The summer I was 21, I was working at the East Oregonian in Pendleton. One day, during lunch at the Rainbow, I noticed a bigger-than-marble-sized lump in my neck behind my right ear. It didn't hurt, and I felt well, so I did what any normal 21-year old would do. I ignored it.

A few days later, I went to the high school track after work to run a few miles, as usual. After one quarter-mile lap, I was exhausted. I managed to walk another lap, then gave up and headed back to my grandmother's house. I felt like I would never make it up that hill.

Once I got there, I decided to take a nap before dinner. I woke up 16 hours later. Still exhausted, I showed up at the newspaper office for work. I was informed by just about everyone that I looked just awful and should go home. My grandmother took one look at me and took me to her doctor.

The doctor heard my story of feeling extremely tired and weak, with a worsening sore throat and fever. He felt the hugely swollen lymph glands in my neck, especially behind my ears. He noticed that my spleen was a little enlarged; he could feel the edge of it below the left side of my ribcage.

A blood test confirmed his suspicion: I had infectious mononucleosis, or "mono." I went home to bed with these instructions: rest, avoid drinking alcohol and avoid playing contact sports for the rest of the summer. I was told that I would feel better in a few weeks.

My throat hurt so much that I couldn't swallow. I spent the next couple of days lying in bed, drooling into a Dixie cup. This was the low point.

Slowly, I began to improve. A week later, I needed only 12 hours of sleep each night, and could go to work without collapsing because of exhaustion.

By the time Round-Up started in mid-September, I was good as new.

It turns out that I had a pretty typical experience with infectious mononucleosis, which is caused by the Epstein-Barr virus. By age 40, 95 percent of Americans have been exposed to this virus. However, only a small percentage of people ever develop the symptoms of mono.

Adolescents and young adults - ages 15 to 25 - are most likely to have the symptoms of mono when they are exposed to the Epstein-Barr virus for the first time. Younger children rarely develop these symptoms.

Perfectly healthy people who have been exposed to the Epstein-Barr virus in the past, whether or not they ever had symptoms, continue to shed the virus in their saliva intermittently for life. This means that transmission of this virus is nearly impossible to prevent.

Infectious mononucleosis is sometimes referred to as "the kissing disease" because kissing (as well as sharing eating utensils or drinking from the same cup) can transmit the Epstein-Barr virus.

Symptoms usually last a month or so; the first two weeks are the most severe. After this, fatigue is the main problem, which slowly improves.

Rare complications of infectious mononucleosis include encephalitis, rupture of the spleen and a chronic fatigue syndrome. Swelling of the throat can be severe enough to interfere with breathing, and needs to be treated with steroids to bring down the swelling.

There is no treatment for infectious mononucleosis. Acetaminophen can be used to bring down the fever and help sore throat, headache and muscle pain. Aspirin should not be given.

Because most high school and college-aged students acquire the Epstein-Barr virus earlier in childhood, it is very unusual to see an outbreak of multiple cases of infectious mononucleosis.

Kathryn B. Brown is a family nurse practitioner with a master's degree in nursing from OHSU. Is there a health topic you would like to read about? Send ideas to kbbrown@eastoregonian.com.

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