Does Your Child have Mononucleosis?

With children finally in school and back on track, you can always look for a derailment. The train wreck has a name called Mononucleosis, more affectionately known as mono. It used to be called the kissing disease because it is spread through saliva. In fact, it is spread by droplet infection, which includes the following: 

1. Sneezing and coughing.
2. Sharing eating utensils and cups.
3. Sharing lip care products and cosmetics.
4. Any activity involving the exchange of saliva, hence the nick name “kissing disease."

Mono is a virus called Epstein–Barre, which causes flu like symptoms. It is contagious and very difficult to prevent. It can incubate for 4-6 weeks before making its presence known. This virus can be spread for weeks, which has made it hard to prevent in the general population. According to Boston Children’s Hospital, 95 percent of adults have been exposed to this virus and have developed immunity to the virus. Adolescents seem to be the population most adversely affected. When small children have mono, their symptoms are less severe than those of the teen (Mayo Clinic). The reason teens get so sick as opposed to younger children is unknown. If an adult is immune compromised, staying away from people with known infectious diseases is a good policy.

Symptoms of Mono include the following:

• Fatigue. Exhaustion is the big problem because it lasts for a long time. Feeling tired can lasts for weeks up to several months.
• Sore throat that can last for weeks. Some kids can also have a strep infection, too.
• Fever can last 7-10 days.
• Headache
• Loss of appetite
• Swollen glands
• Muscle aches
• Skin rash
• Abdominal pain can be caused by spleen enlargement. This enlargement can last for weeks.

These symptoms may vary. Not all kids will experience these symptoms or are the symptoms equal in duration. If your child experiences these symptoms, your health care provider can order a monospot test that can confirm the diagnosis in the office. Blood work can also be taken, which takes longer to get the results. Once a positive diagnosis of mono is confirmed, you know what is causing the problem. The unfortunate news is that there is no cure, vaccine or anti-viral drug. One must try to alleviate the symptoms and wait for the virus to run its course. Steroids may be prescribed for five days, in order, to decrease inflammation.

The best treatment for the symptoms includes:

1. Rest. These children want to sleep and that is what they will do.
2. Drink lots of fluids. Staying well hydrated helps with fever, which can cause dehydration. Drinking cold liquids can help relieve a painful sore throat.
3. Ibuprofen for pain and swelling is a great over the counter pain medication that can help with swelling too. Stay away from acetaminophen and never use aspirin on children.
4. Eat nutritious foods like fruits and vegetables. These have a lot of water and are easy on the stomach. Remember that children may not have a good appetite so make whatever is eaten count nutritiously.
5. Lozenges and ice pops are good for a sore throat. When you suck on a lozenge or hard candy, it is the saliva that coats your throat and relieves the pain.
6. Salt water gargles and tea with honey might help too.
7. Avoid sports with physical contact for a few months or longer depending if the child has an enlarged spleen. Contact sports to avoid include cheerleading, wrestling, football, soccer, rugby or anything that can cause the spleen to rupture. Rough housing with siblings and friends is also off limits because a splenic rupture is life threatening.

Some children are sick for a couple of weeks while other children can take a lot longer to recover. Most kids feel better within one month. If symptoms last longer than six months, which is rare, then the diagnosis becomes chronic EB (Epstein-Barre) infection (CDC, 2011). Children are allowed to return to school when they are fever free and feel well enough to attend. Most often, children will attend school on a part-time basis by alternating classes.

Brittany Hughes M.Ed., a guidance counselor at , says, “If your child misses enough school (10 days in a row or your health care provider anticipates your child’s absence of 10 days or greater) then a home visit teacher may be useful. You will need to speak to your child’s guidance counselor and email teachers."

TLC is mandatory. Your child will feel physically bad, miss friends and worry about their academic career. Stay well.