Did they really need to do a study about this?  I mean, hasn’t mononucleosis always been known as “the kissing disease”?

Among university students, kissing was a significant risk factor for primary Epstein-Barr virus infection, according to researchers from the University of Minnesota.

Mononucleosis is caused most often by the Epstein-Barr Virus (EBV – human herpesvirus type 4).  What most people don’t realize is that at least 50% of people have EBV infection before the age of five!  That’s right – mono is most common in toddlers and preschoolers.  Since everything seems to go into their mouths, it is easy to see why!  Symptoms in this age group are usually so mild that parents (correctly) assume their child has a mild virus.  Symptoms usually resolve in a week.  Kids who get mono before the age of five are more fortunate than those who get it later.

When kids start kindergarten, they learn that spoons and cups shouldn’t be shared, toys shouldn’t be licked, and boys (and girls) have “cooties”!  The swapping of saliva practically disappears and so does the incidence of mononucleosis.

Until middle school and high school.  By this time there are no cooties.  Teens start sharing spoons and drinks and cigarettes (yuk!) and KISSES!  Symptoms in older kids are typically more severe and more prolonged and include fever, tonsillitis (sometimes severe), enlarged lymph nodes (producing the so-called “bull neck”), rashes, dehydration and significant fatigue.  And, unlike most viruses that last a few days or so, this one can last for weeks.  Hepatitis can occur.  The spleen can become enlarged.  (This is why we don’t allow children with mono to play contact sports until all their symptoms have subsided and their spleens are no longer felt on a belly exam.)  Mono is simply a miserable illness.

While the clinical diagnosis of mononucleosis in a teenager is usually not difficult, doctors often order bloodwork to confirm it.    Treatment is mainly supportive.  Hydration is of paramount importance (10-12 ounces per hour is not too much, as long as the child is eating something, or the types of drinks are varied and not only water).  Maintaining good nutrition can be hard during the worst of mono, so adding a daily multivitamin is not a bad idea.  Acetominophen or Ibuprofen can help the fever and sore throat pain.  Warm salt water gargles also can provide relief from the swelling and inflammation of the tonsils.  Oral steroids are indicated when the tonsils become so big and painful that swallowing is difficult.  Intravenous fluids are sometimes necessary when kids can’t or won’t drink.  Antibiotics are not beneficial because this is a viral, not bacterial, infection.

What is interesting is that after most symptoms resolve, some people continue to complain of fatigue and difficulty concentrating.  For this reason, it may take some time and good communication with the school to get your child back up to speed after missing so many days with more severe symptoms.

Read more on this study at Helio.com:

More on EBV infectious mononucleosis here: