excellence in the field of otolaryngology services.

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