Mono and Epstein Barr Symptoms – is it really a kissing disease?

Infectious Diseases

 Epstein Barr Symptoms & Mono

Is Mono really a kissing disease? 

Most kids are exposed to mono by the time they are adolescents, though few will become ill with the disease, which can linger for months. I have had mono twice (yes it is possible, though uncommon), and know well how frustrating it is to feel endlessly fatigued and struggle with a sore throat for weeks. Rest assured, it will be over soon!

What is mono (mononucleosis)?

Mono is a viral infection that causes fatigue, sore throat and swollen lymph nodes (glands) in the neck. It is often called ‘the kissing disease’ as it spreads though saliva and close contact with those infected.

Mono is most commonly caused by Epstein Barr Virus, though other viruses, like cytomegalovirus can also cause the same symptoms.

What does Mono look like?

Many people with mono have fatigue, sore throat and malaise. Most children with mono have swollen glands in the neck, and pus in the throat. Some will get a rash (little red dots) if they are misdiagnosed as having a bacterial infection (like strep throat) and receive Amoxicillin.


Epstein Barr Symptoms

  • Fatigue
  • Fever
  • Sore throat when swallowing
  • Swollen throat glands
  • Enlarged spleen
  • General ill feeling
  • Decreased appetite
  • Muscle aches
  • Decreased appetite

Some kids get headache, jaundice (skin turns yellow), neck stiffness, cough, chest pain or shortness of breath.

How can I tell if my child has mono?

Doctors can check the blood for evidence of mono (monospot test or antibody titers). The white blood cell count may also be higher than normal, with an elevated ‘abnormal lymphocyte’ count.


Unfortunately, treatment for mono is mostly symptomatic. Rest is the most important factor. For sore throat, fever and aches, I suggest Ibuprofen, which is a great fever and pain reliever and anti-inflammatory. For very severe cases, steroids may be prescribed.

Have your child drink lots of fluids, and he/she can gargle with salt water to relieve some throat discomfort. The best medicine for sore throat – honey and warm water. Honey may have the power to shorten the duration of the virus too!

Is there anything to be avoided?

Children with mono must avoid contact sports or anything that places they abdomen at risk of injury. This is because children with mono may have swollen spleens that are susceptible to rupture.

How long does it last?

Fever associated with mono often abates within a week or two, and sore throat and swollen glands up to a month. Most recover fully by 2-3 months.


  • Bacterial infections of the throat
  • Hepatitis leading to jaundice
  • Hemolytic anemia
  • Orchitis – inflammation of the testicles
  • Nervous system (brain) complications
    • Seizures
    • Meningitis
    • Guillain-Barre Syndrome
    • Bell’s palsy (temporary facial paralysis)
  • Spleen rupture
  • Death – in people with compromised immunity

When to see your doctor

If your child is feeling well and looks well, there is no need to see a doctor unless you are worried. Most kids with mono never undergo testing and do not become unwell.

See your doc if you child has:

  • Difficulty breathing
  • Abdominal pain
  • Persistent fever for more than 5 days
  • Severely swollen tonsils
  • Yellow skin color
  • Arm or leg weakness

Can you prevent getting mono?

Yes and no. It is very contagious and can live outside the body for hours. Obviously, try to avoid contact with people that have mono, though you can be contagious without having obvious symptoms, which is hard to avoid.

If your child is coughing a lot here’s a great article on Croupy Cough!

Dr. Dina Kulik, MD, FRCPC, PEM

Written By: Dr. Dina Kulik, MD, FRCPC, PEM

Dina is a wife, mother of 4, and adrenaline junky. She loves to share children’s health information from her professional and personal experience. More About Dr Dina.

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