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Infectious mononucleosis / 'Mono'-Symptoms-Risk factors-Diagnosis-Treatment

Last Updated on Apr 19, 2013
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Mononucleosis is caused by Epstein Barr virus of the Herpes Family. Also called the 'kissing disease,' due to its oral mode of transmission, it is quite prevalent among adolescents in the West.


Other names: EBV infectious mononucleosis, Pfeiffer's disease, Filatov's disease, ‘kissing disease’ and ‘mono’

Mononucleosis or ‘mono’ is an infectious disease brought about by the Epstein Barr virus of the Herpes virus family. A similar condition is known to be caused by the Cytomegalovirus too.

Infectious Mononucleosis

Infectious mononucleosis has, since the 1800s, been recognized as a clinical syndrome with fever, adenopathy and pharyngitis. In 1920, it was first clinically described by Sprunt and Evans in the Bulletin of the Johns Hopkins Hospital.

Although these studies described the ‘kissing disease’ they failed to associate it with the EBV because the causative virus was then, yet to be described. They titled their article "Mononuclear leukocytosis in reaction to acute infection (infectious mononucleosis)." When mono occurs there is an increased proliferation of any one type of lymphocytes that assume an atypical appearance.

The disease spreads through the saliva of an infected person and is mostly brought about by an affected individual kissing an unaffected person. Due to this predominantly oral mode of transmission, mono is also called the “kissing disease”.


Although the disease mainly affects adolescents and young adults it has been observed in people of all ages, from children to the mature adults. In the USA, it is particularly common in the college going youngsters due to their liberal attitude towards sex.

EBV may remain symptom less for many years, unlike other herpes viruses. Mononucleosis symptoms are more vigorous in individuals who are at a stage when their immune response is at its best. It has been commonly observed that the highest rate of occurrence is between 15-25 years of age.

Almost all Americans and many young adults in the West harbor the herpes virus Epstein-Barr virus (EBV), by the time they are in their late thirties.

The virus first multiplies within the pharynx and hence the sore throat. One of the most common causes of infectious pharyngitis is EBV- infectious mononucleosis. Other common symptoms of mono include sever fatigue, sore throat, draconic headache, fever, swollen glands, and enlarged spleen.

The virus causing mono remains potent for upto 18 months and is capable of transmitting the disease even after the symptoms have disappeared. The reason behind this still remains murky.


Once EBV infects a person, it remains for life in the cells of the person as treating the virus is almost impossible. However, it is self- limiting and although the infection period can be very trying, the vast majority of the infected people recover from it.

That is one of the reasons why some physicians argue that mono, “the kissing disease,” has become trivialized and that trials for new drugs and vaccines are lacking and that not enough work and resources have been directed towards it, despite the fact that the disease is capable of causing serious complications in those with weak immune system and also in transplant patients.

There are no antiviral drugs or vaccines currently available to ward off this painful infection. The only successful herpes vaccination has been against the chicken pox virus varicella .

Mono is caused by the Epstein-Barr virus (EBV). It is most often seen in adolescents and young adults. Children can get the virus, but it often goes unnoticed because their symptoms are mild. Adults usually do not get mono, because they have immunity to the virus.

Mono can be spread through contact with saliva, mucus from the nose and throat, and sometimes tears. Because the virus can be spread through kissing, it has earned the nickname the "kissing disease." If you have mono, you can avoid passing the virus to others by not kissing anyone and by not sharing things like glasses, eating utensils or toothbrushes.

As soon as you get over mono, your symptoms will go away for good, but you will always carry the virus that caused it. The virus may become active from time to time without causing any symptoms. When the virus is active, it can be spread to others.

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