Dr. Lynn Cates
Specializing in pediatric infectious diseases and childhood immunizations.
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 Ask Dr. Cates
Mononucleosis' Contagion Period | | | QUESTION | | | Dear Dr. Cates,
My seven-and-a-half-year-old old son has just been diagnosed with mono. I need to know how contagious it is, how long to keep him out of school, etc.— Kay in Decatur, Georgia | | | ANSWER |
October 9, 2000 | | | Dear Kay,
Infectious mononucleosis is caused by the Epstein-Barr virus. It's spread through the exchange of oral secretions (saliva) through physical contact such as kissing, so it can spread within families, daycare centers, or other close-knit settings. The incubation period--that is, the period between exposure to the infection and the appearance of the first symptoms--is about 30 to 50 days. The virus can be spread from the respiratory tract for months after the symptoms have disappeared.
The range of symptoms caused by mono can vary dramatically--from no symptoms at all to serious complications. Symptoms can include fever, sore throat, swollen lymph glands, prolonged fatigue, hepatitis, and even encephalitis (inflammation of the brain). For reasons that we don't understand, young children usually have a much milder form of mono and recover more quickly than teenagers or adults. In fact, children under the age of four years often don't show any symptoms at all or require any treatment.
Because the range of symptoms can vary so much, a healthcare provider should be consulted about when it is okay for your son to return to school and his regular activities. Your doctor probably will want to check his spleen to see if it is enlarged since that is a common occurrence with mono. Usually the spleen is protected by the rib cage, but when it is enlarged, it can be ruptured (or torn) by trauma to the left side of the abdomen, which can result in potentially life-threatening internal bleeding. Children with enlarged spleens can return to school after they have been cleared by their healthcare providers, but their activities should be restricted (no contact sports, for instance, or riding bicycles or scooters).
— by Lynn Cates, M.D., F.A.A.P. |
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