What Are the Stages of Mono and How Long Do They Last?
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The timeline of mono (mononucleosis) includes the following three stages:
- Prodrome stage, when symptoms start
- Acute stage, when you feel the worst
- Convalescent stage, when you begin to recover
These begin after a period of incubation, in which mono is in your system, but there are no obvious signs of it yet.
Some people may have symptoms for only two to four weeks. Others may have lingering effects—especially fatigue—until the virus that causes the illness becomes inactive, which can take months.
This article walks you through the stages of mono so you can get a better sense of what to expect and how to get over mono faster. It also looks at possible complications and ways to prevent getting mono and passing the virus to others.
Verywell / Danie Drankwalter
Mono Incubation Period
The Epstein-Barr virus (EBV) is the most common cause of mono. It can take around four to six weeks for symptoms of mononucleosis to appear after you have been infected.
The period of time between exposure and the start of symptoms is called the incubation period.
Though you may feel OK during this time, it’s still possible for you to pass the virus on to others.
The Prodrome Stage of Mono
The first stage of mono is called the prodrome stage. It ususally lasts three to five days.
Mono symptoms start to appear during this phase. These can include:
- Fatigue or low energy
- Feeling “off” or uncomfortable
- Not feeling hungry
- Sore throat
You can also have mono without symptoms. In particular, kids under the age of 10 may have very mild symptoms or none at all.
The Acute Stage of Mono
The second phase of mono is called the acute stage. During this time, a person’s symptoms may start to get worse. Acute symptoms are often referred to as “classic” symptoms.
For most people, the acute symptoms of mono last for 2 to 4 weeks.
Not everyone will experience every symptom of mono. Keep in mind that mono symptoms can also show up at different times over the course of the infection.
Splenic rupture is a rare complication of mononucleosis, but it can be serious when it happens. You should avoid physical activity that could lead to spleen rupture for three weeks after symptoms begin, though some research suggests that the risk may persist for up to 31 days.
The Convalescent Stage of Mono
The last phase of mono is the convalescent stage. This is when you recover from the infection, which can take anywhere from three to six months.
By this stage, most mono symptoms have gotten better. However, some people still feel weak and tired.
How Long Is Mono Contagious?
Even after symptoms have cleared, the virus can be passed in saliva for up to 18 months.
Mono Treatment
There’s no cure or specific treatment for mono. It can take a long time to get over the infection, and there’s not much you can do to make the process go faster.
Supporting your body as it heals and fights off the virus is the best approach.
You can do this by:
- Resting and getting plenty of fluids
- Using over-the-counter (OTC) or prescription medications for pain and fever (Ask your provider before you use acetaminophen, as this medication can increase the risk of liver damage.)
Do I Need to Isolate If I Have Mono?
Epstein-Barr infections are very common. In the United States, most people have been infected with this virus by the age of 40. Even so, you should take steps to avoid passing the virus along to others. This does not mean you have to isolate, however.
The mono virus is mostly spread through your spit (saliva). Mono can also spread if you cough or sneeze close to somebody.
When you are around others:
- Avoid sharing eating and drinking utensils.
- Refrain from kissing.
- Do not share personal items, like lip balms.
- Cover your coughs and sneezes using the inside of your elbow.
- Wash your hands frequently.
Complications of Mono
People with severe mono can experience potentially serious complications, such as:
The effects of these complications may persist even after you’ve recovered from mono itself.
Studies have shown that the Epstein-Barr virus might be linked to certain types of cancer, including Burkitt’s lymphoma and Hodgkin lymphoma.
Mono has also been associated with an increased risk of developing autoimmune diseases like multiple sclerosis.
Rarely, people with mono can develop a chronic active Epstein-Barr virus (CAEBV) infection. This can occur in people with a first-time infection or in people who have already recovered from the illness if the virus reactivates within the body.
When to See a Healthcare Provider
Your symptoms should start to improve in a week or two. If they don’t, make another appointment with your healthcare provider.
You should also contact your healthcare provider if:
- You have an extreme headache or severe body aches
- You have weakness in your arms or legs
- You have a persistent high fever
- You feel dizzy or faint
When to Go to the ER
Some complications of mono can be life-threatening. Seek emergency care at once if you develop:
- Sudden, sharp pain in your upper left abdomen
- Trouble breathing or swallowing
- A stiff neck
- Extreme fatigue/weakness
Summary
Mono is a contagious illness that is usually caused by the Epstein-Barr virus. Mono has three stages: prodrome (when symptoms start), acute stage (when symptoms worsen), and convalescent (recovery).
Mono has a long incubation period, so it can be difficult to pinpoint when the illness actually started. On average, the prodrome phase lasts three to five days, the acute phase typically lasts between 4 and 6 weeks, and the final recovery stage can go on for up to six months.
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