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Mystified by Mono?

Q. My 18-year-old college freshman has mono, diagnosed at health services yesterday. She plans to continue going to classes and resting when she can. Will this be OK? She was home last weekend, and slept in a room she shares with her 15-year-old sister. What kind of exposure does it take for others in the family to get it? What is the incubation period? Should we be tested?

Believe it or not, most everyone gets mononucleosis early on in their lives, but usually they show few or no symptoms. One out of every two children has had the disease by the age of 5.

Mono is caused by the Epstein-Barr virus, which is related to the herpes virus that causes cold sores. It isn't very contagious, but true to its nickname, "the kissing disease," it's transmitted easily through saliva. Usually people get it from kissing someone who has the disease but isn't experiencing any symptoms (a "carrier"), or by sharing a drink with them. Incubation is long - around 30 to 50 days in adults and 7 to 14 days in children and teens. I wouldn't worry about getting tested.

The Epstein-Barr virus infects certain white blood cells, the ones that fight infection in the body. Symptoms cover a broad range, and usually involve fever, sore throat, swollen lymph nodes, and exhaustion. The fatigue can knock you out for a week or two at first, when you barely feel like moving. After the tiredness and weakness go away, it's important to take it easy, but you can go about the normal activities of life.

Most people get through mono quickly and uneventfully. The virus will stay in your body for the rest of your life, though it doesn't produce any more problems. Some research has linked Epstein-Barr with chronic fatigue syndrome, but most people with Epstein-Barr don't get chronic fatigue, and there isn't a lot of evidence for a connection.

Your daughter should rest as much as she can to help her body recover faster. It would be wise to drink lots of fluids, and gargle with saltwater to relieve her sore throat. She shouldn't take aspirin, because taking aspirin when you have a virus can lead to a serious condition called Reye's syndrome. Tylenol is a good substitute. There are also several tonics that may help her boost her immunity and fight off the virus. Astragalus membranceous, a relative of locoweed, is a good antiviral and immune stimulant. I use a product called Astra-8, which mixes astragalus with several other Chinese herbs. The dose is three tablets twice a day. If you have trouble finding it, call the manufacturer, Health Concerns, in Oakland, California, at (800) 233 9355.

Echinacea, obtained from the roots of the purple coneflower, is renowned for its effectiveness against colds and should work well in this case, too. You can buy tinctures, capsules, tablets, extracts, or teas of echinacea in health-food stores. Test the product for freshness by putting a bit on the tongue - if you feel a numbing sensation, it's good. The dose is a dropperful of tincture in water four times a day, or two capsules of freeze-dried extract four times a day.

Other than that, be scrupulous about washing dishes and glasses in hot water and not sharing foods with your daughter. Welcome to the world of teenagers.


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