Mono and School

  • Mononucleosis is a virus (Epstein-Barr virus) that affects the blood cells and glands. Even though anyone can get mononucleosis, most people who get the illness are between the ages of 15 and 25. Mono can keep you out of work or school for several weeks or months.

    The Epstein-Barr virus is member of the herpes family. Although this virus is one of several herpes viruses, it has nothing to do with cold sores or genital herpes, although it may trigger an outbreak if you already suffer from either strain of herpes.

    Mono is classified as a herpes virus because once you've been infected, the virus stays in your body for the rest of your life. However, you probably won't get the symptoms of mono more than once.

    You can get mononucleosis through direct contact with infected saliva. Anything as innocent as sharing a straw or an eating utensil can expose you to the virus.

    Another common way to catch Mono is by kissing someone who's infected. This is why the illness is sometimes called the "kissing disease." Although a quick kiss between friends probably won't do any harm, intimate kissing with someone who's infected or who has recently had mononucleosis can put you at greater risk for getting the disease. The virus can lie dormant and be passed onto you or others without the infected person ever having symptoms of the virus.



    The virus has a long incubation period and sometimes won't show symptoms until 30 to 60 days after infection. Most often symptoms appear two weeks to 60 days after you've been infected. The most common symptom is constant fatigue, a constant state of feeling tired. The most distinguishing mono symptom is enlarged glands, or lymph nodes, in the neck, armpit and groin. Other signs include:

    • Fever, sometimes up to 103 degrees Fahrenheit
    • Very sore throat
    • Swollen lymph glands
    • Headaches
    • Muscles that ache
    • Enlarged or swollen liver and spleen


    Common Treatments

    Although there's no magic pill to make mono go away, there are some things you can do to feel better. The best recommended treatment is to get plenty of rest (especially during the beginning stages of the illness when your symptoms are the worst) and drink plenty of water and fluids.

    Do NOT take aspirin unless your doctor tells you to take it.

    When you start feeling better, take it slow. Although you can return to work or school once your fever disappears, you may still feel tired. Your body will tell you when it's time to rest, so listen to it. Keep things low-key and try taking afternoon naps.

    Many health care providers recommend avoiding sports for at least a month after the symptoms disappear, especially if your spleen is enlarged. An enlarged spleen can rupture easily, causing severe abdominal pain and requiring emergency surgery. Avoid all contact sports or even wrestling with your friends until your health care provider gives you permission.


    Complications can affect:


    • Autoimmune hemolytic anemia (destruction of red blood cells)
    • Thrombocytopenia (decrease in the number of platelets, which assist in blood
    • clotting)
    • Granulocytopenia (deficiency of white blood cells).
    • These blood complications usually improve over one to two months, without any
    • treatment.



    • The Spleen can become enlarged
    • Infrequently, the spleen can rupture in someone with mononucleosis. When the spleen does rupture in such cases, it usually happens during the second or third week of the illness. Severe abdominal pain is the most common symptom associated with a ruptured spleen. Surgery is the only way to treat this potential complication of mono.


    Nervous system

    • The most common are cranial nerve palsies (including Bell's palsy) and encephalitis (inflammation of the brain).
    • Guillain-Barré syndrome (inflammation of certain nerves, causing muscle weakness and paralysis)
    • Seizures
    • Meningitis
    • Transverse myelitis (inflammation of the spinal cord or bone marrow).



    • Hepatitis, which is inflammation of the liver, is common. In most cases, this complication improves without treatment.



    • Pericarditis (inflammation of the membrane that surrounds the heart)
    • Myocarditis (inflammation of the middle layer of the heart wall).



    • Difficulty breathing can occur in someone with mono, because swollen tonsils can block the airway.


    What about school?

    The most important thing is for the student to rest and get well. Rest is the best way to prevent some of the very serious complications to having mono.

    The nurse and/or student’s counselor can notify teachers that the student has mono and may be out or on a reduced schedule for a period of time.

    • Extra time for turning in late homework
    • Possible reduced assignments
    • Special arrangements for taking tests
    • Allow the student to rest in the health office as needed
    • Student and Teacher remain in email contact and have student check for assignments
    • A reduced schedule would be having the student pick specific classes to attend each day or sometime during the week rather than try to maintain a full schedule.

    If the student has complications and may be out at least 4 weeks, Home Hospital services may be started.

    It is important that the student and family maintain close contact with teachers, nurse and/or student’s counselor to help facilitate the balance between healing and gaining credit for classes. We want to remove as much stress from the student and family as possible yet maintain the integrity of the student meeting the educational objectives of their classes for credit.