Mononucleosis: The “Kissing Disease” Unmasked

Dr Jeeve Kanalingam mononucleosis

Mononucleosis, often referred to as “mono” or the “kissing disease,” is an infectious ailment known for its fatigue-inducing properties and its association with a joint viral agent. 

But beyond its catchy nicknames, what do we truly understand about this condition? Let’s delve deep into the world of mononucleosis, shedding light on its causes, symptoms, treatment, and more with Dr Jeeve Kanagalingam, Senior Consultant at The ENT Clinic.

Understanding Mononucleosis

Dr Jeeve explains. “Mono or more precisely, Infectious Mononucleosis, is caused by a viral infection. The virus is called the Epstein-Barr Virus (EBV), which belongs to the Herpes family of human viruses. It is implicated in mononucleosis and other more serious conditions such as lymphoma and nose cancer (nasopharyngeal carcinoma).” 

It is commonly named the “kissing disease” because the virus that causes it can be found in the mouth and is easily spread through kissing, but it can also be transmitted through sneezing, coughing, or sharing a glass or utensils with someone infected.

He added, “The EBV virus is spread through saliva. So sharing of cups, utensils, and indeed, kissing is a mode of transmission. In reality, most cases are probably not caused by kissing infected persons!”

Who’s at Risk?

Although mononucleosis can strike at any age, it’s most prevalent among teenagers and young adults, especially college students. This is partly because of their proximity to environments like schools and dormitories. However, by adulthood, most people have been exposed to the EBV and have developed immunity against it.

Symptoms & Diagnostics

Symptoms of mononucleosis can be varied and may take between 4 to 6 weeks to manifest after exposure.

Dr Jeeve stated that “The main symptoms of mononucleosis are a sore throat, a prolonged high fever that may spike to over 40 degrees Celsius, body ache and fatigue. The lymph nodes (or “glands”) in the neck swell – earning mononucleosis the laymen’s term of “glandular fever”. In some cases, the liver and spleen may swell.”

Dr Jeeve explained that diagnostics are done via blood tests. “These include a full blood count, the Paul-Bunnell (or Monospot) test and serological tests for the Epstein-Barr virus. Throat swabs are not very useful. All these tests may not yield positive results early in the course of the illness and therefore have a significant “false negative” rate.”

It’s worth noting that some people might be asymptomatic carriers, meaning they have the virus but display no symptoms.


Viruses, such as Mononucleosis, do not respond to antibiotics. Hence, medication “that reduces pain and inflammation, such as paracetamol and ibuprofen, are often used. Antiseptic gargles that contain chlorhexidine or iodine. Lots of fluids to rehydrate the patient who has a high fever. Finally, steroids can help sore throats and swollen glands resolve quickly.”, explained Dr Jeeve. 

Supportive care also includes:

  • Rest: It’s the most recommended remedy. Some individuals might need several weeks of it.
  • Hydration: Drinking fluids helps prevent dehydration and soothes a sore throat.
  • Pain Relievers: Over-the-counter pain medications can help reduce fever and relieve a sore throat.
  • Avoiding Strenuous Activities: Due to the potential for a swollen spleen, which can rupture, it’s advised to avoid heavy lifting or contact sports for a few weeks.

Preventing Mononucleosis

There’s no vaccine for EBV, so prevention primarily focuses on good hygiene practices. Dr Jeeve suggests, “Simple hygienic precautions such as not sharing cups and utensils is important, especially amongst students who live in shared accommodation. One key strategy is to have a serving spoon or chopsticks when sharing dishes with others. Eating from the “common bowl” is regarded as the main mode of transmission of EBV.”


Mononucleosis is a common ailment, especially among young adults, that can result in weeks of fatigue and discomfort. While often not severe, understanding its causes, symptoms, and the measures to treat and prevent it can ensure a swift recovery and reduce its spread. If you or someone you know is experiencing the symptoms mentioned above, it’s crucial to consult with a healthcare professional to get a proper diagnosis and advice on managing the condition.

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