Infectious mononucleosis, commonly known as mono, is caused by the Epstein-Barr Virus (EBV). Once infected, EBV remains in the body for life, usually dormant. Mono can reactivate or “flare up” again, even years after the initial illness.
How Mono Reactivates
After initial infection, EBV establishes a latent, or dormant, presence within immune cells. In this state, the virus typically does not cause active symptoms. However, certain factors can trigger the dormant virus to become active again.
Periods of physical or emotional stress can contribute to EBV reactivation. A compromised immune system, due to other illnesses, certain medical conditions, or immunosuppressive treatments, can also provide an opportunity for the virus to reactivate. This process is a reactivation of the existing virus within the body, rather than a new infection from an external source.
While the virus may reactivate, it often does so without noticeable symptoms. In many instances, viral shedding during reactivation is asymptomatic. However, some individuals may experience a return of symptoms, though these are generally milder than the initial acute infection.
Recognizing a Reactivation
When mono reactivates, symptoms resemble the initial infection but are typically less severe and prolonged. Common indications include fatigue, a sore throat, and swollen lymph nodes, often in the neck and armpit areas. A mild fever, headaches, and muscle aches may also be present.
A rash or enlarged spleen are less common during reactivation than primary infection. These symptoms are not exclusive to mono reactivation; many other common illnesses, like the common cold or influenza, can present similarly.
Due to this symptom overlap, distinguishing a mono flare-up from other viral infections can be challenging without medical evaluation. The subtle nature of reactivated symptoms means self-diagnosis can be misleading. While observing symptom duration and intensity offers clues, professional assessment is advisable.
When to Seek Medical Advice
If symptoms resembling a mono flare-up persist or cause concern, consult a healthcare professional. A doctor can evaluate to determine the cause and rule out other similar conditions. This often involves reviewing your medical history and performing a physical examination.
To confirm EBV reactivation, specific blood tests, such as EBV antibody tests, may be performed. These tests distinguish between a past infection, a current primary infection, or viral reactivation. While there is no specific antiviral treatment for mono, medical guidance focuses on managing symptoms through supportive care.
Supportive care includes adequate rest, proper hydration, and over-the-counter pain relievers for discomfort or fever. In rare instances, severe symptoms or complications, like a significantly enlarged spleen, might necessitate specific medical attention. A healthcare provider can offer tailored recommendations and monitor for potential complications.