From the Guidelines
The protocol for mononucleosis (mono) exposure primarily involves supportive care as there is no specific preventive treatment after exposure. If you've been exposed to someone with mono, understand that the virus (Epstein-Barr virus or EBV) spreads through saliva and close contact, with an incubation period of 4-6 weeks 1. No quarantine is necessary after exposure since the virus is common and many people carry it asymptomatically.
Key Considerations
- The virus spreads through saliva and close contact
- Incubation period is 4-6 weeks
- No quarantine is necessary after exposure
If symptoms develop (fever, sore throat, fatigue, swollen lymph nodes), treatment focuses on:
- Rest
- Adequate hydration
- Over-the-counter pain relievers like acetaminophen (500-1000mg every 6 hours) or ibuprofen (400-600mg every 6-8 hours) for fever and discomfort
- Avoid aspirin in children and teenagers due to Reye's syndrome risk
- Gargling with warm salt water (1/2 teaspoon salt in 8oz warm water) can help sore throat symptoms
Preventing Transmission
According to the study on infection prevention and control in pediatric ambulatory settings 1, hand hygiene is the single most important method of preventing transmission of infectious agents. This can be achieved by using an alcohol-based hand rub or washing with soap and water before and after each patient encounter.
Additional Precautions
Most importantly, avoid contact sports and strenuous activity for at least 3-4 weeks after diagnosis to prevent splenic rupture, as the spleen often enlarges during mono infection. Alcohol should be avoided while recovering to prevent additional liver stress. Most people recover completely within 2-4 weeks, though fatigue may persist longer.
From the Research
Protocol for Mononucleosis (Mono) Exposure
The protocol for mononucleosis (mono) exposure involves several key considerations, including:
- Diagnosis: The diagnosis of infectious mononucleosis is confirmed with laboratory findings of a positive heterophile antibody ("Monospot"), polymerase chain reaction, or antibodies specific to EBV 2, 3, 4.
- Transmission: Transmission occurs primarily through sharing oral secretions, thus IM is known as the "kissing disease" 2, 3.
- Clinical Manifestations: Common clinical manifestations include fever, pharyngitis, posterior cervical lymphadenopathy, and splenomegaly 2, 3, 5, 4.
- Management: The management of IM is primarily supportive, with no role for antivirals or corticosteroids 2, 5, 4.
- Return to Play: The return to play decision is complex and should be based on a systematic approach to laboratory evaluation and consideration of the risk of splenic rupture 2, 6.
- Activity Restriction: Patients should be advised to avoid contact sports or strenuous exercise for 8 weeks or while splenomegaly is still present 3, 4.
Key Considerations
Some key considerations in the protocol for mononucleosis (mono) exposure include:
- The risk of splenic rupture, which is a relatively rare occurrence, typically occurring within a month of symptom onset 2, 3, 6.
- The importance of prompt diagnosis to avoid unnecessary investigations and treatments and to minimize complications 3.
- The need for a systematic approach to laboratory evaluation and return to play decisions to minimize clinical variation 6.
- The importance of considering the individual patient's energy level and symptoms when guiding activity 4.