Mono or the Flu? Know the Differences

It’s not uncommon to confuse infectious mononucleosis- or mono,  with the flu, as the two viruses share many of the same symptoms.

Over the past few weeks both our  Danbury as well as West Hartford urgent care centers have seen folks coming in presenting with flu like symptoms which have turned out to be mono once tested.

Is it Mono or the Flu? Know the Differences

Mono has a mysterious connotation, so let’s clarify. Usually caused by the Epstein Bar Virus (EBV),a highly contagious virus within the herpes family, mono is a group of symptoms that are a direct result of EBV.

What are the symptoms of mono?

Typical symptoms usually include

  • a fever, chills and aches
  • swollen lymph glands in the neck and/or armpits
  • headache
  • fatigue and nausea
  • muscle weakness
  • swollen tonsils with white patches and a sore throat
  • night sweats
  • a measles like skin rash on the body or face

Most cases of mono are mild and resolve easily with minimal treatment. The infection is typically not serious and usually goes away on its own in one to two months, which is a long time for many to endure, and longer lasting than the flu.

Who is at risk for mono and how does it spread?

Teenagers are the prime target of mono, although as stated above, anyone can be at risk. Spread primarily through saliva, mono has also been called the “kissing disease”. Blood is not involved, strictly saliva, hence the name. Anyone who regularly comes into close contact with large numbers of people is at an increased risk for mono. This is why high school and college students frequently become infected.

The following groups have a higher risk for getting mono:

  • young people between the ages of 15 and 30
  • students
  • medical interns
  • nurses
  • caregivers
  • people who take medications that suppress the immune system

How is mono diagnosed?

Your doctor can usually diagnose infectious mono based on the presence of symptoms such as a fever, a sore throat, and swollen lymph glands. Your age is also a good indicator. As stated above, mono usually occurs in teenagers, but it can occur in people of any age. Blood tests known as a ‘rapid test’ may be used to confirm the diagnosis if your doctor is unsure, but often the test will need to be repeated in 10-14 days since it often takes a few days for al of the EBV antibodies to appear.

How is mono treated?

There is no known antiviral prescription or vaccine for mono, however if symptoms are very bad, your doctor may prescribe a corticosteroid medication to reduce swelling in the throat or tonsils. As with the flu, treatment is, for the most part aimed at easing the symptoms, so over the counter medications like Tylenol to reduce fever and throat lozenges for the sore throat is the normal course of action.

Other at home remedies include getting plenty of rest, gargling with salt water, staying hydrated, ideally with water, and eating warm chicken soup (always a good idea!)

And patience. You should wait at least one month before doing any vigorous activities or playing contact sports to avoid rupturing your spleen, which may be swollen from the infection. Talk to your doctor about when you can return to your normal activities. A ruptured spleen in people who have mono is rare. However, call your doctor immediately if you have mono and experience a sharp, sudden and intense pain in your upper abdomen.

Are there complications that can occur from mono?

Mono is typically not serious. In some cases, people who have mono get secondary infections such as strep throat, sinus infections, or tonsillitis. In rare cases, some people may develop the following complications:

Enlarged spleen. A ruptured spleen will usually occur between four and 21 days after you begin to have symptoms. Occasionally people might experience jaundice (yellowing of the skin or eyes), or inflammation of the liver (hepatitis). These occurences are rare however.

Although about 50% of mono patients no longer have symptoms past 8 weeks, there is such a thing known as chronic EBV infection which can occur if symptoms last for more than six months. EBV will remain dormant in your blood cells for the rest of your life, and it can occasionally reactivate without symptoms. It’s possible to spread the virus to others through contact with your saliva during this time.

Is mono preventable?

No, not really.  Mono is almost impossible to prevent. Almost all adults have been infected with EBV by age 35 and have built up antibodies to fight the infection. Healthy people who have been infected with EBV in the past can carry and spread the infection periodically for the rest of their lives.

The good news, however, is that people normally get mono only once in their lives.

Are you experiencing any of these combinations of symptoms? If so, don’t wait to see your doctor and be diagnosed. Although not treatable with medicines or vaccines mono is highly infectious.


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