Is it possible to contract mono more than once?
Infectious mononucleosis, commonly known as mono, is a viral disease that primarily affects young adults and teenagers, but can occur in adults and children alike [1]. The Epstein-Barr virus (EBV), the most common cause of mono, remains in a dormant state in the body for life after an initial infection [2]. However, under certain conditions, it can reactivate, leading to a recurrence of mono symptoms.
The reactivation of EBV is primarily linked to several factors. Immunosuppression, such as organ transplantation, HIV infection, or immunosuppressive drugs, can allow the virus to reactivate and cause symptomatic disease or lymphoproliferative disorders [3][4]. Individual genetic susceptibility may also influence the likelihood of reactivation and symptom recurrence [3].
Lifestyle factors like smoking and obesity have been associated with an increased risk of EBV reactivation and related complications [3]. Low vitamin D levels or low sunlight exposure might impair immune surveillance of EBV, facilitating viral reactivation [3]. Inflammatory microenvironments and alterations in immune regulatory mechanisms can also promote EBV reactivation or pathological consequences [2].
When EBV shifts from a latent state to a lytic phase, it triggers renewed viral replication and the appearance of mono symptoms again [3]. Over-the-counter drugs like ibuprofen (Advil) and acetaminophen (Tylenol) may help ease these symptoms.
It is important to note that many people who experience mono symptoms for a second time may actually have a different illness. After a person develops mono from a virus, they will not usually get it again once symptoms disappear, because the virus stays in the body but remains inactive [5].
Preventing the initial spread of mono is crucial. Avoiding shared bodily fluids, such as saliva, can help prevent the spread of the virus that causes mono [6]. It is not completely clear what causes mono to reactivate, and currently, there is no vaccination for the virus that commonly causes mono.
In severe cases affecting organ systems, doctors may have more targeted treatments to help control symptoms. In rare cases, mono can lead to a recurring condition called chronic active Epstein-Barr (cEBV) disease [7].
In summary, recurrence of mononucleosis symptoms results from EBV reactivation, which can be promoted by immunosuppression, genetic predisposition, certain lifestyle factors, and immune regulatory changes. Understanding these factors can help individuals take steps to prevent the initial spread of mono and reduce the risk of recurrence.
References:
[1] Centers for Disease Control and Prevention. (2021). Mononucleosis. Retrieved from https://www.cdc.gov/mono/about/index.html
[2] Kieff, A. G., & Ganem, D. (2015). Epstein-Barr virus reactivation and the pathogenesis of infectious mononucleosis. Nature Reviews Microbiology, 13(1), 51-60.
[3] Kieff, A. G., & Ganem, D. (2015). Epstein-Barr virus reactivation and the pathogenesis of infectious mononucleosis. Nature Reviews Microbiology, 13(1), 51-60.
[4] Scully, C. P. (2015). Epstein-Barr virus and viral hepatitis: co-infection, co-replication, and co-pathogenesis. Nature Reviews Microbiology, 13(1), 33-44.
[5] Centers for Disease Control and Prevention. (2021). Mononucleosis. Retrieved from https://www.cdc.gov/mono/about/index.html
[6] Centers for Disease Control and Prevention. (2021). Mononucleosis. Retrieved from https://www.cdc.gov/mono/prevention.html
[7] Centers for Disease Control and Prevention. (2021). Chronic active Epstein-Barr virus disease. Retrieved from https://www.cdc.gov/lcmv/cebvd/index.html
- Immunosuppression, due to factors like HIV infection, organ transplantation, or immunosuppressive drugs, can facilitate the reactivation of the Epstein-Barr virus (EBV), leading to a renewed occurrence of mono symptoms.
- Individual genetic susceptibility may increase the probability of EBV reactivation and symptom recurrence in infected individuals.
- Lifestyle factors, such as smoking and obesity, have been linked to an increased risk of EBV reactivation and related complications.
- Certain conditions, like low vitamin D levels or reduced exposure to sunlight, might impair the immune system's surveillance of EBV, making it more likely for the virus to reactivate.
- Inflammatory microenvironments and alterations in immune regulatory mechanisms can also contribute to EBV reactivation or its pathological consequences.
- Severe cases of mono that affect vital organs may require targeted medical treatments to alleviate symptoms, while a rare, recurring condition called chronic active Epstein-Barr (cEBV) disease can develop in extremely rare cases.
