So I’ve been diagnosed with mono at the ripe old age of 47. I’ve suspected in the past that I had mono, but didn’t get a blood test when I was having symptoms.
Since mono is caused the the Epstein-Barre virus, which doesn’t go away after you’ve had it, would it be possible for the virus to go into remission then flare up again?
I am not a doctor, but I can tell you that I’ve had confirmed cases of mono twice, and a third suspected case that had all the symptoms but didn’t show up on the test. (My doctor told me that he was still pretty sure that was what I had, despite the test results.)
ETA: Oh, and I forgot to say that I’m very sorry to hear that you have it. All three occasions were miserable. The only good part about them was that I didn’t feel how miserable I was feeling during the 22 hours a day I was asleep.
It is highly unlikely a non-immunocompromised individual will get a recurrent case of Epstein-Barr -based “mono.”
As with everything in my profession, there are fine points:
The diagnosis of “mono” is often made clinically, and often no confirmatory test of any kind is done. Sometimes the label “mono” is applied simply because strep is “excluded” (a whole other favorite topic of mine).
Cytomegalovirus can look just like E-B so sometimes you get one and then the other.
The “monospot” that is often done is a heterophile antibody test that doesn’t actually test for EB virus. What you’d really need to prove acute mono is a test such as an EB-specific IgM titre series, and we don’t bother with that. An individual with a sore throat can have a positive monospot that’s positive from exposure 6 months earlier (and their current sore throat is not mononucleosis despite the positive monospot), OR they could have a negative monospot but have their current sore throat actually be from EB virus–their heterophile titre just has gotten high enough to be positive yet…
Lots of viruses give sore throats and lymph nodes. Associated tests like elevated liver enzymes help, but since we don’t treat mono with much of anything except maybe corticosteroids for the really miserable, it’s not a diagnosis made with much rigor unless the patient is very ill.
So…the medical line is you don’t get it more than once unless you are immunocompromised. It’s sort of like zoster (chicken pox); the clinical manifestations go away but the virus in your system isn’t technically dead. Still, unlike zoster, EB virus-based mono is not felt to be a recurring illness.
Another rule of thumb: we never say never.
Is there something brutally obvious about being immunocompromised? (It seems like it should be)
Bear in mind that I have a long history of weird health issues.
I would think that, barring a one-in-a-million chance, if you were immunocompromised you woudl know it. It involves things like AIDS, or being on medicines that really kick your immune system’s ass, like chemotherapy or immune system suppresors (these include anti-rejection drugs for transplants as well as steroids and drgs to fight things like arthritis, crohn’s disease, etc). Your doctor would be pretty negligent (in my opinion) to place you on any of these treatments and not warn you about your immune system status.
Taking arthritis drugs? Prednisone?
–Cliffy