Infectious mononucleosis (referred to as “the kissing disease” from its oral transmission) is an infectious, widespread viral disease caused by the Epstein Barr virus, a type of herpes virus, which over 90% of adults are likely to have acquired immunity by the age of 40. In adolescents and young adults, the disease is characterized by fever, sore throat and fatigue, along with several other possible signs and symptoms. It is primarily diagnosed by observation of symptoms, but suspicion can be confirmed by rapid diagnostic mono tests. Mononucleosis is a self-limiting disease and little treatment is normally required, despite the sometimes painful and severe symptoms.
One of the more interesting features of mononucleosis is that once the acute symptoms of an initial infection disappear, they often do not return. But once infected, the patient carries the virus for the rest of their life. The virus lives dormant in B lymphocytes. Independent infections of mononucleosis may be contracted multiple times, regardless of whether the patient is already carrying the virus dormant. Periodically, the virus can reactivate, during which time the patient is again infectious, but usually without any symptoms of illness. Therefore an infected person could spread the disease, unknowingly through kissing or some other oral transmission. But usually, a patient has few, if any, further symptoms or problems from the latent B lymphocyte infection.
Patients who have had mononucleosis are sometimes vunerable to chronic fatigue syndrome. In 1987 scientists used the term chronic fatigue syndrome to describe a condition resembling “chronic active Epstein-Barr virus (EBV) infection” but which presented no evidence of EBV as its cause. It’s important to immediately test patients for the virus that causes mononucleosis to rule out other possibilities, including depression, IBS, fibromyalgia, and even diabetes, when they present symptoms that are not easily identifiable. One of the easiest ways to test for mononucleosis is with an in office mononucleosis test .