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Infectious mononucleosis (mono) is common among college students. Caused by the Epstein-Barr virus (EBV), mono is spread through intimate contact with saliva – thus, the nickname “the kissing disease.” It’s unlikely to spread through casual contact. EBV isn’t transmitted through the air, so there’s no need to isolate someone with mono. The virus is often found in healthy people who’ve had mono in the past, but still carry and spread the illness.

The time from exposure to illness (the incubation period) ranges from four to six weeks. Early symptoms include fever, nausea, and headaches, usually followed by a severe sore throat and swollen neck glands. There can be a variety of other symptoms and sometimes unusual complications, but for most the illness is relatively mild and they recover in a couple of weeks. Some people experience significant fatigue during this time.


  • Mono is caused by a virus, so antibiotics aren’t effective. Antibiotics are only used if a secondary bacterial illness develops.
  • The virus attacks lymphocytes, a type of white blood cell, which leads to inflammation of lymph nodes, the liver and spleen. Those with mono should avoid alcohol, which is metabolized in the liver, and contact sports, to prevent spleen injury.
  • For relief of sore throat pain, use over-the-counter analgesics such as Ibuprofen and frequent warm salt water gargles.
  • Extra rest and good hydration are essential.
  • Those with severely swollen tonsils or other serious complications are sometimes given a short course of steroids to suppress the inflammation.


Most people recover from mono within 10 – 14 days; about a third of college students with the illness don’t even need bed rest. However, some people become quite ill and need several weeks to recover; brief hospitalization may even be needed. Although the illness is often over in a couple of weeks, fatigue can sometimes last two or three months, requiring extra rest. Careful monitoring by your healthcare provider is recommended.