Mononucleosis in children: symptoms and treatment of this infectious disease

Mononucleosis in children is quite common: the so-called "kissing disease" often affects children during early childhood or adolescence and for this reason it is important to learn to recognize it.

Mononucleosis in children is quite contagious: it is transmitted through the exchange of saliva (which is why it is called the "kissing disease") or the droplets that are dispersed when coughing or sneezing and which, knows end up on toys or cutlery, carry the virus and infection.

Mononucleosis in children is less common than in adolescents between the ages of 15 and 18, but it is not uncommon for this. The symptoms with which the disease presents in children are not very different from those of the flu: sore throat and swollen lymph nodes, feeling tired and more.

Let's find out together in detail by which virus this disease is caused, what are all the symptoms with which it presents itself, how to diagnose it, treat it and - above all - prevent it in our children.

Before proceeding, we remind you of the importance of some hygiene rules to preserve the health of the little ones, as shown in the following video.

What causes mononucleosis in children and how does it get infected?

Mononucleosis is caused by the Epstein Barr virus (abbreviated to EBV), which belongs to the "herpes virus" family, such as chicken pox. In rarer cases it can also be caused by other lesser known viruses, such as Cytomegalovirus (CMV).

The Epstein Barr virus is quite widespread and it is easy to get infected and contract the infection: just an exchange of saliva with an infected person, and this can happen either directly (whether it is a kiss or a short sneeze) than indirect, using or touching, for example, the same objects (toys, glasses and so on ...).

Mononucleosis in children spreads mainly through this indirect form: the child puts a contaminated object in his mouth and contracts EBV. The Epstein Barr virus, at that point, escapes the child's immune system by hiding in the cells, where it can also remain hidden. for a lifetime, without showing symptoms. Attention, however: even those who have no symptoms can be contagious! However, those who have never had mononucleosis despite having been infected with EBV, will probably never have it.

Mononucleosis in infants is very contagious especially in the early stages of the disease, when the amount of EBV in saliva is greater. Already after 5-7 days from the onset of symptoms it decreases drastically.

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What are the symptoms of mononucleosis in children?

Mononucleosis affects about 90% of people who have contracted the Epstein-Barr virus. If the incubation in adults lasts between 30 and 50 days, in a child it has a much shorter duration, between 10 and 15 days.

The symptoms with which the kissing disease occurs can be different. Generally these are rather mild symptoms: some children overcome it without practically noticing that they have ever had it! If, however, the symptoms become more evident, high and persistent fever may appear, swollen lymph nodes (on the neck, in the armpits and in the lower abdomen), sore throat due to the enlargement of the tonsils (on which white plaques appear -yellow) resulting in difficulty in swallowing, enlargement of the spleen (so-called "splenomegaly"), rash or rash similar to measles, headache, loss of appetite.

In children under the age of 5, some complications such as eyelid edema and gastroenteritis may also occur. If the feeling of tiredness can last even for consecutive months, the other symptoms generally do not last more than four weeks.

How is the diagnosis made?

The diagnosis of mononucleosis in children is, of course, up to the pediatrician. The doctor, observing the symptoms, will be able to recognize it, although to have a confirmation, specific haematological and immunological tests may be necessary, able to detect the presence of antibodies against the virus.

Usually the pediatrician notices mononucleosis in children by observing the presence of white-yellowish plaques on the tonsils or by noting an enlarged lymph nodes. Among the necessary tests, however, to detect the presence of antibodies against EBV, we remember the specific blood test to search for antibodies; analysis of transaminase levels; detection of birulin, a substance that derives from the degradation of white blood cells, which provides important information about liver health.

Treatment and prevention

Mononucleosis in children tends to resolve on its own within 2-4 weeks, without any complications. For this reason there are no specific therapies, but we proceed only with the treatment of symptoms. However, the pediatrician will advise the child to keep hydrated as much as possible, resorting - if necessary and in case of fever, sore throat or headache - to antipyretic or anti-inflammatory drugs.

They will also help a "balanced diet, rich in fruit and vegetables, which can help strengthen his immune system, as well as prolonged rest.

To prevent mononucleosis it is important to avoid contact with the saliva of those infected with the virus, both during the illness and in the days following the end of the symptoms. Most adults are immune to this disease, therefore it is not necessary to isolate the child, but it is necessary to pay attention to hygiene rules to reduce the risk of contagion.

Most feared complications: from ruptured spleen to meningitis

Among the most feared complications of mononucleosis in children - fortunately quite rare - there is the rupture of the spleen, which can occur following the excessive enlargement of this organ. Doctors recommend a lot of rest for this!

Another of the worst complications is that of infection by the virus of the nervous system, which can cause meningitis or encephalitis. Furthermore, EBV can affect the heart and lungs. Remember, however, not to be alarmed: in most cases, mononucleosis will disappear on its own without any consequences!

For more scientific information on mononucleosis in children, you can consult the website of the Bambino Gesù Pediatric Hospital.

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