Mono (Infectious Mononucleosis): Transmission, Prevention, and Clinical Notes

Infectious mononucleosis is caused by Epstein-Barr virus (EBV, HHV-4).

Transmission

• Saliva: Kissing ("kissing disease"), sharing drinks/utensils, lip balm, toothbrushes.
• Respiratory droplets: Cough/sneeze (less efficient).
• Blood/organ transplant: Rare.
• Not spread by: Casual contact, surfaces, air (no aerosol transmission).

Epidemiology

• Peak incidence: 15–24 years.
• ~90% of adults seropositive by age 35.
• Asymptomatic shedding lifelong → reservoir.

Prevention

• Avoid sharing saliva-contaminated items.
• Good hygiene (handwashing).
• No vaccine yet (in development).

Clinical Note

Symptoms: fever, pharyngitis, lymphadenopathy, fatigue, splenomegaly. Avoid contact sports 3–4 weeks (splenic rupture risk). Supportive care only—no antiviral for routine cases.