How do you get mono? It spreads through saliva and is often called 'the kissing disease'
- Mono spreads through saliva.
- You can get mono through kissing someone, sharing food or utensils, and being exposed to respiratory droplets with coughs or sneezes.
- Here's how to know if you have mono and what you can do to prevent the spread.
- This article was medically reviewed by Jason R. McKnight, MD, MS, a family medicine physician and clinical assistant professor at Texas A&M College of Medicine.
Mononucleosis, or mono, is a contagious disease typically caused by the Epstein-Barr virus (EBV).
Most people are exposed to EBV at some point in their lives, but not everyone becomes infected or shows serious symptoms. According to the Centers for Disease Control (CDC), about one out of four young adults who contract EBV will actually develop mono.
Mono is characterized by fever, a sore throat, swollen lymph nodes, and extreme fatigue that can last for weeks. The illness is most common among adolescents and young adults between the ages of 15 and 24 years old.
Here's what you need to know about how mono spreads, the symptoms of the illness, and what you can do to protect yourself.
How do you get mono?
While other viruses can lead to mono, EBV is the most common cause. EBV is spread through saliva, which is why mono is commonly known as the "kissing disease," says Julia Blank, MD, family medicine physician at Providence Saint John's Health Center.
But kissing isn't the only way the virus spreads. You can also contract it by coming into contact with someone else's saliva in other ways, including:
- Sharing silverware, food, or drinks
- Sharing lip balm or chapstick
- Sharing a toothbrush
- If someone with the virus coughs or sneezes near you, and the respiratory droplets get into your nose or mouth
- The virus can also spread through bodily fluids during sexual contact
Teens and young adults are commonly in close contact with one another, especially those in a college setting, which helps explain why they are most at risk for contracting mono, Blank says. In fact, about 75% of young adults ages 18 to 22 who contract EBV will develop mono.
It is possible for children and older adults to get mono, though they usually don't develop typical mono symptoms. In children under the age of 10, symptoms may be so mild that they're hardly noticeable and not distinguishable from other minor illnesses like a cold.
Older adults can get mono, but it is rare, occurring in one out of 1,000 people over age 30 each year. Adults who do get mono typically don't display characteristic symptoms, like sore throat and swollen lymph nodes. Instead, enlargement of the liver and jaundice (yellow skin) are more common symptoms for older adults.
Signs of mono
The most common symptoms of mono include:
- Fever
- Sore throat
- Swollen lymph nodes in the neck or armpits
- Headache
- Rash
- Extreme fatigue
At first, the symptoms of mono may be hard to distinguish from other illnesses like strep throat or the flu, but symptoms from mono can last much longer than a typical flu or cold, Blank says.
If you are experiencing any of these symptoms for longer than two weeks, it's more likely to be mono and not the flu, Blank says. While the fever or sore throat may subside within a couple of weeks, some symptoms, like fatigue, can linger for much longer.
Most people with mono will feel better in about two to four weeks, but persistent fatigue that makes you feel exhausted could last as long as six months in some cases.
To determine whether you have mono, visit your primary care physician for an official diagnosis. Your healthcare provider may order different blood tests that look at white blood cell counts and potential EBV antibodies that indicate a mono infection. If you have it, follow these recommendations to treat mono and relieve your symptoms.
In addition, there are other less common symptoms of mono that can require further treatment. These include:
- An enlarged spleen. This occurs in about 50% of mono cases, as a result of increased white blood cells your body produces to fight off the infection, Blank says. These cells, known as lymphocytes, then infiltrate and enlarge the spleen. Signs of an enlarged spleen can include pain in the upper left abdomen or feeling full after eating a small amount as the spleen presses into the stomach.
- A swollen liver. This may lead to mild liver damage, which could cause temporary jaundice, or yellowing of the skin.
- Swollen tonsils. This can result in difficulty swallowing.
Though rare, these symptoms can result in more serious health complications, so consult your doctor if you notice any of these.
How to prevent the spread of mono
The symptoms of mono usually occur within four to six weeks of contracting EBV. But people who have mono can be contagious from the time they first contract EBV, even if they haven't yet developed symptoms.
Preventing the spread of mono can be difficult, since someone with mono can infect others before knowing they are sick themselves. However, you can lower your risk by:
- Washing your hands frequently
- Not sharing eating utensils, dishes, drinks or toothbrushes with others
- Not kissing anyone who is displaying symptoms of mono
You are likely most contagious while symptomatic, so if you suspect you may have mono, you should limit contact with others to avoid getting anyone else sick. In fact, some research has found that mono may even be contagious for several months after symptoms reside, so it might be smart to take these precautions for some time to reduce the risk of spreading illness.