Infectious mononucleosis is caused by viruses. It is more commonly known as glandular fever, kissing disease, or mono.

After picking up the virus, the patient will show signs and symptoms of mono 4 to 6 weeks later. The condition peaks within two to three weeks, but tiredness can continue for months.

The recovery period for mono is longer than many other viruses, but a case of mono is not likely to cause lasting problems.

Fast facts on mono

  • Mono is mostly caused by the Epstein-Barr virus (EBV).
  • It is characterized by a short period of infectious symptoms, followed by an extended bout of fatigue.
  • The disease can spread through deep kissing. For this reason, it is known as "the kissing disease."
  • Mono can be draining but does not often cause long-term damage.
  • Infection tends to resolve without treatment. However, people with mono should visit a doctor if symptoms complicate.

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Mono can lead to viral symptoms followed by a longer period of persistent fatigue.

The symptoms of mono occur as a viral infection followed by prolonged tiredness. Four of the main symptoms are:

The fatigue level peaks and eventually falls, but will persist in a less severe form. The normal duration of this tiredness is weeks, but the sensation can last for months.

At the onset of mono, the severe tiredness is tied to key initial symptoms of the EBV infection. EBV causes a sore throat and swollen neck glands along with malaise, a general feeling of ill health.

A study in 2013 suggested that a severe sore throat affects around 95 percent of cases. A sore throat can develop suddenly, but it can also be subtle if other symptoms are also developing slowly.

Mono progresses slowly.

The main virus behind mono, EBV, has an incubation period. This means that after getting the virus, no symptoms are produced until after 4 to 6 weeks. Studies have found this to be the time between exposure, perhaps a kissing session or eating or drinking after someone infected with the virus, and the onset of mono symptoms.

Symptoms endure for different lengths of time for different. Mono typically has a sudden phase of apparent symptoms, followed by a longer phase of post-viral fatigue.

After incubation, the initial illness usually lasts for 2 to 3 weeks. Fatigue often lasts for several weeks and, less often, lower fitness levels can last for 6 months or more.

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EBV is present in most people, and the virus can spread through kissing.

EBV causes the majority of mono cases. Another virus called cytomegalovirus (CMV) can also sometimes cause symptoms similar to mono, as can other infections.

EBV is almost everywhere, and most people have carried EBV at some point in their lives. Around 90 percent of adults worldwide have EBV by young adulthood. The virus does not often cause serious disease. It is spread through bodily fluids, such as saliva, blood, or urine.

The virus is contagious. Kissing is the main way it spreads, but EBV can also transmit through other routes, including:

  • sharing food and drink
  • sharing toothbrushes
  • contact with toys that have been drooled on

Most commonly, teenagers and young adults pass on the virus and get the infection. Research suggests mono is spread most often through deep kissing.

A study of 546 first-year university students, reporting in 2013, confirmed some findings related to kissing first published in 1955.

The study followed two groups of students. The results were as follows:

  • The virus antibody was present in 63 percent (344) of participants.
  • The other 37 percent (202) had no antibody to the virus.
  • The presence of the virus was very similar across students both from the class of 2010 and the class of 2011.

For 3 years, the team followed up with the students, taking monthly mouthwash and blood samples. The team examined virus transmission and immune system responses.

Health questionnaires were also filled in each month. The researchers created a data set on the sexual behavior, exercise, stress, and diet of each student.

Cases of mono illness were also recorded and described by the research.

The study found that deep kissing was the major reason for transmission of the virus. The researchers concluded this because the results were the same when the young adults practiced deep kissing, whether or not they also had full sex.

Students who did not report any kissing were much less likely to catch the virus.

The vast majority of mono cases are infections that impact quality of life followed by a recovery period. Recovery takes longer than for other common viruses of the upper airways, such as influenza or the common cold.

In rare cases, mono can complicate. A person should seek immediate medical assistance if any unusual or advanced symptoms appear, such as breathing problems or stomach pain.

Doctors occasionally need to provide care for young people or children with the following complications of mono:

  • the onset of other, more serious infections
  • a more serious immune response to mono, causing blood disturbances
  • severe inflammation of the throat that affects breathing
  • a swollen liver or spleen
  • rash

As long as they have recovered well, people who have had mono are recommended to avoid contact sports for 3 weeks after the normal illness, to avoid injury to the spleen.

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Mono often clears up on its own, but people with the disease should visit a doctor if symptoms get worse.

Mono is an illness that eventually clears up without treatment, although some people need care for complications.

There is no vaccine for mono at present. It is wise to abstain from kissing if mono is diagnosed, as this will more readily prevent the disease from spreading to others.

The virus gets into the body unnoticed a number of weeks before any signs of infection. That is when the virus is most likely to spread among people. Anyone with signs of a viral infection should avoid close contact with others, and take the following steps:

  • Rest and drink plenty of fluids throughout the day.
  • Use painkillers and anti-inflammatories as approved by a doctor, such as ibuprofen.

Fluids can include unsweetened fruit juice. Loss of appetite is normal, but people should maintain simple food intake. Avoid alcohol when unwell, as mono may already be putting strain on the liver.

Mono can be debilitating and draining during recovery, but people with the disease do not need to worry about long-term impact.