Infectious mononucleosis, commonly known as mono, is a viral infection frequently caused by the Epstein-Barr virus (EBV). This condition is often spread through saliva, earning it the nickname “the kissing disease,” but it can also transmit through shared food or drinks. Typical symptoms of mono include fatigue, a sore throat, fever, and swollen lymph nodes in the neck and armpits. While these symptoms can be uncomfortable, the infection generally resolves on its own without long-term health consequences.
Mono Mortality Rates
Death from mononucleosis is extremely rare. Most individuals who contract mono experience mild to moderate symptoms and recover fully. In the United States, approximately 45 out of 100,000 people develop infectious mono each year. Serious complications are uncommon, affecting less than 5% of cases, with fatalities being even less frequent.
Rare Complications Leading to Death
Though generally not life-threatening, mono can lead to severe outcomes through rare complications. One such complication is splenic rupture, where the spleen, which often enlarges during mono, can tear. This can occur spontaneously or after even mild abdominal trauma, leading to severe internal bleeding and requiring immediate medical attention. Splenic rupture is reported in about 0.1% to 0.5% of cases and is considered the most frequent cause of death in mononucleosis.
Another complication is severe airway obstruction. This can happen if tonsils or lymph nodes become extremely swollen, potentially blocking the ability to breathe or swallow. Neurological complications, such as encephalitis (inflammation of the brain) or meningitis (inflammation of the membranes surrounding the brain and spinal cord), are also possible. These can manifest with symptoms like confusion, seizures, or personality changes.
Myocarditis, an inflammation of the heart muscle, is another complication that can occur during the first three weeks of the illness. Though often self-resolving, severe myocarditis can damage the heart. Additionally, while mild liver inflammation (hepatitis) is common with mono, severe liver inflammation leading to liver failure has been reported, particularly in immunocompromised individuals.
Who Is Most Vulnerable
Certain individuals face a slightly elevated risk of developing severe complications. This includes people with conditions like HIV/AIDS or individuals undergoing immunosuppressive therapy, such as organ transplant recipients.
Very young infants may also have a slightly different symptom presentation, often with milder or undiagnosed infections. Older adults, especially those over 40, might experience more prolonged fever, fatigue, and body aches, and have a higher likelihood of liver enlargement and jaundice.