How Long Does Mono Last, and Does It Go Away

You've probably heard about the "kissing disease," also called mono (infectious mononucleosis). Mononucleosis is caused by the Epstein-Barr virus (EBV), and it commonly spreads through saliva (which explains how it got its nickname). There are lots of stories about it keeping you in bed for a month and leaving you feeling wiped out. The fact of the matter is that its symptoms can last for a frustratingly long time.

However long the symptoms last (usually 2 to 4 weeks), it does eventually go away. And the good news is, you'll usually recover from mono without any major issues. But there are a few warning signs to look out for.

How long does mono last?

The process of being infected and recovering from mono can last for several months. In most people, mono symptoms generally last for up to 4 weeks. But many times, you're infected with the virus at least a month before symptoms start. And the recovery of mono can last much longer.

That's because mono comes in stages. Each stage of mono comes with its own symptoms and lasts for a different amount of time. Let's review the four stages of mono:

• Incubation: This is when you're infected with the Epstein-Barr virus that causes mono, but you don't have any symptoms yet. During this stage the virus multiplies in your body until there are enough copies of it that you start to feel sick. Mono has a very long incubation period of about 6 weeks. This means that even if you've been exposed to the virus, you might not feel any symptoms of mono for about a month and a half.

• Prodrome: This is when you first start to feel symptoms, but they aren't so severe. Mono's prodrome stage lasts about 4 to 5 days.

• Acute phase: This is when you feel the most sick from mono. The acute phase is when you feel classic symptoms like fever, extreme fatigue, sore throat, body aches, and swollen lymph nodes. Acute mono can last 2 to 4 weeks.

• Convalescent phase: This is the recovery phase of mono. Most of your symptoms will have resolved, but you might still feel tired and weak. Mono's convalescent phase can last for a long time, sometimes up to 6 months or longer.

How long are you contagious with mono?

Mono is different from many viruses because the body doesn't rid itself of the virus after an infection. As a result, 90% of people who have had mono will be intermittently contagious for the rest of their lives. After you get sick with mono, the virus can remain in your body for the rest of your life - even if you never experience symptoms of mono ever again.

Luckily though, mono isn't very good at transmitting itself from person to person. This means that even though there are a lot of people walking around who are shedding the Epstein-Barr virus, it usually takes a large amount of exposure to the virus to actually get sick from it.

Does the Epstein-Barr virus ever go away?

So your mono symptoms have improved, but are you out of the woods yet? Does mono go away? Even after you recover from mono, the virus that most commonly causes it - EBV - stays in your body. But it goes into a state of dormancy (sleep), where it lives quietly in a few cells without causing any harm. This is because the immune system has developed antibodies (special immune system proteins) to keep the virus in check. Then, every few years, EBV may reactivate without you having any symptoms. This is when you become contagious again without being aware of it.

In some cases, a person will have multiple mono infections with full-on symptoms. If that happens, there's a possibility that the person has a weakened immune system.

What are the symptoms of mono?

So what does mono look like? There are several classic signs of mono that can help you distinguish it from other viral illnesses. The classic symptoms of mono are:

• Extreme fatigue

• Fever

• Severe sore throat

• Headache

• Body aches

• Swollen lymph nodes in the neck and armpits

• Swollen liver or spleen

• Rash

How long does it take for mono symptoms to show up?

The incubation period for mono is unusually long and lasts about 6 weeks. This means that after you've been exposed to mono, it might be a long time before you actually develop any symptoms.

This is important since lots of people blame their illness on a recent exposure. But the truth is that if you really want to know where you got your mono from, you have to think back to a possible exposure from a month and a half ago.

Treatment for mono

You may be wondering if mono is curable? Scientists haven't yet discovered a cure for mononucleosis. So treatments are usually focused on helping you feel as comfortable as possible while your body deals with the infection.

Tips for feeling better

While the amount of time you have mono can't be shortened, it doesn't have to be miserable. Here are a few things that can make you feel better:

• Rest, hydration, and good nutrition: It may seem simple, but taking care of your body's usual needs is the best way to help it recover. This is especially true when you're sick. That's because your body is working extra hard to fight the sickness - on top of all the other things it normally does.

• Over-the-counter (OTC) medications for fever and aches: Talk to a healthcare professional about taking fever-reducing medications like acetaminophen (Tylenol) or ibuprofen. But never take aspirin during a mono infection because it can cause a life-threatening illness called Reye's syndrome, especially in children.

Antibiotics aren't usually helpful against viruses. In the case of mono, certain antibiotics can actually cause you to break out in a rash. These include:

• Amoxicillin

• Ampicillin

• Cephalexin

• Minocycline

What happens if mono goes untreated?

Mono symptoms in most healthy individuals will resolve over 2 to 4 weeks. In the rare case you experience a serious complication from mono, you'll need to see a healthcare professional right away for treatment.

Is mono serious?

Mono is not usually a serious infection. But some serious complications, like splenic rupture or airway compromise, can happen very quickly. And others, like hemolytic anemia or hepatitis, slowly build up over the course of your mono infection. Whether fast or slow, they're all dangerous.

Here's a little more information about these complications:

• Splenic rupture: Mono may cause your spleen to enlarge, which makes it fragile. If you have any kind of high-impact force to your torso, your spleen can rupture and cause internal bleeding. This is why it's best to avoid sports or high-impact activities while you have mono.

• Airway compromise: EBV can infect cells in your throat and cause swelling. If your tonsils or the lymph nodes in your neck get too swollen they can block your airway, which makes it difficult to breathe.

• Hemolytic anemia: This is a condition where your immune system destroys your red blood cells (RBCs) and can lead to anemia (low RBC count).

• Hepatitis: EBV can cause hepatitis, or inflammation of the liver tissue. You may experience abdominal pain, or it can cause jaundice (a yellowing of the skin and eyes) if the liver damage is bad enough.

Signs you should see a healthcare professional

If you've recently been diagnosed with mono, there are some warning signs that mean you'll need to get medical care, including:

• Difficulty breathing or trouble swallowing

• Dizziness

• Confusion

• Sharp pain in your left side

• Chest pain

• Easy bruising or bleeding

• Extra paleness of the skin

• Yellowing of the skin or eyes

• Dark urine

• Increase in weakness of the arms or legs

• Symptoms of mono that continue to persist past 8 weeks

Does mono cause chronic fatigue?

If it's been several weeks and the worst of your mono symptoms have improved, but you're still tired, you're not alone. About 10% of adults have lingering symptoms of mono 6 months after a mono infection. And a small percentage of adolescents have been reported to have chronic fatigue syndrome (CFS) up to 2 years after a mono infection.

CFS is a condition where someone can experience extreme fatigue even after simple activities, and the fatigue doesn't improve with rest. Sometimes EBV is thought to play a role in causing it, but the exact reason why isn't known yet. Some studies have shown that the severity of initial mono symptoms can increase the chance of developing CFS. Newer research shows that parts of the EBV virus may be the cause of CFS in a subset of people.

If you think you may have symptoms of CFS, the first step is to make sure there aren't other causes for your fatigue, like hypothyroidism, depression, or anemia. A visit to a healthcare professional can help you rule out other possible causes and determine the next steps.

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