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Kiss Off
Facing the Facts and Myths of Mononucleosis
By Kelly Burgess
s particular condition is caused by the Epstein-Barr virus (EBV) or the cytomegalovirus. It is estimated that 95 percent of adults in the United States between the ages of 35 and 40 have been exposed to the Epstein-Barr virus.
When children are infected, they don't usually experience any noticeable symptoms. In underdeveloped countries, children are usually exposed to the virus at a young age. In the United States, exposure occurs later, usually during the adolescent and young adult years, which is why it is so closely associated in our culture with teenagers. Generally, it is thought that this group develops mononucleosis in half of exposures. 
Although Cook thinks that she developed mononucleosis from drinking out of a teammate's water bottle who had the condition, Dr. Ellen Wald, chief of the division of allergy, immunology and infectious diseases at Children's Hospital of Pittsburgh, is skeptical. Unlike viruses like those that cause influenza or the common cold, the virus that causes mononucleosis is not airborne. Rather, it is contracted by very close contact over time. This is what has led to its other nickname – The Kissing Disease. However, as Dr. Wald points out, that doesn't necessarily mean that it's only contracted via kissing.
"When we're friends with someone, we tend to be much closer physically than we realize," says Dr. Wald. "We study together and hug each other and have rather intimate contact, even though we may not think of it that way."
While Cook may not have any idea how she contracted mononucleosis, her symptoms were classic: extreme fatigue, sore throat, fever and swollen glands. These are also symptoms of strep, often a secondary infection when mononucleosis is present, but what distinguishes mononucleosis from strep is the duration of the illness. Strep usually goes away in three or four days, while mononucleosis lasts for several weeks.
Occasionally, usually early in the course of the illness, a rash is present. Also, in about 30 percent of all cases, the spleen or liver can become enlarged. In those cases, the affected person needs to avoid possible injury to the abdominal area. This means giving up sports for several weeks, which can be a real hardship for some of today's dedicated athletes.